Through a Screen Darkly: Black Creation and Consumption of Platformed Mental Health Content

Background and Purpose: In 2020, Black adults indicated a greater likelihood than White adults of forgoing mental health treatment due to associated costs (Artiga, & Haldar, 2022). However, a 2019 study found that 85% of social media users expressed interest in using social media for well-being programs, offering a potential avenue for expanding mental health care, especially for Black Americans who use social media platforms frequently (Naslund, 2019; Auxier, 2021). Ensuring the accuracy and quality of mental health information on these platforms is crucial. The rise of Black TikTok mental health influencers has sparked debates about therapy's nature and knowledge authority (Avella, 2023). Concerns include inaccurate diagnoses and the trivialization of mental illnesses, leading to misguided self-diagnoses and stigmatization (Rutter, 2023). Reports also indicate a prevalence of unsubstantiated mental health advice on TikTok, with 84% of mental health advice videos found to be inaccurate (PlushCare, 2022). This project examines the content creation and consumer uptake of mental health information produced by Black therapist-influencers, revealing insights into Black individuals' engagement with such content.

Methods: Twenty-seven, semi-structured interviews were conducted with Black social media users who had consumed ten or more of Black TikTok therapists’ videos within the past year. Four semi-structured interviews were conducted with four large “reach” (40k+ followers) Black mental health content creators who were also licensed therapists. Recruitment involved social media ads, snowball sampling, and direct messages to TikTok accounts, resulting in a geographically diverse sample of 31 participants from the United States. All interviews were conducted virtually, and ATLAS.ti facilitated coding and analysis using grounded theory and an inductive approach.

Results: The findings unveiled new mental health perspectives online, shaped by content creators, and how consumers perceive their mental well-being in relation to such content. Regarding the production of information, all the content creators explained that they use their personal and professional experiences to demonstrate “authenticity and relatability,” though several also described spending many hours researching for their videos, employing traditional sources of psychological knowledge such as the DSM-5 and their professional continuing education courses. They are aware of leveraging their therapist status but prioritize producing content they genuinely believe in over gaming algorithms for views. Consumers, drawing on themes of self-improvement, self-acceptance, and self-love, often define and endorse certain “ideal versions” of themselves. While some learn about new diagnoses and identify with mental health features, few self-diagnose. Finally, content consumers identified two primary uses for social media mental health content: information and entertainment.

Conclusion and Implications: In navigating this evolving mental health landscape, it is imperative to prioritize the dissemination of accurate and evidence-based mental health information while also fostering spaces for diverse voices and increased access to mental health knowledge. The scholarly and practical collaboration between social work mental health professionals and social media platforms is essential to ensure that online spaces serve as supportive resources for Black individuals’ mental health and well-being.