free research mental health

September 12, 2024

How can we understand mental health trends in an online world?

Ivan Jaric, Joseph Frith, Uri Roll and Josh Firth propose 'Mental Health Culturomics'

Image credit: Earth, by WikiImages from Pixabay

World suicide prevention day

Changing the Narrative on Suicide

In this 'Journey's in Mental Health' blog our contributor shares their experiences. 

Warning: The content discusses suicide, which some may find triggering

Image credit: Myriams-Fotos from Pixabay

Get to know more about our Lived Experience Section

We speak to Section Editor Sandersan Onie who specializes in suicide prevention interventions, informed by his own experiences

Image credit: Sandersan Onie, Black Dog Institute

Patient expectations are a feature of treatment strategy rather than a source of bias

Ralph Horwitz and colleagues suggest that expectations could be a useful factor in the management of mental health 

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Climate & mental health: A roadmap to global heat resilience

The Wellcome Trust and The Physiological Society share their plans to help tackle mental health effects of climate change

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wellbeing & emotion

Finding Meaning in Chronic Illness and its Relationship to Psychological Well-Being: A Mixed-Methods Study

Rebecca Purc-Stephenson and Rachel Edwards suggest therapeutic approaches to support those with chronic illnesses

Image credit: Needle, by NoName_13 from Pixabay

mental health psychology

Managing PTSD with exercise: What do clinicians think?

Jo Billings and colleagues highlight the need for more guidance for trauma clinicians on how to effectively use exercise to help treat PTSD

Image credit: Pete Linforth from Pixabay

What are the effects of diagnostic labels?

Nick Haslam and colleagues examine how diagnostic labels affect empathy, help-seeking and stigma

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Gender differences in severity and parental estimation of adolescent’s pandemic-related stress in the United States

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behavioural medicine and mental health economics

Cost-effectiveness of automated digital CBT ( Daylight ) for generalized anxiety disorder: A Markov simulation model in the United States

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epidemiology of mental health

Prevalence and covariates of depression among older adults in Nepal: A systematic review and meta-analysis

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public mental health & policy

Psychological support for older crime victims - understanding barriers using Metropolitan Police data

Image credit: Hands, by Sabine van Erp, Pixabay

Community Case Studies - NTDs

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75 Free Online Academic Journals for Counselors

This is a list of 70+ free and open-access online academic journals for counselors and other mental health professionals.

(Updated 5/23/21) This list is comprised of 70+ academic journals that you can access online. Most of the journals are open-access; others offer limited access (with some free articles).

All of the publications are related to mental health, addiction, or wellness. I use many of them for research for this blog.

The research is relevant to all health professionals and to anyone who is interested in learning more about mental illness. 

75 Free Online Academic Journals for Mental Health Professionals

• Abnormal and Behavioural Psychology   
• Addiction Science and Clinical Practice   
• Addiction Professional
• Addictive Behavior Reports
• Addictive Behaviors   
• Aggression and Violent Behavior   
• Alcohol and Alcoholism
• Alcohol Research: Current Reviews
• The American Journal of Drug and Alcohol Abuse
• Annals of Behavioural Science   
• Behavior and Brain Functions
• Bipolar Disorder  
• BMC Neuroscience  
• BMC Psychiatry
• BMC Psychology  
• Borderline Personality Disorder and Emotion Regulation
• Brain: A Journal of Neurology
• Brain and Cognition
• Brain Disorders and Therapy  
• The British Journal of Psychiatry
• Child and Adolescent Psychiatry and Mental Health
• Clinical Depression  
• Clinical Psychology Review  
• Cognitive Psychology
• Consciousness and Cognition
• Culture and Psychology
• Current Addiction Reports
• Current Opinion in Psychology
• Current Psychology Letters: Behaviour, Brain, & Cognition
• Drug and Alcohol Dependence
• Dual Diagnosis  
• Emotion Review
• Electronic Journal of Research in Educational Psychology
• European Journal of Trauma and Disassociation
• Frontiers in Psychology
• Harm Reduction Journal  
• Health Psychology and Behavioral Medicine
• Health Psychology Open  
• International Journal of High Risk Behaviors and Addiction
• International Journal of Mental Health and Psychiatry  
• International Journal of Mental Health Systems
• JAMA Internal Medicine
• Journal of Abnormal Psychology
• Journal of Addictive Behaviors, Therapy, & Rehabilitation  
• Journal of Alcoholism and Drug Abuse  
• Journal of Anxiety Disorders
• Journal of Applied Behavior Analysis
• Journal of Behavior Therapy and Experimental Psychiatry
• Journal of Obsessive Compulsive and Related Disorders
• Journal of Depression and Anxiety  
• Journal of Drug Abuse  
• Journal of Eating Disorders  
• Journal of Experimental Social Psychology  
• Journal of Human Values  
• Journal of Interpersonal Violence  
• Journal of Mental Disorders and Treatment  
• The Journal of Neuroscience
• Journal of Psychological Abnormalities
• Journal of Psychology and Psychotherapy   
• Journal of Sleep Disorders and Therapy  
• Journal of Substance Abuse Treatment  
• Journal of Traumatic Stress Disorders & Treatment  
• Learning & Memory
• Mental Health and Physical Activity
• New Ideas in Psychology
• Nicotine & Tobacco Research  
• Nutrition Journal  
• Personality and Individual Differences
• PsyArt Journal
• Punishment and Society
• Schizophrenia Bulletin
• Sexual Offender Treatment
• Sleep Science and Practice  
• Social Media + Society  
• Social Psychological and Personality Science  
• Substance Abuse: Research and Treatment  
• Substance Abuse Treatment, Prevention, and Policy  
• Theory & Psychology  
• Thinking Skills and Creativity
• Tobacco Use Insights

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Research Topics & Ideas: Mental Health

100+ Mental Health Research Topic Ideas To Fast-Track Your Project

If you’re just starting out exploring mental health topics for your dissertation, thesis or research project, you’ve come to the right place. In this post, we’ll help kickstart your research topic ideation process by providing a hearty list of mental health-related research topics and ideas.

PS – This is just the start…

We know it’s exciting to run through a list of research topics, but please keep in mind that this list is just a starting point . To develop a suitable education-related research topic, you’ll need to identify a clear and convincing research gap , and a viable plan of action to fill that gap.

If this sounds foreign to you, check out our free research topic webinar that explores how to find and refine a high-quality research topic, from scratch. Alternatively, if you’d like hands-on help, consider our 1-on-1 coaching service .

Overview: Mental Health Topic Ideas

• Mood disorders
• Anxiety disorders
• Psychotic disorders
• Personality disorders
• Obsessive-compulsive disorders
• Post-traumatic stress disorder (PTSD)
• Neurodevelopmental disorders
• Eating disorders
• Substance-related disorders

Mood Disorders

Research in mood disorders can help understand their causes and improve treatment methods. Here are a few ideas to get you started.

• The impact of genetics on the susceptibility to depression
• Efficacy of antidepressants vs. cognitive behavioural therapy
• The role of gut microbiota in mood regulation
• Cultural variations in the experience and diagnosis of bipolar disorder
• Seasonal Affective Disorder: Environmental factors and treatment
• The link between depression and chronic illnesses
• Exercise as an adjunct treatment for mood disorders
• Hormonal changes and mood swings in postpartum women
• Stigma around mood disorders in the workplace
• Suicidal tendencies among patients with severe mood disorders

Anxiety Disorders

Research topics in this category can potentially explore the triggers, coping mechanisms, or treatment efficacy for anxiety disorders.

• The relationship between social media and anxiety
• Exposure therapy effectiveness in treating phobias
• Generalised Anxiety Disorder in children: Early signs and interventions
• The role of mindfulness in treating anxiety
• Genetics and heritability of anxiety disorders
• The link between anxiety disorders and heart disease
• Anxiety prevalence in LGBTQ+ communities
• Caffeine consumption and its impact on anxiety levels
• The economic cost of untreated anxiety disorders
• Virtual Reality as a treatment method for anxiety disorders

Psychotic Disorders

Within this space, your research topic could potentially aim to investigate the underlying factors and treatment possibilities for psychotic disorders.

• Early signs and interventions in adolescent psychosis
• Brain imaging techniques for diagnosing psychotic disorders
• The efficacy of antipsychotic medication
• The role of family history in psychotic disorders
• Misdiagnosis and delayed treatment of psychotic disorders
• Co-morbidity of psychotic and mood disorders
• The relationship between substance abuse and psychotic disorders
• Art therapy as a treatment for schizophrenia
• Public perception and stigma around psychotic disorders
• Hospital vs. community-based care for psychotic disorders

Personality Disorders

Research topics within in this area could delve into the identification, management, and social implications of personality disorders.

• Long-term outcomes of borderline personality disorder
• Antisocial personality disorder and criminal behaviour
• The role of early life experiences in developing personality disorders
• Narcissistic personality disorder in corporate leaders
• Gender differences in personality disorders
• Diagnosis challenges for Cluster A personality disorders
• Emotional intelligence and its role in treating personality disorders
• Psychotherapy methods for treating personality disorders
• Personality disorders in the elderly population
• Stigma and misconceptions about personality disorders

Obsessive-Compulsive Disorders

Within this space, research topics could focus on the causes, symptoms, or treatment of disorders like OCD and hoarding.

• OCD and its relationship with anxiety disorders
• Cognitive mechanisms behind hoarding behaviour
• Deep Brain Stimulation as a treatment for severe OCD
• The impact of OCD on academic performance in students
• Role of family and social networks in treating OCD
• Alternative treatments for hoarding disorder
• Childhood onset OCD: Diagnosis and treatment
• OCD and religious obsessions
• The impact of OCD on family dynamics
• Body Dysmorphic Disorder: Causes and treatment

Post-Traumatic Stress Disorder (PTSD)

Research topics in this area could explore the triggers, symptoms, and treatments for PTSD. Here are some thought starters to get you moving.

• PTSD in military veterans: Coping mechanisms and treatment
• Childhood trauma and adult onset PTSD
• Eye Movement Desensitisation and Reprocessing (EMDR) efficacy
• Role of emotional support animals in treating PTSD
• Gender differences in PTSD occurrence and treatment
• Effectiveness of group therapy for PTSD patients
• PTSD and substance abuse: A dual diagnosis
• First responders and rates of PTSD
• Domestic violence as a cause of PTSD
• The neurobiology of PTSD

Neurodevelopmental Disorders

This category of mental health aims to better understand disorders like Autism and ADHD and their impact on day-to-day life.

• Early diagnosis and interventions for Autism Spectrum Disorder
• ADHD medication and its impact on academic performance
• Parental coping strategies for children with neurodevelopmental disorders
• Autism and gender: Diagnosis disparities
• The role of diet in managing ADHD symptoms
• Neurodevelopmental disorders in the criminal justice system
• Genetic factors influencing Autism
• ADHD and its relationship with sleep disorders
• Educational adaptations for children with neurodevelopmental disorders
• Neurodevelopmental disorders and stigma in schools

Eating Disorders

Research topics within this space can explore the psychological, social, and biological aspects of eating disorders.

• The role of social media in promoting eating disorders
• Family dynamics and their impact on anorexia
• Biological basis of binge-eating disorder
• Treatment outcomes for bulimia nervosa
• Eating disorders in athletes
• Media portrayal of body image and its impact
• Eating disorders and gender: Are men underdiagnosed?
• Cultural variations in eating disorders
• The relationship between obesity and eating disorders
• Eating disorders in the LGBTQ+ community

Substance-Related Disorders

Research topics in this category can focus on addiction mechanisms, treatment options, and social implications.

• Efficacy of rehabilitation centres for alcohol addiction
• The role of genetics in substance abuse
• Substance abuse and its impact on family dynamics
• Prescription drug abuse among the elderly
• Legalisation of marijuana and its impact on substance abuse rates
• Alcoholism and its relationship with liver diseases
• Opioid crisis: Causes and solutions
• Substance abuse education in schools: Is it effective?
• Harm reduction strategies for drug abuse
• Co-occurring mental health disorders in substance abusers

Choosing A Research Topic

These research topic ideas we’ve covered here serve as thought starters to help you explore different areas within mental health. They are intentionally very broad and open-ended. By engaging with the currently literature in your field of interest, you’ll be able to narrow down your focus to a specific research gap .

It’s important to consider a variety of factors when choosing a topic for your dissertation or thesis . Think about the relevance of the topic, its feasibility , and the resources available to you, including time, data, and academic guidance. Also, consider your own interest and expertise in the subject, as this will sustain you through the research process.

Always consult with your academic advisor to ensure that your chosen topic aligns with academic requirements and offers a meaningful contribution to the field. If you need help choosing a topic, consider our private coaching service.

Good morning everyone. This are very patent topics for research in neuroscience. Thank you for guidance

What if everything is important, original and intresting? as in Neuroscience. I find myself overwhelmd with tens of relveant areas and within each area many optional topics. I ask myself if importance (for example – able to treat people suffering) is more relevant than what intrest me, and on the other hand if what advance me further in my career should not also be a consideration?

This information is really helpful and have learnt alot

Phd research topics on implementation of mental health policy in Nigeria :the prospects, challenges and way forward.

This info is indeed help for someone to formulate a dissertation topic. I have already got my path from here.

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BMJ Mental Health

is a peer reviewed, open access journal from BMJ covering clinically relevant research in mental health and psychiatry.

Impact Factor: 6.6 Citescore: 6.8 All metrics >>

BMJ Mental Health (formerly Evidence-Based Mental Health ) is an open access, peer reviewed journal publishing evidence-based, innovative research, systematic reviews, and methodological papers in the area of mental health. It facilitates multidisciplinary collaboration among psychiatrists, psychologists and other mental health professionals, encourages debate on clinically relevant topics, and informs real world practice to improve patient and carer outcomes.

BMJ Mental Health invites submissions in all areas of mental health including digital health; medical statistics; precision mental health; evaluation of psychotherapies; studies in children, young people and in the elderly; forensic psychiatry; health economics; data science and computational mental health.

BMJ Mental Health is indexed in MEDLINE, Scopus, DOAJ and the Web of Science

Submissions and article proposals are welcomed by the international editorial team , which is led by Editor-in-Chief Professor Andrea Cipriani (University of Oxford).

BMJ Mental Health accepts submissions of a wide range of article types, including original research, reviews and perspective pieces.

The Author Information section provides specific article requirements to help you turn your research into an article suitable for BMJ Mental Health.

Information is also provided on editorial policies and open access .

What I Stand for as Editor-in-Chief

In BMJ Mental Health 's first Editorial, Professor Andrea Cipriani outlines the aims, scope and vision for the journal, and discusses the benefits of an accessible, fully open access journal in the field of mental health.

Professor Cipriani also discusses what he will stand for as Editor-in-Chief of BMJ Mental Health , including embedding evidence-based research in routine mental healthcare and fighting stigma and ideology in mental health.

Topic Collections

Climate Attributable Mental Health: Impacts and Interventions

Climate related disasters such as wildfires, drought, heat waves and floods and their consequences are resulting in deaths and disease from causes ranging from cardio-respiratory disease to malnutrition and malaria. Mental ill health too, is on the rise, however, causal pathways and psychiatric diagnoses in relation to climate change remains less well recognised and estimated. This Topic Collection in BMJ Mental Health plans to bring together the latest evidence on the burden of climate-attributable mental health impacts and potential actions to address these impacts.

Submission deadline:  6th September 2024

Chronopsychiatry: From Discovery Science to Clinical Innovation

In recent years, there has been a resurgence of interest exploring the intersection sleep/circadian science and mental health. BMJ Mental Health is calling for submissions on circadian mental health research and innovation with particular focus on major depression, psychosis, bipolar disorder, dementia, neurodevelopmental disorders (ASD and ADHD) and substance misuse disorders.

Submission deadline: 9th September 2024

Most Read Articles

Child and adolescent mental health :

17 February 2024

Digital mental health :

15 February 2024

Pharmacological treatments :

12 April 2024

Perspective :

14 March 2024

Adult mental health :

3 September 2024

Latest Articles

30 August 2024

25 August 2024

Psychosocial interventions :

24 August 2024

Featured Video

Bmj mental health - our full story.

Listen to Editor of BMJ Mental Health, Andrea Cipriani, talk about the journal's aims and scope, the advice he has for authors thinking about submitting to the journal, what the journal has to offer to readers, highlights from the journal and what the journal has planned for 2024.

Related Journals

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Journal of Neurology, Neurosurgery and Psychiatry

Recruiter: Leeds and York Partnership NHS Foundation Trust

Pembroke Dock

Recruiter: Hywel Dda University Health Board

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Recruiter: Southern Health NHS Foundation Trust

Recruiter: Avon and Wiltshire Mental Health Partnership NHS Trust

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Research articles

The relation between cortical gene expression and the neural correlates of risky behavior

In a large dataset from the UK Biobank, the authors examine the relationships between regional gene expressions and structural and functional features of the cerebral cortex associated with risky behavior.

• Abdel Abdellaoui
• Karin J. H. Verweij

Associated transcriptional, brain and clinical variations in schizophrenia

This study examining blood transcriptomic, neuroimaging and clinical data in people with schizophrenia shows a relationship between individual variations in gene transcription, brain structure and cognitive performance.

• Long-Biao Cui
• Shu-Wan Zhao
• Yongbin Wei

Neocortical serotonin 2A receptor binding, neuroticism and risk of developing depression in healthy individuals

In this study, the authors used molecular brain imaging and measures of neuroticism to identify that high 5-HT 2A R binding and higher levels of neuroticism predicted an increased risk of developing depression up to 19 years after assessment.

• Anjali Sankar
• Simon C. Ziersen
• Vibe G. Frokjaer

Mapping cerebellar anatomical heterogeneity in mental and neurological illnesses

This study maps cerebellar anatomy across the lifespan using over 54,000 brain scans from 132 scanning sites and identifies that patients with autism spectrum disorder, mild cognitive impairment, Alzheimer disease, and schizophrenia are likely to have deviations in cerebellar anatomy.

• Esten Leonardsen
• Torgeir Moberget

Exploration of first onsets of mania, schizophrenia spectrum disorders and major depressive disorder in perimenopause

The authors investigate first onsets of psychiatric disorders during perimenopause, finding higher incidence rates of major depressive disorder and mania.

• Lisa M. Shitomi-Jones
• Clare Dolman
• Arianna Di Florio

Building machine learning prediction models for well-being using predictors from the exposome and genome in a population cohort

Machine learning prediction models for adult well-being were built on longitudinal data from the Netherlands Twin Register population cohort. The exposome, but not the genome, predicted well-being in adulthood, with key factors including optimism, personality, social support and neighborhood housing characteristics.

• Dirk H. M. Pelt
• Philippe C. Habets
• Meike Bartels

Brain, lifestyle and environmental pathways linking physical and mental health

In a large-scale UK Biobank study of multimodal brain imaging and physiological markers, the authors find brain-mediated patterns of organ function and lifestyle pathways that are predictive of specific mental health outcomes.

• Ye Ella Tian
• James H. Cole
• Andrew Zalesky

Mood instability metrics to stratify individuals and measure outcomes in bipolar disorder

This study introduces a method to measure outcomes in bipolar disorder by quantifying mood instability over time.

• Sarah H. Sperry
• Anastasia K. Yocum
• Melvin G. McInnis

Different hierarchical reconfigurations in the brain by psilocybin and escitalopram for depression

Psilocybin and escitalopram create significantly different reconfigurations in the global functional hierarchy of brain dynamics with opposite statistical effect responses in people with major depressive disorder.

• Gustavo Deco
• Yonatan Sanz Perl
• Morten L. Kringelbach

Modeling impulsivity and risk aversion in the subthalamic nucleus with deep brain stimulation

Using a card gambling task paired with intracranial recordings and deep brain stimulation of the right subthalamic nucleus, the authors dissociate objective and subjective markers of risk taking and demonstrate the role of stimulation localization on risk-related behavior.

• Valerie Voon
• Luis Manssuer

Childhood-onset type 1 diabetes and subsequent adult psychiatric disorders: a nationwide cohort and genome-wide Mendelian randomization study

In this study, analyzing Czech national register-based data and using genome-wide Mendelian randomization, the authors report elevated risk for developing substance use, mood, anxiety and personality disorders in individuals with childhood-onset type 1 diabetes, and show that these associations are unlikely to be explicable by common underlying biological mechanisms.

• Tomáš Formánek
• Benjamin I. Perry

Depressive symptoms and sex differences in the risk of post-COVID-19 persistent symptoms: a prospective population-based cohort study

In this cohort study, the authors find that depressive symptoms at the beginning of the pandemic may partially explain why women participants who had a COVID-19 episode were more likely than their male counterparts to report at least one post-COVID-19 persistent symptom seven to ten months later.

• Joane Matta
• Baptiste Pignon
• Cédric Lemogne

Shared genetics of ADHD, cannabis use disorder and cannabis use and prediction of cannabis use disorder in ADHD

In this study, the authors use a combination of genetic methodologies to investigate the genetic associations between attention-deficit/hyperactivity disorder, cannabis use disorder and cannabis use.

• Trine Tollerup Nielsen
• Jinjie Duan
• Ditte Demontis

Deep brain stimulation of habenula reduces depressive symptoms and modulates brain activities in treatment-resistant depression

Using deep brain stimulation of the habenula with implanted electrodes in patients with treatment-resistant depression, this study found a substantial reduction in depression scores at follow-up over multiple time points.

• Zhiyan Wang

Tumor location is associated with mood dysfunction in patients with diffuse glioma

The authors report how the anatomical location of diffuse gliomas is related to the occurrence of severe depressive symptoms or the absence of depressive symptoms.

• Maisa N. G. van Genderen
• Vera Belgers
• Philip C. De Witt Hamer

Individual differences in autism-like traits are associated with reduced goal emulation in a computational model of observational learning

Using a computational approach, Wu et al. find that autism-related traits are associated with reduced observational learning specifically through reduced goal emulation, revealing difficulties in social goal inference.

• Qianying Wu
• Caroline J. Charpentier

Opioid-induced neuroanatomical, microglial and behavioral changes are blocked by suvorexant without diminishing opioid analgesia

The authors demonstrate that, in a mouse model of heroin use disorder, co-administration of morphine and suvorexant prevented both morphine-induced anatomical changes in hypocretin neurons and morphine anticipation and reduced morphine withdrawal behavior but spared analgesia, suggesting applications for reducing opioid addiction potential in humans.

• Ronald McGregor
• Ming-Fung Wu
• Jerome M. Siegel

A cognitive neural circuit biotype of depression showing functional and behavioral improvement after transcranial magnetic stimulation in the B-SMART-fMRI trial

The authors investigate functional connectivity before and after transcranial magnetic stimulation in veterans with treatment-resistant depression stratified by cognitive biotype, demonstrating associated brain connectivity-mediated improvement in cognitive behavioral task performance.

• Leonardo Tozzi
• Claire Bertrand
• Leanne Maree Williams

Characterizing the phenotypic and genetic structure of psychopathology in UK Biobank

In this study using UK Biobank and genomic data, the phenotypic and genetic factor structures across ten psychiatric conditions are analyzed, finding general genetic and phenotypic consistency but greater potential gene and environment disparities in conditions associated with externalizing disorders.

• Camille M. Williams
• Franck Ramus

Prenatal cannabis exposure, the brain, and psychopathology during early adolescence

The authors used data from the ABCD Study to examine the effects of prenatal cannabis exposure on neuroimaging metrics and mental health in adolescents.

• David A. A. Baranger
• Alex P. Miller
• Ryan Bogdan

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Mental health

• Affordable, effective and feasible strategies exist to promote, protect and restore mental health.
• The need for action on mental health is indisputable and urgent.
• Mental health has intrinsic and instrumental value and is integral to our well-being.
• Mental health is determined by a complex interplay of individual, social and structural stresses and vulnerabilities.

Concepts in mental health

Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community. It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in. Mental health is a basic human right. And it is crucial to personal, community and socio-economic development.

Mental health is more than the absence of mental disorders. It exists on a complex continuum, which is experienced differently from one person to the next, with varying degrees of difficulty and distress and potentially very different social and clinical outcomes.

Mental health conditions include mental disorders and psychosocial disabilities as well as other mental states associated with significant distress, impairment in functioning, or risk of self-harm. People with mental health conditions are more likely to experience lower levels of mental well-being, but this is not always or necessarily the case.

Determinants of mental health

Throughout our lives, multiple individual, social and structural determinants may combine to protect or undermine our mental health and shift our position on the mental health continuum.

Individual psychological and biological factors such as emotional skills, substance use and genetics can make people more vulnerable to mental health problems.

Exposure to unfavourable social, economic, geopolitical and environmental circumstances – including poverty, violence, inequality and environmental deprivation – also increases people’s risk of experiencing mental health conditions.

Risks can manifest themselves at all stages of life, but those that occur during developmentally sensitive periods, especially early childhood, are particularly detrimental. For example, harsh parenting and physical punishment is known to undermine child health and bullying is a leading risk factor for mental health conditions.

Protective factors similarly occur throughout our lives and serve to strengthen resilience. They include our individual social and emotional skills and attributes as well as positive social interactions, quality education, decent work, safe neighbourhoods and community cohesion, among others.

Mental health risks and protective factors can be found in society at different scales. Local threats heighten risk for individuals, families and communities. Global threats heighten risk for whole populations and include economic downturns, disease outbreaks, humanitarian emergencies and forced displacement and the growing climate crisis.

Each single risk and protective factor has only limited predictive strength. Most people do not develop a mental health condition despite exposure to a risk factor and many people with no known risk factor still develop a mental health condition. Nonetheless, the interacting determinants of mental health serve to enhance or undermine mental health.

Mental health promotion and prevention

Promotion and prevention interventions work by identifying the individual, social and structural determinants of mental health, and then intervening to reduce risks, build resilience and establish supportive environments for mental health. Interventions can be designed for individuals, specific groups or whole populations.

Reshaping the determinants of mental health often requires action beyond the health sector and so promotion and prevention programmes should involve the education, labour, justice, transport, environment, housing, and welfare sectors. The health sector can contribute significantly by embedding promotion and prevention efforts within health services; and by advocating, initiating and, where appropriate, facilitating multisectoral collaboration and coordination.

Suicide prevention is a global priority and included in the Sustainable Development Goals. Much progress can be achieved by limiting access to means, responsible media reporting, social and emotional learning for adolescents and early intervention. Banning highly hazardous pesticides is a particularly inexpensive and cost–effective intervention for reducing suicide rates.

Promoting child and adolescent mental health is another priority and can be achieved by policies and laws that promote and protect mental health, supporting caregivers to provide nurturing care, implementing school-based programmes and improving the quality of community and online environments. School-based social and emotional learning programmes are among the most effective promotion strategies for countries at all income levels.

Promoting and protecting mental health at work is a growing area of interest and can be supported through legislation and regulation, organizational strategies, manager training and interventions for workers.

Mental health care and treatment

In the context of national efforts to strengthen mental health, it is vital to not only protect and promote the mental well-being of all, but also to address the needs of people with mental health conditions.

This should be done through community-based mental health care, which is more accessible and acceptable than institutional care, helps prevent human rights violations and delivers better recovery outcomes for people with mental health conditions. Community-based mental health care should be provided through a network of interrelated services that comprise:

• mental health services that are integrated in general health care, typically in general hospitals and through task-sharing with non-specialist care providers in primary health care;
• community mental health services that may involve community mental health centers and teams, psychosocial rehabilitation, peer support services and supported living services; and
• services that deliver mental health care in social services and non-health settings, such as child protection, school health services, and prisons.

The vast care gap for common mental health conditions such as depression and anxiety means countries must also find innovative ways to diversify and scale up care for these conditions, for example through non-specialist psychological counselling or digital self-help.

WHO response

All WHO Member States are committed to implementing the “Comprehensive mental health action plan 2013–2030" , which aims to improve mental health by strengthening effective leadership and governance, providing comprehensive, integrated and responsive community-based care, implementing promotion and prevention strategies, and strengthening information systems, evidence and research. In 2020, WHO’s “Mental health atlas 2020” analysis of country performance against the action plan showed insufficient advances against the targets of the agreed action plan.

WHO’s “World mental health report: transforming mental health for all” calls on all countries to accelerate implementation of the action plan. It argues that all countries can achieve meaningful progress towards better mental health for their populations by focusing on three “paths to transformation”:

• deepen the value given to mental health by individuals, communities and governments; and matching that value with commitment, engagement and investment by all stakeholders, across all sectors;
• reshape the physical, social and economic characteristics of environments – in homes, schools, workplaces and the wider community – to better protect mental health and prevent mental health conditions; and
• strengthen mental health care so that the full spectrum of mental health needs is met through a community-based network of accessible, affordable and quality services and supports.

WHO gives particular emphasis to protecting and promoting human rights, empowering people with lived experience and ensuring a multisectoral and multistakeholder approach.

WHO continues to work nationally and internationally – including in humanitarian settings – to provide governments and partners with the strategic leadership, evidence, tools and technical support to strengthen a collective response to mental health and enable a transformation towards better mental health for all. 

• World mental health report: transforming mental health for all
• Comprehensive Mental Health Action Plan 2013─2030
• Mental health atlas 2020

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Mental Health and Mental Disorders Evidence-Based Resources

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Evidence-based resources related to Mental Health And Mental Disorders (32)

• First-Episode Psychosis and Co-Occurring Substance Use Disorders Guide
• Treatment for Suicidal Ideation, Self-harm, and Suicide Attempts Among Youth
• Specialised early intervention teams for recent‐onset psychosis
• Psychological therapies for women who experience intimate partner violence
• Psychological interventions for post‐traumatic stress disorder (PTSD) in people with severe mental illness
• Pre‐deployment programmes for building resilience in military and frontline emergency service personnel
• Pharmacological treatment for psychotic depression
• Cognitive‐behavioural interventions for children who have been sexually abused
• Antidepressant treatment for postnatal depression
• LGBTQ+ Behavioral Health (youth.gov)
• Depression and Suicide Risk in Adults: Screening
• Depression and Suicide Risk in Children and Adolescents: Screening
• Anxiety in Children and Adolescents: Screening
• Anxiety Disorders in Adults: Screening
• Screening for Depression and Suicide Risk in Adults
• Eating Disorders in Adolescents and Adults: Screening
• Suicide and Violence Prevention
• Mental Health: Targeted School-Based Cognitive Behavioral Therapy Programs to Reduce Depression and Anxiety Symptoms
• Mental Health: Universal School-Based Cognitive Behavioral Therapy Programs to Reduce Depression and Anxiety Symptoms
• Perinatal Depression: Preventive Interventions
• Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults: Screening
• The Surgeon General’s Call to Action to Implement the National Strategy for Suicide Prevention
• The Way Forward: Federal Action for a System that Works for All People Living with SMI and SED and their Families and Caregivers
• Evidence-Based Practices Resource Center
• Depression in Children and Adolescents: Screening
• Teen Depression: More Than Just Moodiness
• Mental Health: Mental Health Benefits Legislation
• Mental Health: Collaborative Care for the Management of Depressive Disorders
• Depression in Adults: Screening
• Schizophrenia: Overview
• Depression: Overview
• Intensive Case Management for Severe Mental Illness

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Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice

John a. naslund.

a Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA

Ameya Bondre

b CareNX Innovations, Mumbai, India

John Torous

c Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA

Kelly A. Aschbrenner

d Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH

Social media platforms are popular venues for sharing personal experiences, seeking information, and offering peer-to-peer support among individuals living with mental illness. With significant shortfalls in the availability, quality, and reach of evidence-based mental health services across the United States and globally, social media platforms may afford new opportunities to bridge this gap. However, caution is warranted, as numerous studies highlight risks of social media use for mental health. In this commentary, we consider the role of social media as a potentially viable intervention platform for offering support to persons with mental disorders, promoting engagement and retention in care, and enhancing existing mental health services. Specifically, we summarize current research on the use of social media among mental health service users, and early efforts using social media for the delivery of evidence-based programs. We also review the risks, potential harms, and necessary safety precautions with using social media for mental health. To conclude, we explore opportunities using data science and machine learning, for example by leveraging social media for detecting mental disorders and developing predictive models aimed at characterizing the aetiology and progression of mental disorders. These various efforts using social media, as summarized in this commentary, hold promise for improving the lives of individuals living with mental disorders.

Introduction

Social media has become a prominent fixture in the lives of many individuals facing the challenges of mental illness. Social media refers broadly to web and mobile platforms that allow individuals to connect with others within a virtual network (such as Facebook, Twitter, Instagram, Snapchat, or LinkedIn), where they can share, co-create, or exchange various forms of digital content, including information, messages, photos, or videos ( Ahmed, Ahmad, Ahmad, & Zakaria, 2019 ). Studies have reported that individuals living with a range of mental disorders, including depression, psychotic disorders, or other severe mental illnesses, use social media platforms at comparable rates as the general population, with use ranging from about 70% among middle-age and older individuals, to upwards of 97% among younger individuals ( Aschbrenner, Naslund, Grinley, et al., 2018 ; M. L. Birnbaum, Rizvi, Correll, Kane, & Confino, 2017 ; Brunette et al., 2019 ; Naslund, Aschbrenner, & Bartels, 2016 ). Other exploratory studies have found that many of these individuals with mental illness appear to turn to social media to share their personal experiences, seek information about their mental health and treatment options, and give and receive support from others facing similar mental health challenges ( Bucci, Schwannauer, & Berry, 2019 ; Naslund, Aschbrenner, Marsch, & Bartels, 2016b ).

Across the United States and globally, very few people living with mental illness have access to adequate mental health services ( Patel et al., 2018 ). The wide reach and near ubiquitous use of social media platforms may afford novel opportunities to address these shortfalls in existing mental health care, by enhancing the quality, availability, and reach of services. Recent studies have explored patterns of social media use, impact of social media use on mental health and wellbeing, and the potential to leverage the popularity and interactive features of social media to enhance the delivery of interventions. However, there remains uncertainty regarding the risks and potential harms of social media for mental health ( Orben & Przybylski, 2019 ), and how best to weigh these concerns against potential benefits.

In this commentary, we summarized current research on the use of social media among individuals with mental illness, with consideration of the impact of social media on mental wellbeing, as well as early efforts using social media for delivery of evidence-based programs for addressing mental health problems. We searched for recent peer reviewed publications in Medline and Google Scholar using the search terms “mental health” or “mental illness” and “social media”, and searched the reference lists of recent reviews and other relevant studies. We reviewed the risks, potential harms, and necessary safety precautions with using social media for mental health. Overall, our goal was to consider the role of social media as a potentially viable intervention platform for offering support to persons with mental disorders, promoting engagement and retention in care, and enhancing existing mental health services, while balancing the need for safety. Given this broad objective, we did not perform a systematic search of the literature and we did not apply specific inclusion criteria based on study design or type of mental disorder.

Social Media Use and Mental Health

In 2020, there are an estimated 3.8 billion social media users worldwide, representing half the global population ( We Are Social, 2020 ). Recent studies have shown that individuals with mental disorders are increasingly gaining access to and using mobile devices, such as smartphones ( Firth et al., 2015 ; Glick, Druss, Pina, Lally, & Conde, 2016 ; Torous, Chan, et al., 2014 ; Torous, Friedman, & Keshavan, 2014 ). Similarly, there is mounting evidence showing high rates of social media use among individuals with mental disorders, including studies looking at engagement with these popular platforms across diverse settings and disorder types. Initial studies from 2015 found that nearly half of a sample of psychiatric patients were social media users, with greater use among younger individuals ( Trefflich, Kalckreuth, Mergl, & Rummel-Kluge, 2015 ), while 47% of inpatients and outpatients with schizophrenia reported using social media, of which 79% reported at least once-a-week usage of social media websites ( Miller, Stewart, Schrimsher, Peeples, & Buckley, 2015 ). Rates of social media use among psychiatric populations have increased in recent years, as reflected in a study with data from 2017 showing comparable rates of social media use (approximately 70%) among individuals with serious mental illness in treatment as compared to low-income groups from the general population ( Brunette et al., 2019 ).

Similarly, among individuals with serious mental illness receiving community-based mental health services, a recent study found equivalent rates of social media use as the general population, even exceeding 70% of participants ( Naslund, Aschbrenner, & Bartels, 2016 ). Comparable findings were demonstrated among middle-age and older individuals with mental illness accessing services at peer support agencies, where 72% of respondents reported using social media ( Aschbrenner, Naslund, Grinley, et al., 2018 ). Similar results, with 68% of those with first episode psychosis using social media daily were reported in another study ( Abdel-Baki, Lal, D.-Charron, Stip, & Kara, 2017 ).

Individuals who self-identified as having a schizophrenia spectrum disorder responded to a survey shared through the National Alliance of Mental Illness (NAMI), and reported that visiting social media sites was one of their most common activities when using digital devices, taking up roughly 2 hours each day ( Gay, Torous, Joseph, Pandya, & Duckworth, 2016 ). For adolescents and young adults ages 12 to 21 with psychotic disorders and mood disorders, over 97% reported using social media, with average use exceeding 2.5 hours per day ( M. L. Birnbaum et al., 2017 ). Similarly, in a sample of adolescents ages 13-18 recruited from community mental health centers, 98% reported using social media, with YouTube as the most popular platform, followed by Instagram and Snapchat ( Aschbrenner et al., 2019 ).

Research has also explored the motivations for using social media as well as the perceived benefits of interacting on these platforms among individuals with mental illness. In the sections that follow (see Table 1 for a summary), we consider three potentially unique features of interacting and connecting with others on social media that may offer benefits for individuals living with mental illness. These include: 1) Facilitate social interaction; 2) Access to a peer support network; and 3) Promote engagement and retention in services.

Summary of potential benefits and challenges with social media for mental health

Facilitate Social Interaction

Social media platforms offer near continuous opportunities to connect and interact with others, regardless of time of day or geographic location. This on demand ease of communication may be especially important for facilitating social interaction among individuals with mental disorders experiencing difficulties interacting in face-to-face settings. For example, impaired social functioning is a common deficit in schizophrenia spectrum disorders, and social media may facilitate communication and interacting with others for these individuals ( Torous & Keshavan, 2016 ). This was suggested in one study where participants with schizophrenia indicated that social media helped them to interact and socialize more easily ( Miller et al., 2015 ). Like other online communication, the ability to connect with others anonymously may be an important feature of social media, especially for individuals living with highly stigmatizing health conditions ( Berger, Wagner, & Baker, 2005 ), such as serious mental disorders ( Highton-Williamson, Priebe, & Giacco, 2015 ).

Studies have found that individuals with serious mental disorders ( Spinzy, Nitzan, Becker, Bloch, & Fennig, 2012 ) as well as young adults with mental illness ( Gowen, Deschaine, Gruttadara, & Markey, 2012 ) appear to form online relationships and connect with others on social media as often as social media users from the general population. This is an important observation because individuals living with serious mental disorders typically have few social contacts in the offline world, and also experience high rates of loneliness ( Badcock et al., 2015 ; Giacco, Palumbo, Strappelli, Catapano, & Priebe, 2016 ). Among individuals receiving publicly funded mental health services who use social media, nearly half (47%) reported using these platforms at least weekly to feel less alone ( Brusilovskiy, Townley, Snethen, & Salzer, 2016 ). In another study of young adults with serious mental illness, most indicated that they used social media to help feel less isolated ( Gowen et al., 2012 ). Interestingly, more frequent use of social media among a sample of individuals with serious mental illness was associated with greater community participation, measured as participation in shopping, work, religious activities or visiting friends and family, as well as greater civic engagement, reflected as voting in local elections ( Brusilovskiy et al., 2016 ).

Emerging research also shows that young people with moderate to severe depressive symptoms appear to prefer communicating on social media rather than in-person ( Rideout & Fox, 2018 ), while other studies have found that some individuals may prefer to seek help for mental health concerns online rather than through in-person encounters ( Batterham & Calear, 2017 ). In a qualitative study, participants with schizophrenia described greater anonymity, the ability to discover that other people have experienced similar health challenges, and reducing fears through greater access to information as important motivations for using the Internet to seek mental health information ( Schrank, Sibitz, Unger, & Amering, 2010 ). Because social media does not require the immediate responses necessary in face-to-face communication, it may overcome deficits with social interaction due to psychotic symptoms that typically adversely affect face-to-face conversations ( Docherty et al., 1996 ). Online social interactions may not require the use of non-verbal cues, particularly in the initial stages of interaction ( Kiesler, Siegel, & McGuire, 1984 ), with interactions being more fluid, and within the control of users, thereby overcoming possible social anxieties linked to in-person interaction ( Indian & Grieve, 2014 ). Furthermore, many individuals with serious mental disorders can experience symptoms including passive social withdrawal, blunted affect and attentional impairment, as well as active social avoidance due to hallucinations or other concerns ( Hansen, Torgalsbøen, Melle, & Bell, 2009 ); thus, potentially reinforcing the relative advantage, as perceived by users, of using social media over in person conversations.

Access to a Peer Support Network

There is growing recognition about the role that social media channels could play in enabling peer support ( Bucci et al., 2019 ; Naslund, Aschbrenner, et al., 2016b ), referred to as a system of mutual giving and receiving where individuals who have endured the difficulties of mental illness can offer hope, friendship, and support to others facing similar challenges ( Davidson, Chinman, Sells, & Rowe, 2006 ; Mead, Hilton, & Curtis, 2001 ). Initial studies exploring use of online self-help forums among individuals with serious mental illnesses have found that individuals with schizophrenia appeared to use these forums for self-disclosure, and sharing personal experiences, in addition to providing or requesting information, describing symptoms, or discussing medication ( Haker, Lauber, & Rössler, 2005 ), while users with bipolar disorder reported using these forums to ask for help from others about their illness ( Vayreda & Antaki, 2009 ). More recently, in a review of online social networking in people with psychosis, Highton-Williamson et al (2015) highlight that an important purpose of such online connections was to establish new friendships, pursue romantic relationships, maintain existing relationships or reconnect with people, and seek online peer support from others with lived experience ( Highton-Williamson et al., 2015 ).

Online peer support among individuals with mental illness has been further elaborated in various studies. In a content analysis of comments posted to YouTube by individuals who self-identified as having a serious mental illness, there appeared to be opportunities to feel less alone, provide hope, find support and learn through mutual reciprocity, and share coping strategies for day-to-day challenges of living with a mental illness ( Naslund, Grande, Aschbrenner, & Elwyn, 2014 ). In another study, Chang (2009) delineated various communication patterns in an online psychosis peer-support group ( Chang, 2009 ). Specifically, different forms of support emerged, including ‘informational support’ about medication use or contacting mental health providers, ‘esteem support’ involving positive comments for encouragement, ‘network support’ for sharing similar experiences, and ‘emotional support’ to express understanding of a peer’s situation and offer hope or confidence ( Chang, 2009 ). Bauer et al. (2013) reported that the main interest in online self-help forums for patients with bipolar disorder was to share emotions with others, allow exchange of information, and benefit by being part of an online social group ( Bauer, Bauer, Spiessl, & Kagerbauer, 2013 ).

For individuals who openly discuss mental health problems on Twitter, a study by Berry et al. (2017) found that this served as an important opportunity to seek support and to hear about the experiences of others ( Berry et al., 2017 ). In a survey of social media users with mental illness, respondents reported that sharing personal experiences about living with mental illness and opportunities to learn about strategies for coping with mental illness from others were important reasons for using social media ( Naslund et al., 2017 ). A computational study of mental health awareness campaigns on Twitter provides further support with inspirational posts and tips being the most shared ( Saha et al., 2019 ). Taken together, these studies offer insights about the potential for social media to facilitate access to an informal peer support network, though more research is necessary to examine how these online interactions may impact intentions to seek care, illness self-management, and clinically meaningful outcomes in offline contexts.

Promote Engagement and Retention in Services

Many individuals living with mental disorders have expressed interest in using social media platforms for seeking mental health information ( Lal, Nguyen, & Theriault, 2018 ), connecting with mental health providers ( M. L. Birnbaum et al., 2017 ), and accessing evidence-based mental health services delivered over social media specifically for coping with mental health symptoms or for promoting overall health and wellbeing ( Naslund et al., 2017 ). With the widespread use of social media among individuals living with mental illness combined with the potential to facilitate social interaction and connect with supportive peers, as summarized above, it may be possible to leverage the popular features of social media to enhance existing mental health programs and services. A recent review by Biagianti et al (2018) found that peer-to-peer support appeared to offer feasible and acceptable ways to augment digital mental health interventions for individuals with psychotic disorders by specifically improving engagement, compliance, and adherence to the interventions, and may also improve perceived social support ( Biagianti, Quraishi, & Schlosser, 2018 ).

Among digital programs that have incorporated peer-to-peer social networking consistent with popular features on social media platforms, a pilot study of the HORYZONS online psychosocial intervention demonstrated significant reductions in depression among patients with first episode psychosis ( Alvarez-Jimenez et al., 2013 ). Importantly, the majority of participants (95%) in this study engaged with the peer-to-peer networking feature of the program, with many reporting increases in perceived social connectedness and empowerment in their recovery process ( Alvarez-Jimenez et al., 2013 ). This moderated online social therapy program is now being evaluated as part of a large randomized controlled trial for maintaining treatment effects from first episode psychosis services ( Alvarez-Jimenez et al., 2019 ).

Other early efforts have demonstrated that use of digital environments with the interactive peer-to-peer features of social media can enhance social functioning and wellbeing in young people at high risk of psychosis ( Alvarez-Jimenez et al., 2018 ). There has also been a recent emergence of several mobile apps to support symptom monitoring and relapse prevention in psychotic disorders. Among these apps, the development of PRIME (Personalized Real-time Intervention for Motivational Enhancement) has involved working closely with young people with schizophrenia to ensure that the design of the app has the look and feel of mainstream social media platforms, as opposed to existing clinical tools ( Schlosser et al., 2016 ). This unique approach to the design of the app is aimed at promoting engagement, and ensuring that the app can effectively improve motivation and functioning through goal setting and promoting better quality of life of users with schizophrenia ( Schlosser et al., 2018 ).

Social media platforms could also be used to promote engagement and participation in in-person services delivered through community mental health settings. For example, the peer-based lifestyle intervention called PeerFIT targets weight loss and improved fitness among individuals living with serious mental illness through a combination of in-person lifestyle classes, exercise groups, and use of digital technologies ( Aschbrenner, Naslund, Shevenell, Kinney, & Bartels, 2016 ; Aschbrenner, Naslund, Shevenell, Mueser, & Bartels, 2016 ). The intervention holds tremendous promise as lack of support is one of the largest barriers toward exercise in patients with serious mental illness ( Firth et al., 2016 ) and it is now possible to use social media to counter such. Specifically, in PeerFIT, a private Facebook group is closely integrated into the program to offer a closed platform where participants can connect with the lifestyle coaches, access intervention content, and support or encourage each other as they work towards their lifestyle goals ( Aschbrenner, Naslund, & Bartels, 2016 ; Naslund, Aschbrenner, Marsch, & Bartels, 2016a ). To date, this program has demonstrate preliminary effectiveness for meaningfully reducing cardiovascular risk factors that contribute to early mortality in this patient group ( Aschbrenner, Naslund, Shevenell, Kinney, et al., 2016 ), while the Facebook component appears to have increased engagement in the program, while allowing participants who were unable to attend in-person sessions due to other health concerns or competing demands to remain connected with the program ( Naslund, Aschbrenner, Marsch, McHugo, & Bartels, 2018 ). This lifestyle intervention is currently being evaluated in a randomized controlled trial enrolling young adults with serious mental illness from a variety of real world community mental health services settings ( Aschbrenner, Naslund, Gorin, et al., 2018 ).

These examples highlight the promise of incorporating the features of popular social media into existing programs, which may offer opportunities to safely promote engagement and program retention, while achieving improved clinical outcomes. This is an emerging area of research, as evidenced by several important effectiveness trials underway ( Alvarez-Jimenez et al., 2019 ; Aschbrenner, Naslund, Gorin, et al., 2018 ), including efforts to leverage online social networking to support family caregivers of individuals receiving first episode psychosis services ( Gleeson et al., 2017 ).

Challenges with Social Media for Mental Health

The science on the role of social media for engaging persons with mental disorders needs a cautionary note on the effects of social media usage on mental health and well being, particularly in adolescents and young adults. While the risks and harms of social media are frequently covered in the popular press and mainstream news reports, careful consideration of the research in this area is necessary. In a review of 43 studies in young people, many benefits of social media were cited, including increased self-esteem, and opportunities for self-disclosure ( Best, Manktelow, & Taylor, 2014 ). Yet, reported negative effects were an increased exposure to harm, social isolation, depressive symptoms and bullying ( Best et al., 2014 ). In the sections that follow (see Table 1 for a summary), we consider three major categories of risk related to use of social media and mental health. These include: 1) Impact on symptoms; 2) Facing hostile interactions; and 3) Consequences for daily life.

Impact on Symptoms

Studies consistently highlight that use of social media, especially heavy use and prolonged time spent on social media platforms, appears to contribute to increased risk for a variety of mental health symptoms and poor wellbeing, especially among young people ( Andreassen et al., 2016 ; Kross et al., 2013 ; Woods & Scott, 2016 ). This may partly be driven by the detrimental effects of screen time on mental health, including increased severity of anxiety and depressive symptoms, which have been well documented ( Stiglic & Viner, 2019 ). Recent studies have reported negative effects of social media use on mental health of young people, including social comparison pressure with others and greater feeling of social isolation after being rejected by others on social media ( Rideout & Fox, 2018 ). In a study of young adults, it was found that negative comparisons with others on Facebook contributed to risk of rumination and subsequent increases in depression symptoms ( Feinstein et al., 2013 ). Still, the cross sectional nature of many screen time and mental health studies makes it challenging to reach causal inferences ( Orben & Przybylski, 2019 ).

Quantity of social media use is also an important factor, as highlighted in a survey of young adults ages 19 to 32, where more frequent visits to social media platforms each week were correlated with greater depressive symptoms ( Lin et al., 2016 ). More time spent using social media is also associated with greater symptoms of anxiety ( Vannucci, Flannery, & Ohannessian, 2017 ). The actual number of platforms accessed also appears to contribute to risk as reflected in another national survey of young adults where use of a large number of social media platforms was associated with negative impact on mental health ( Primack et al., 2017 ). Among survey respondents using between 7 and 11 different social media platforms compared to respondents using only 2 or fewer platforms, there was a 3 times greater odds of having high levels of depressive symptoms and a 3.2 times greater odds of having high levels of anxiety symptoms ( Primack et al., 2017 ).

Many researchers have postulated that worsening mental health attributed to social media use may be because social media replaces face-to-face interactions for young people ( Twenge & Campbell, 2018 ), and may contribute to greater loneliness ( Bucci et al., 2019 ), and negative effects on other aspects of health and wellbeing ( Woods & Scott, 2016 ). One nationally representative survey of US adolescents found that among respondents who reported more time accessing media such as social media platforms or smartphone devices, there was significantly greater depressive symptoms and increased risk of suicide when compared to adolescents who reported spending more time on non-screen activities, such as in-person social interaction or sports and recreation activities ( Twenge, Joiner, Rogers, & Martin, 2018 ). For individuals living with more severe mental illnesses, the effects of social media on psychiatric symptoms have received less attention. One study found that participation in chat rooms may contribute to worsening symptoms in young people with psychotic disorders ( Mittal, Tessner, & Walker, 2007 ), while another study of patients with psychosis found that social media use appeared to predict low mood ( Berry, Emsley, Lobban, & Bucci, 2018 ). These studies highlight a clear relationship between social media use and mental health that may not be present in general population studies ( Orben & Przybylski, 2019 ), and emphasize the need to explore how social media may contribute to symptom severity and whether protective factors may be identified to mitigate these risks.

Facing Hostile Interactions

Popular social media platforms can create potential situations where individuals may be victimized by negative comments or posts. Cyberbullying represents a form of online aggression directed towards specific individuals, such as peers or acquaintances, which is perceived to be most harmful when compared to random hostile comments posted online ( Hamm et al., 2015 ). Importantly, cyberbullying on social media consistently shows harmful impact on mental health in the form of increased depressive symptoms as well as worsening of anxiety symptoms, as evidenced in a review of 36 studies among children and young people ( Hamm et al., 2015 ). Furthermore, cyberbullying disproportionately impacts females as reflected in a national survey of adolescents in the United States, where females were twice as likely to be victims of cyberbullying compared to males ( Alhajji, Bass, & Dai, 2019 ). Most studies report cross-sectional associations between cyberbullying and symptoms of depression or anxiety ( Hamm et al., 2015 ), though one longitudinal study in Switzerland found that cyberbullying contributed to significantly greater depression over time ( Machmutow, Perren, Sticca, & Alsaker, 2012 ).

For youth ages 10 to 17 who reported major depressive symptomatology, there was over 3 times greater odds of facing online harassment in the last year compared to youth who reported mild or no depressive symptoms ( Ybarra, 2004 ). Similarly, in a 2018 national survey of young people, respondents ages 14 to 22 with moderate to severe depressive symptoms were more likely to have had negative experiences when using social media, and in particular, were more likely to report having faced hostile comments, or being “trolled”, from others when compared to respondents without depressive symptoms (31% vs. 14%) ( Rideout & Fox, 2018 ). As these studies depict risks for victimization on social media and the correlation with poor mental health, it is possible that individuals living with mental illness may also experience greater hostility online compared to individuals without mental illness. This would be consistent with research showing greater risk of hostility, including increased violence and discrimination, directed towards individuals living with mental illness in in-person contexts, especially targeted at those with severe mental illnesses ( Goodman et al., 1999 ).

A computational study of mental health awareness campaigns on Twitter reported that while stigmatizing content was rare, it was actually the most spread (re-tweeted) demonstrating that harmful content can travel quickly on social media ( Saha et al., 2019 ). Another study was able to map the spread of social media posts about the Blue Whale Challenge, an alleged game promoting suicide, over Twitter, YouTube, Reddit, Tumblr and other forums across 127 countries ( Sumner et al., 2019 ). These findings show that it is critical to monitor the actual content of social media posts, such as determining whether content is hostile or promotes harm to self or others. This is pertinent because existing research looking at duration of exposure cannot account for the impact of specific types of content on mental health and is insufficient to fully understand the effects of using these platforms on mental health.

Consequences for Daily Life

The ways in which individuals use social media can also impact their offline relationships and everyday activities. To date, reports have described risks of social media use pertaining to privacy, confidentiality, and unintended consequences of disclosing personal health information online ( Torous & Keshavan, 2016 ). Additionally, concerns have been raised about poor quality or misleading health information shared on social media, and that social media users may not be aware of misleading information or conflicts of interest especially when the platforms promote popular content regardless of whether it is from a trustworthy source ( Moorhead et al., 2013 ; Ventola, 2014 ). For persons living with mental illness there may be additional risks from using social media. A recent study that specifically explored the perspectives of social media users with serious mental illnesses, including participants with schizophrenia spectrum disorders, bipolar disorder, or major depression, found that over one third of participants expressed concerns about privacy when using social media ( Naslund & Aschbrenner, 2019 ). The reported risks of social media use were directly related to many aspects of everyday life, including concerns about threats to employment, fear of stigma and being judged, impact on personal relationships, and facing hostility or being hurt ( Naslund & Aschbrenner, 2019 ). While few studies have specifically explored the dangers of social media use from the perspectives of individuals living with mental illness, it is important to recognize that use of these platforms may contribute to risks that extend beyond worsening symptoms and that can affect different aspects of daily life.

In this commentary we considered ways in which social media may yield benefits for individuals living with mental illness, while contrasting these with the possible harms. Studies reporting on the threats of social media for individuals with mental illness are mostly cross-sectional, making it difficult to draw conclusions about direction of causation. However, the risks are potentially serious. These risks should be carefully considered in discussions pertaining to use of social media and the broader use of digital mental health technologies, as avenues for mental health promotion, or for supporting access to evidence-based programs or mental health services. At this point, it would be premature to view the benefits of social media as outweighing the possible harms, when it is clear from the studies summarized here that social media use can have negative effects on mental health symptoms, can potentially expose individuals to hurtful content and hostile interactions, and can result in serious consequences for daily life, including threats to employment and personal relationships. Despite these risks, it is also necessary to recognize that individuals with mental illness will continue to use social media given the ease of accessing these platforms and the immense popularity of online social networking. With this in mind, it may be ideal to raise awareness about these possible risks so that individuals can implement necessary safeguards, while also highlighting that there could also be benefits. For individuals with mental illness who use social media, being aware of the risks is an essential first step, and then highlighting ways that use of these popular platforms could also contribute to some benefits, ranging from finding meaningful interactions with others, engaging with peer support networks, and accessing information and services.

To capitalize on the widespread use of social media, and to achieve the promise that these platforms may hold for supporting the delivery of targeted mental health interventions, there is need for continued research to better understand how individuals living with mental illness use social media. Such efforts could inform safety measures and also encourage use of social media in ways that maximize potential benefits while minimizing risk of harm. It will be important to recognize how gender and race contribute to differences in use of social media for seeking mental health information or accessing interventions, as well as differences in how social media might impact mental wellbeing. For example, a national survey of 14- to 22-year olds in the United States found that female respondents were more likely to search online for information about depression or anxiety, and to try to connect with other people online who share similar mental health concerns, when compared to male respondents ( Rideout & Fox, 2018 ). In the same survey, there did not appear to be any differences between racial or ethnic groups in social media use for seeking mental health information ( Rideout & Fox, 2018 ). Social media use also appears to have a differential impact on mental health and emotional wellbeing between females and males ( Booker, Kelly, & Sacker, 2018 ), highlighting the need to explore unique experiences between gender groups to inform tailored programs and services. Research shows that lesbian, gay, bisexual or transgender individuals frequently use social media for searching for health information and may be more likely compared to heterosexual individuals to share their own personal health experiences with others online ( Rideout & Fox, 2018 ). Less is known about use of social media for seeking support for mental health concerns among gender minorities, though this is an important area for further investigation as these individuals are more likely to experience mental health problems and more likely to experience online victimization when compared to heterosexual individuals ( Mereish, Sheskier, Hawthorne, & Goldbach, 2019 ).

Similarly, efforts are needed to explore the relationship between social media use and mental health among ethnic and racial minorities. A recent study found that exposure to traumatic online content on social media showing violence or hateful posts directed at racial minorities contributed to increases in psychological distress, PTSD symptoms, and depression among African American and Latinx adolescents in the United States ( Tynes, Willis, Stewart, & Hamilton, 2019 ). These concerns are contrasted by growing interest in the potential for new technologies including social media to expand the reach of services to underrepresented minority groups ( Schueller, Hunter, Figueroa, & Aguilera, 2019 ). Therefore, greater attention is needed to understanding the perspectives of ethnic and racial minorities to inform effective and safe use of social media for mental health promotion efforts.

Research has found that individuals living with mental illness have expressed interest in accessing mental health services through social media platforms. A survey of social media users with mental illness found that most respondents were interested in accessing programs for mental health on social media targeting symptom management, health promotion, and support for communicating with health care providers and interacting with the health system ( Naslund et al., 2017 ). Importantly, individuals with serious mental illness have also emphasized that any mental health intervention on social media would need to be moderated by someone with adequate training and credentials, would need to have ground rules and ways to promote safety and minimize risks, and importantly, would need to be free and easy to access.

An important strength with this commentary is that it combines a range of studies broadly covering the topic of social media and mental health. We have provided a summary of recent evidence in a rapidly advancing field with the goal of presenting unique ways that social media could offer benefits for individuals with mental illness, while also acknowledging the potentially serious risks and the need for further investigation. There are also several limitations with this commentary that warrant consideration. Importantly, as we aimed to address this broad objective, we did not conduct a systematic review of the literature. Therefore, the studies reported here are not exhaustive, and there may be additional relevant studies that were not included. Additionally, we only summarized published studies, and as a result, any reports from the private sector or websites from different organizations using social media or other apps containing social media-like features would have been omitted. Though it is difficult to rigorously summarize work from the private sector, sometimes referred to as “gray literature”, because many of these projects are unpublished and are likely selective in their reporting of findings given the target audience may be shareholders or consumers.

Another notable limitation is that we did not assess risk of bias in the studies summarized in this commentary. We found many studies that highlighted risks associated with social media use for individuals living with mental illness; however, few studies of programs or interventions reported negative findings, suggesting the possibility that negative findings may go unpublished. This concern highlights the need for a future more rigorous review of the literature with careful consideration of bias and an accompanying quality assessment. Most of the studies that we described were from the United States, as well as from other higher income settings such as Australia or the United Kingdom. Despite the global reach of social media platforms, there is a dearth of research on the impact of these platforms on the mental health of individuals in diverse settings, as well as the ways in which social media could support mental health services in lower income countries where there is virtually no access to mental health providers. Future research is necessary to explore the opportunities and risks for social media to support mental health promotion in low-income and middle-income countries, especially as these countries face a disproportionate share of the global burden of mental disorders, yet account for the majority of social media users worldwide ( Naslund et al., 2019 ).

Future Directions for Social Media and Mental Health

As we consider future research directions, the near ubiquitous social media use also yields new opportunities to study the onset and manifestation of mental health symptoms and illness severity earlier than traditional clinical assessments. There is an emerging field of research referred to as ‘digital phenotyping’ aimed at capturing how individuals interact with their digital devices, including social media platforms, in order to study patterns of illness and identify optimal time points for intervention ( Jain, Powers, Hawkins, & Brownstein, 2015 ; Onnela & Rauch, 2016 ). Given that most people access social media via mobile devices, digital phenotyping and social media are closely related ( Torous et al., 2019 ). To date, the emergence of machine learning, a powerful computational method involving statistical and mathematical algorithms ( Shatte, Hutchinson, & Teague, 2019 ), has made it possible to study large quantities of data captured from popular social media platforms such as Twitter or Instagram to illuminate various features of mental health ( Manikonda & De Choudhury, 2017 ; Reece et al., 2017 ). Specifically, conversations on Twitter have been analyzed to characterize the onset of depression ( De Choudhury, Gamon, Counts, & Horvitz, 2013 ) as well as detecting users’ mood and affective states ( De Choudhury, Gamon, & Counts, 2012 ), while photos posted to Instagram can yield insights for predicting depression ( Reece & Danforth, 2017 ). The intersection of social media and digital phenotyping will likely add new levels of context to social media use in the near future.

Several studies have also demonstrated that when compared to a control group, Twitter users with a self-disclosed diagnosis of schizophrenia show unique online communication patterns ( Michael L Birnbaum, Ernala, Rizvi, De Choudhury, & Kane, 2017 ), including more frequent discussion of tobacco use ( Hswen et al., 2017 ), symptoms of depression and anxiety ( Hswen, Naslund, Brownstein, & Hawkins, 2018b ), and suicide ( Hswen, Naslund, Brownstein, & Hawkins, 2018a ). Another study found that online disclosures about mental illness appeared beneficial as reflected by fewer posts about symptoms following self-disclosure (Ernala, Rizvi, Birnbaum, Kane, & De Choudhury, 2017). Each of these examples offers early insights into the potential to leverage widely available online data for better understanding the onset and course of mental illness. It is possible that social media data could be used to supplement additional digital data, such as continuous monitoring using smartphone apps or smart watches, to generate a more comprehensive ‘digital phenotype’ to predict relapse and identify high-risk health behaviors among individuals living with mental illness ( Torous et al., 2019 ).

With research increasingly showing the valuable insights that social media data can yield about mental health states, greater attention to the ethical concerns with using individual data in this way is necessary ( Chancellor, Birnbaum, Caine, Silenzio, & De Choudhury, 2019 ). For instance, data is typically captured from social media platforms without the consent or awareness of users ( Bidargaddi et al., 2017 ), which is especially crucial when the data relates to a socially stigmatizing health condition such as mental illness ( Guntuku, Yaden, Kern, Ungar, & Eichstaedt, 2017 ). Precautions are needed to ensure that data is not made identifiable in ways that were not originally intended by the user who posted the content, as this could place an individual at risk of harm or divulge sensitive health information ( Webb et al., 2017 ; Williams, Burnap, & Sloan, 2017 ). Promising approaches for minimizing these risks include supporting the participation of individuals with expertise in privacy, clinicians, as well as the target individuals with mental illness throughout the collection of data, development of predictive algorithms, and interpretation of findings ( Chancellor et al., 2019 ).

In recognizing that many individuals living with mental illness use social media to search for information about their mental health, it is possible that they may also want to ask their clinicians about what they find online to check if the information is reliable and trustworthy. Alternatively, many individuals may feel embarrassed or reluctant to talk to their clinicians about using social media to find mental health information out of concerns of being judged or dismissed. Therefore, mental health clinicians may be ideally positioned to talk with their patients about using social media, and offer recommendations to promote safe use of these sites, while also respecting their patients’ autonomy and personal motivations for using these popular platforms. Given the gap in clinical knowledge about the impact of social media on mental health, clinicians should be aware of the many potential risks so that they can inform their patients, while remaining open to the possibility that their patients may also experience benefits through use of these platforms. As awareness of these risks grows, it may be possible that new protections will be put in place by industry or through new policies that will make the social media environment safer. It is hard to estimate a number needed to treat or harm today given the nascent state of research, which means the patient and clinician need to weigh the choice on a personal level. Thus offering education and information is an important first step in that process. As patients increasingly show interest in accessing mental health information or services through social media, it will be necessary for health systems to recognize social media as a potential avenue for reaching or offering support to patients. This aligns with growing emphasis on the need for greater integration of digital psychiatry, including apps, smartphones, or wearable devices, into patient care and clinical services through institution-wide initiatives and training clinical providers ( Hilty, Chan, Torous, Luo, & Boland, 2019 ). Within a learning healthcare environment where research and care are tightly intertwined and feedback between both is rapid, the integration of digital technologies into services may create new opportunities for advancing use of social media for mental health.

As highlighted in this commentary, social media has become an important part of the lives of many individuals living with mental disorders. Many of these individuals use social media to share their lived experiences with mental illness, to seek support from others, and to search for information about treatment recommendations, accessing mental health services, and coping with symptoms ( Bucci et al., 2019 ; Highton-Williamson et al., 2015 ; Naslund, Aschbrenner, et al., 2016b ). As the field of digital mental health advances, the wide reach, ease of access, and popularity of social media platforms could be used to allow individuals in need of mental health services or facing challenges of mental illness to access evidence-based treatment and support. To achieve this end and to explore whether social media platforms can advance efforts to close the gap in available mental health services in the United States and globally, it will be essential for researchers to work closely with clinicians and with those affected by mental illness to ensure that possible benefits of using social media are carefully weighed against anticipated risks.

Acknowledgements

Dr. Naslund is supported by a grant from the National Institute of Mental Health (U19MH113211). Dr. Aschbrenner is supported by a grant from the National Institute of Mental Health (1R01MH110965-01).

Publisher's Disclaimer: This Author Accepted Manuscript is a PDF file of a an unedited peer-reviewed manuscript that has been accepted for publication but has not been copyedited or corrected. The official version of record that is published in the journal is kept up to date and so may therefore differ from this version.

Conflict of Interest

The authors have nothing to disclose.

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Mental Health Myths and Facts

Can you tell the difference between a mental health myth and fact? Learn the truth about the most common mental health myths and information to help destigmatize them. SAMHSA works to prevent and treat mental health conditions and provides support for people seeking or already in recovery .

Get the Facts

Myth: mental health issues can't affect me..

Fact: Mental health issues can affect anyone. In 2020, about:

• One in 5 American adults experienced a mental health condition in a given year
• One in 6 young people have experienced a major depressive episode
• One in 20 Americans have lived with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression

Additionally, suicide is a leading cause of death in the United States. In fact, it was the second leading cause of death for people ages 10-24. Suicide has accounted for the loss of more than 45,979 American lives in 2020, nearly double the number of lives lost to homicide.

Myth: Children don't experience mental health issues.

Fact: Even very young children may show early warning signs of mental health concerns. These mental health conditions are often clinically diagnosable and can be a product of the interaction of biological, psychological, and social factors.

Half of all mental health disorders show first signs before a person turns 14-years-old, and three-quarters of mental health disorders begin before age 24.

Unfortunately, only half of children and adolescents with diagnosable mental health conditions receive the treatment they need. Early mental health support can help a child before problems interfere with other developmental needs.

Find more resources to start the conversation early.

Myth: People with mental health conditions are violent.

Fact: Most people with mental health conditions are no more likely to be violent than anyone else.

Only 3%–5% of violent acts can be attributed to individuals living with a serious mental illness. In fact, people with severe mental illnesses are over 10 times more likely to be victims of a violent crime than the general population. You probably know someone with a mental health condition and don't even realize it, because many people with mental health conditions are highly active and productive members of our communities.

Myth: People with mental health needs, even those who are managing their mental health conditions, cannot tolerate the stress of holding down a job.

Fact: People with mental health conditions can be just as productive as other employees, especially when they are able to manage their mental health condition well. Employers  often do not know if someone has a mental health condition, but if the condition is known to the employer, they often report good attendance and punctuality as well as motivation, good work, and job tenure on par with, or greater than, other employees.

Myth: Mental health issues are a result of personality weakness or character flaws, and people can "snap out of it" if they try hard enough.

Fact: Mental health conditions have nothing to do with being lazy or weak and many people need help to get better. Many factors contribute to mental health conditions, including:

• Biological factors, such as genes, physical illness, injury, or brain chemistry
• Life experiences, such as trauma or a history of abuse
• Family history of mental health conditions

People with mental health conditions can get better and many seek recovery support.

Myth: There is no hope for people with mental health issues. Once a friend or family member develops a mental health condition, they will never recover.

Fact: Studies show that people with mental health conditions get better and many are on a path to recovery. Recovery refers to the process in which people can live, work, learn, and participate fully in their communities. There are more treatments, services, and community support systems than ever before, and they work:

Myth: Therapy and self-help are a waste of time. Why bother when you can just take a pill?

Fact: Treatment for mental health conditions vary depending on the individual and could include medication, therapy, or both. Many individuals do best when they work with a support system during the healing and recovery process.

Myth: I can't do anything for a person with a mental health issue.

Fact:  Friends and loved ones can make a big difference. In 2020, only 20% of adults received any mental health treatment in the past year, which included 10% who received counseling or therapy from a professional. Friends and family can be important influences to help someone get the treatment and services they need by:

• Reaching out and letting them know you are available to help
• Helping them access mental health services
• Help them learn self-care and coping techniques
• Learning and sharing facts about mental health, especially if you hear something that isn't true
• Treating them with respect, just as you would anyone else
• Refusing to define them by their diagnosis or using labels such as "crazy", instead use person-first language

Myth: It is impossible to prevent a mental health condition.

Fact:  Prevention of mental, emotional, and behavioral disorders focuses on addressing known risk factors, such as exposure to trauma, that can affect the chances that children, youth, and young adults will develop mental health conditions. Promoting a person’s social-emotional well-being leads to:

• Higher overall productivity
• Better educational outcomes
• Lower crime rates
• Stronger economies
• Improved quality of life
• Increased lifespan
• Improved family life

APA Services pushed for new rule strengthening mental health care access

• Mental Health
• Managed Care and Insurance

The Biden administration finalized a new rule on September 9 designed to ensure that Americans with private health insurance can more easily access mental health services. This will help to rectify a stark disparity highlighted in a 2024 study showing that patients were 10.6 times more likely to go out of network for psychological care than for specialty medical care.

The new rule aims to hold insurance companies accountable for practices preventing patients from accessing mental health care as easily as medical care. It mandates that insurance companies assess whether networks include enough mental health providers to meet patient needs, and how that compares to network access for medical patients. This is crucial, as inadequate networks have left many mental health patients feeling like they are navigating “ghost” networks, where finding an in-network provider is nearly impossible. Most of the new requirements will roll out in 2026.

APA Services, the companion advocacy organization to APA, was a major proponent of this new rule and waged a campaign to encourage members to submit comments to the U.S. Department of Labor in support of the rule. In fact, more than 15% of the total number of all federal comments submitted were from psychologists. In addition, 28 of APA’s state, provincial, and territorial psychological associations submitted comments as well.

Katherine B. McGuire, MSc, APA Services chief advocacy officer, noted that the rule’s publication is the fruit of long years of advocacy led by APA Services staff in close coordination with other national behavioral health consumer and provider organizations. “We would simply not be where we are today without the years of diligent work that we and the mental health community devoted to sounding the alarm that stronger enforcement was needed.”

Key points of the new parity rule

• Psychologists’ advocacy: APA Services has long advocated for action to address the suffering caused by inadequate mental health care access. The new rule is seen as a major step toward resolving the mental health crisis.
• Regulatory tools: New tools for regulators include requiring insurers to gather and assess data on whether mental health patients have less access to care compared to medical patients. Insurers must take corrective steps to address significant disparities.
• Network adequacy: Agencies supporting parity have recognized that low pay for mental health providers is one major cause of inadequate insurance networks. The rule ensures that insurance networks take reasonable corrective actions if outcomes data shows that mental health patients have less access to care than medical patients.

The 2008 Mental Health Parity and Addiction Equity Act was a significant step towards ensuring that insurance providers offer equal coverage for mental and medical health services. However, as many providers know, the law’s promise has often fallen short, particularly in areas like insurance network adequacy. Patients frequently struggle to find mental health providers who accept their insurance, while providers struggle with administrative demands seemingly unrelated to clinical care and low reimbursements that have not kept pace with inflation or the rising costs of doing business.

Jared Skillings, PhD, ABPP, APA’s chief of professional practice, highlighted the ongoing challenges. “The American Psychological Association knows that many Americans have faced unnecessary suffering because they have been unable to get timely or adequate mental health care through their insurance. We have been hearing for years about the challenges that psychologists face, including bureaucratic hurdles and low reimbursement.” Skillings emphasized the urgency of addressing these issues. “Ignoring mental health costs lives. That’s why we have fought for this action and change. We are optimistic that the new Parity Rule will be a major step toward addressing the nation’s mental health crisis.”

Skillings pointed out that some insurance companies attribute the main cause of network inadequacy to a workforce shortage. However, APA and recent studies disagree, identifying low reimbursement rates as a significant factor. “There is a large pool of psychologists ready to work with insurance companies if treated fairly,” said Skillings.

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Running & antidepressants have similar benefits for mental health, study finds.

It’s well known that exercise is good for your mental health. Many research studies have confirmed this, yet very few directly compare movement to other methods, often using it as an add-on and not a first line of defense. 

However, research directly studied how exercise (specifically running) compares to antidepressants for depression and anxiety symptoms. Here are the findings—and what they mean for those struggling.

Running and antidepressants reduce depression by 44%

A study published in the Journal of Affective Disorders found that running therapy and antidepressants had similar effects on mental health 1 —about 44% of each group showed improvements in symptoms. 

The 141 participants included in the study had been diagnosed with depression or anxiety before starting treatment. The group was offered the choice of running or antidepressants (SSRIs), with 45 choosing the medication and 96 opting for outdoor running two or more times each week—which they'd follow for 16 weeks.

The lack of randomization was meant to mimic a real-world scenario, researchers said. However, it is worth noting that it does mean the study may be slightly biased. Those who opted for medication may have been less likely to choose running due to depression severity and thus less likely to show improvements with either method. 

The study design also shows some people have an aversion to antidepressants that mirrors what could happen in a doctor's office—some patients want to exhaust other options first, and this study provides one research-backed option for mental health professionals to suggest. 

Other research has shown that some people are less likely to respond positively to antidepressants due to genetic biotypes , further calling for other effective treatment options.

"Interestingly, our study did show a larger decrease in anxiety symptoms after six weeks in the antidepressant group, which suggests faster improvement on especially anxiety-related symptoms," researchers write.

The running group also had a lower adherence rate than the antidepressant group (52% compared to 82%), suggesting that while this method may be effective, it is more difficult to stick with. 

It's worth noting, though, that the participants in the running therapy group also saw improvements in waist circumference, weight, and cardiovascular function—all of which are important markers for overall health and risk of many chronic diseases. 

Is it just running, or all forms of exercise?

This study only focused on running, so it's unclear whether or not participating in another form of aerobic exercise would yield similar results. 

That being said, previous research studies have shown that yoga 2 and general physical activity 3 (including walking) also positively affect mental health. So we can't say that running is the only beneficial workout regimen for depression. It's just one option. 

There are a few reasons why getting the body moving may help with some depression and anxiety symptoms. It may be due to endorphin release, increased oxygen to the brain, perception changes, and more. You can read up on the relationship between exercise and mental health here . 

Plus, this study specifically called for running outdoors, which may have a greater impact on those with depression, given the possibility of connecting with nature ( another A+ habit for brain health ). 

There's no reason to think these two remedies can only exist separately, either. Running may be a positive way to decrease antidepressant use or be used in conjunction with antidepressants for severe depression.

Think of this finding as another tool in the toolbox for health care providers treating depression and those struggling daily. 

RELATED READ: Is the Runner's High Real? A Doctor Explains the Benefits

The takeaway

A study found that antidepressants and running had a similar positive impact on depression when compared directly over the course of 16 weeks. What's more, runners showed positive improvements in various physical health markers. If you've considered picking up running for the physical or mental perks but don't know where to start, here's a beginner's guide . 

• https://pubmed.ncbi.nlm.nih.gov/36828150/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871291/
• https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2720689

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Deanna Barch Receives National Academy of Medicine’s Sarnat Prize for Contributions to Research and Treatment of Mental Health Disorders

Sep 16, 2024 | News

WASHINGTON — The National Academy of Medicine (NAM) today announced that Deanna Barch is the recipient of the 2024 Rhoda and Bernard Sarnat International Prize in Mental Health for her seminal contributions to advancing understanding of the developmental psychopathology and treatment of mental health disorders, in addition to her devoted mentorship of early career investigators. The award, which recognizes her achievements with a medal and $20,000, will be presented at the NAM Annual Meeting on Oct. 20. Barch is vice dean of research, Gregory B. Couch Professor of Psychiatry, and a professor of psychological and brain sciences and of radiology at Washington University in St. Louis.

Barch’s research has shaped understanding of the neural and psychological causes of cognitive impairments and negative symptoms in schizophrenia and opened new perspectives on treatment. Her work helped establish impairments in dopamine-related cognitive control as a core component of schizophrenia-related cognitive dysfunction and a transdiagnostic feature across psychotic disorders.

Barch has also made significant advances in the area of childhood poverty and the mechanisms of its negative impact on brain and behavioral development. She has applied rigorous neuroscience models to early childhood developmental psychopathology in a way that has advanced the field significantly and given greater traction to the importance of early identification, intervention, and elucidation to neural mechanisms of disease and treatment targets.

In addition to her research, Barch has held an active leadership role in several large neuro-imaging consortia. She has facilitated the training and productivity of many early career scientists within and outside her own institution — a high proportion of which are currently pursuing academic careers in mental health research. Barch has received numerous awards and honors, including a National Institute for Mental Health MERIT Award, Association of Women in Neuroscience Mentor Award, and the Society for Biological Psychiatry Gold Medal Lifetime Achievement Award.

“Not only has Dr. Barch led important research that is central to understanding the etiology and developmental mechanisms of mental disorders across the life span, but she has been a tireless mentor to the next generation of clinician scholars,” said NAM President Victor J. Dzau. “Congratulations to Dr. Barch, whose focus on clinical translation to advance public health and dedication to training young scientists show she is an exemplar of a generous scientist.”

Since 1992, the Sarnat Prize has been presented to individuals, groups, or organizations that have demonstrated outstanding achievement in improving mental health. The prize recognizes — without regard for professional discipline or nationality — achievements in basic science, clinical application, and public policy that lead to progress in the understanding, etiology, prevention, treatment, or cure of mental disorders, or to the promotion of mental health. As defined by the nominating criteria, the field of mental health encompasses neuroscience, psychology, social work, nursing, psychiatry, and advocacy.

The award is supported by an endowment created by Rhoda and Bernard Sarnat of Los Angeles. Rhoda Sarnat was a licensed clinical social worker, and Bernard Sarnat was a plastic and reconstructive surgeon and researcher. The Sarnats’ concern about the destructive effects of mental illness inspired them to establish the award. This year’s selection committee was chaired by Peter R. MacLeish, George H.W. and Barbara P. Bush Professor of Neuroscience, and professor, department of neurobiology, Morehouse School of Medicine.

The National Academy of Medicine , established in 1970 as the Institute of Medicine, is an independent organization of eminent professionals from diverse fields including health and medicine; the natural, social, and behavioral sciences; and beyond. It serves alongside the National Academy of Sciences and the National Academy of Engineering as an adviser to the nation and the international community. Through its domestic and global initiatives, the NAM works to address critical issues in health, medicine, and related policy and inspire positive action across sectors. The NAM collaborates closely with its peer academies and other divisions within the National Academies of Sciences, Engineering, and Medicine .

Contact: Dana Korsen, Director of Media Relations Office of News and Public Information 202-334-2138; email [email protected]

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Maslow and Mental Health Recovery: A Comparative Study of Homeless Programs for Adults with Serious Mental Illness

• Original Article
• Published: 12 February 2014
• Volume 42 , pages 220–228, ( 2015 )

Cite this article

• Benjamin F. Henwood 1 ,
• Katie-Sue Derejko 2 ,
• Julie Couture 1 &
• Deborah K. Padgett 2  

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This mixed-methods study uses Maslow’s hierarchy as a theoretical lens to investigate the experiences of 63 newly enrolled clients of housing first and traditional programs for adults with serious mental illness who have experienced homelessness. Quantitative findings suggests that identifying self-actualization goals is associated with not having one’s basic needs met rather than from the fulfillment of basic needs. Qualitative findings suggest a more complex relationship between basic needs, goal setting, and the meaning of self-actualization. Transforming mental health care into a recovery-oriented system will require further consideration of person-centered care planning as well as the impact of limited resources especially for those living in poverty.

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A Mixed-Methods Study of the Recovery Concept, “A Meaningful Day,” in Community Mental Health Services for Individuals with Serious Mental Illnesses

Understanding the ups and downs of living well: the voices of people experiencing early mental health recovery, micropolitics of mental health recovery: an assemblage analysis of people’s experiences of becoming well.

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Henwood, B.F., Derejko, KS., Couture, J. et al. Maslow and Mental Health Recovery: A Comparative Study of Homeless Programs for Adults with Serious Mental Illness. Adm Policy Ment Health 42 , 220–228 (2015). https://doi.org/10.1007/s10488-014-0542-8

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The figure is a stacked line graph, conveying cumulative visit rates and spend rates across mental health diagnoses.

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Kalmin MM , Cantor JH , Bravata DM , Ho P , Whaley C , McBain RK. Utilization and Spending on Mental Health Services Among Children and Youths With Commercial Insurance. JAMA Netw Open. 2023;6(10):e2336979. doi:10.1001/jamanetworkopen.2023.36979

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Utilization and Spending on Mental Health Services Among Children and Youths With Commercial Insurance

• 1 RAND Corporation, Santa Monica, California
• 2 Castlight Health, San Francisco, California
• 3 Stanford University, Palo Alto, California
• 4 RAND Corporation, Arlington, Virginia

The COVID-19 pandemic severely tested the mental health of children and youths due to unprecedented school closures, social isolation and distancing, and COVID-19–related mortality among family. 1 , 2 In response, health systems offered telehealth to increase access to pediatric mental health care. 3 However, the extent to which telehealth availability led to greater pediatric mental health service utilization and spending is largely unknown. In this study, we examined telehealth, in-person, and overall pediatric mental health service utilization and spending rates from January 2019 through August 2022.

In this cross-sectional study among children and youths (aged <19 years) receiving services for the most common pediatric mental health diagnoses (anxiety disorders, adjustment disorder, attention-deficit/hyperactivity disorder [ADHD], major depressive disorder, and conduct disorder), we quantified diagnosis-specific and overall trends and changes in monthly utilization (mental health diagnosis codes used as proxy) and spending rates between 3 phases related to SARS-CoV-2: (1) prepandemic, before the national public health emergency declaration (January 1, 2019, to March 12, 2020); (2) acute, before vaccine availability (March 13 to December 17, 2020); and (3) postacute (December 18, 2020, to August 31, 2022). Monthly medical claims data (categorized by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] diagnostic codes 4 ) provided by Castlight Health were used to measure trends in utilization per 1000 beneficiaries and spending (accounting for inflation by indexing 2020 to 2022 rates to 2019) per 10 000 beneficiaries among approximately 1.9 million children and youths with commercial insurance throughout the US (eAppendix in Supplement 1 ). The RAND institutional review board deemed this study exempt and waived informed consent because deidentified claims data were used. We followed the STROBE reporting guideline.

We estimated longitudinal, fixed-effects regressions segmented by each period for each diagnosis and overall. Fixed effects were included for US state and patient biological sex to account for associated variability. Standard errors were clustered at the state level to account for multiple facilities within each state. Precision estimates were reported using 2-sided 95% CIs. Analyses were conducted with Stata version 16.0 (StataCorp) from April to May 2023.

Among approximately 1.9 million claims for children and youths with commercial insurance, utilization and spending trends were generally consistent across pediatric mental health diagnoses ( Figure ), allowing for collapsing of estimates. Compared with prepandemic, in-person pediatric mental health services declined by 42% during the pandemic’s acute phase, while pediatric telehealth services increased 30-fold (3027%), representing a 13% relative increase in overall utilization. By August 2022, in-person services returned to 75% of prepandemic levels and tele–mental health utilization was 2300% higher than prepandemic levels. During the postacute period, we observed a gradual increase in spending rates compared with prepandemic for in-person, telehealth, and total visits. From January 2019 to August 2022, mental health service utilization increased by 21.7%, while mental health spending rates increased by 26.1%.

The Table shows the diagnosis-specific and overall results of the longitudinal, fixed-effects segmented regressions for utilization and spending accounting for state and patient sex among in-person and telehealth visits. For each diagnosis and overall, there was at least 1 statistically significant difference between 2 consecutive periods (intercept term) and at least 1 statistically significant change within each period (slope) for both utilization and spending.

After comparing mental health care service utilization and spending rates for children and youths with commercial insurance across 3 periods, we found differences between periods as well as different rates of change within each period for both visit types, even after accounting for state and patient sex. Utilization and spending increased over the entire timeframe. ADHD, anxiety disorders, and adjustment disorder accounted for most visits and spending in all phases.

The study has limitations. First, these data represent only children and youths with commercial insurance. Utilization patterns, care needs, and spending may differ for other pediatric patient populations such as Children’s Health Insurance Program recipients or children and youths lacking health insurance. Additionally, we did not have available data to distinguish between new and existing pediatric patients, and thus cannot specify whether increases result from an overall population increase in mental health diagnoses or a utilization increase among existing patients.

Our findings indicate that pediatric telehealth care for mental health needs filled a critical deficit in the immediate period following the emergence of COVID-19 and continues to account for a substantial proportion of pediatric mental health service utilization and spending. Supported by evidence that telehealth can effectively deliver mental health treatment for children and youths, 5 , 6 these findings have important implications for telehealth sustainability beyond the effects of COVID-19.

Accepted for Publication: August 29, 2023.

Published: October 3, 2023. doi:10.1001/jamanetworkopen.2023.36979

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2023 Kalmin MM et al. JAMA Network Open .

Corresponding Author: Mariah M. Kalmin, PhD, RAND Corporation, 1776 Main St, Santa Monica, CA 90401 ( [email protected] ).

Author Contributions: Drs Cantor and Whaley had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Kalmin, Cantor, Whaley, McBain.

Acquisition, analysis, or interpretation of data: Kalmin, Bravata, Ho, Whaley, McBain.

Drafting of the manuscript: Kalmin, Bravata, McBain.

Critical review of the manuscript for important intellectual content: Cantor, Bravata, Ho, Whaley, McBain.

Statistical analysis: Cantor, Whaley.

Obtained funding: Cantor, Bravata, McBain.

Administrative, technical, or material support: All authors.

Supervision: Bravata, Whaley, McBain.

Conflict of Interest Disclosures: Dr Cantor reported receiving grants from the National Institute of Mental Health during the conduct of the study and from the National Institute on Aging outside the submitted work. Dr Bravata reported receiving personal fees from Castlight Health during the conduct of the study. Dr Whaley reported receiving personal fees from Castlight Health outside the submitted work. No other disclosures were reported.

Funding/Support: This study was funded by grants from the National Institute of Mental Health (R21MH126150) and the National Institute on Aging (K01AG061274 and R01AG073286).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 2 .

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Franssy Zablah , Ph.D., is a native Spanish-speaker who was born and raised in Honduras. She is an assistant professor in the Department of Psychological and Brain Sciences at the University of Delaware. Dr. Zablah received her B.A. in psychology from the University of New Orleans and completed a predoctoral internship in integrated behavioral health at Nemours Children’s Hospital, in Wilmington, Delaware. She received her Ph.D. in clinical psychology, with a concentration in children, families, and cultures, from the Catholic University of America. She completed specialized training in dissemination and implementation science as a post-doctoral fellow at the University of Delaware’s Center for Training, Evaluation, and Community Collaboration (C-TECC). She continues to be actively involved in various research and community engagement projects and student supervision at C-TECC.

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New federal rules to make mental health care more accessible, affordable: U-M experts can discuss

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EXPERTS ADVISORY

The federal government has enacted a set of final federal rules aimed at ensuring that people with mental health conditions receive similar insurance coverage for needed care as they would for physical health conditions.

Experts from the University of Michigan and Michigan Medicine can discuss the changes and how they may affect individuals, families, insurers and the health care system, which has made finding and paying for mental health treatment more taxing than other health care needs—and for many people unattainable.

A national shortage of mental health care providers and a rise in diagnosis of mental health conditions exacerbates the issue.

The following U-M experts are available to comment:

Srijan Sen is director of the Eisenberg Family Depression Center and the Frances and Kenneth Eisenberg Professor of Depression and Neurosciences at the U-M Medical School.

“I think the specific changes are worthwhile, most notably reducing prior authorizations and gathering data,” he said. “But I do think the impact of these changes will be limited without concurrent changes to expand the capacity of our mental health care system.”

Contact: Kara Gavin, [email protected] , 734-764-2220

Mark Fendrick , who directs the Center for Value-Based Insurance Design, is a professor of internal medicine at the Medical School and professor of health management and policy at the School of Public Health. He studies how individuals choose to spend money on the health care they most need, and the impact of insurance policy requirements and federal rules on such spending.

“Numerous studies have demonstrated that even modest levels of out-of-pocket cost are associated with lower use of clinically necessary, high-value mental health services and treatments,” he said. “Further, these reductions can lead to downstream consequences including worsening of illness and increased need for acute care and hospitalization.

“Parity in insurance coverage can address the need to balance appropriate access to essential mental health services with growing fiscal pressures faced by public and private payers.”

Joanna Quigley is the associate medical director for child and adolescent outpatient psychiatry and addiction treatment at Michigan Medicine, and a clinical associate professor of psychiatry at the Medical School.

“Moving true parity for mental and behavioral health care continues to be elusive for many, and interventions that remove barriers during a time of unprecedented demand for mental health care, are welcome,” she said. “It will be very important to monitor implementation of these changes, particularly around the goals of limiting the scope of limits set through prior authorization processes and limits on length or type of treatment settings.”

Victor Hong is the director of psychiatric emergency services at Michigan Medicine and clinical associate professor of psychiatry at the Medical School.

“For many years, clinicians, hospital systems and most importantly, patients, have suffered the consequences of continued lack of mental health parity, despite there technically being a law enforcing this issue,” he said. “Any new laws and/or amendments to the law require input from all stakeholders, to ensure that common sense, practical, comprehensive legislation can be forthcoming. Importantly, these laws need teeth sufficient enough so that the penalties for payors motivate changes in their behavior.”

Chad Ellimoottil is the medical director of virtual care for Michigan Medicine, assistant professor of urology at the Medical School and lead author of a report on telehealth in Michigan commissioned by the Michigan Health Endowment Fund and the Flinn Foundation.

“Our recent report on telehealth use in Michigan showed that half of all Michigan counties have less than 10 mental health specialists, and 1 in 5 Michigan counties have one or no such providers,” he said. “In the 38 counties with the most dire shortages, 57% of all visits with such providers take place via telehealth for patients with traditional Medicare, and 47% of all mental health visits were with providers in other counties.

“These data show that telehealth meant greater access to mental health care for people living in areas that lack providers of such care.”

Briana Mezuk is a professor of epidemiology and co-director for the Center for Social Epidemiology and Population Health at the School of Public Health. Her training and research explore the various ways that mental and physical health intersect throughout life.

She says the new federal rules build on much-needed implementation of core provisions in the 2008 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act. It is intended to prevent health insurers from limiting or denying patients seeking mental health care.

“Leaders in the field have argued that there is no health without mental health, and the Wellstone Act seeks to ensure that mental health care is given equal footing to medical care. This is an important milestone in addressing the substantial mental health needs of Americans. However, it is critical to understand that even with these regulations, the mental health care needs of Americans will not be met by specialists alone—there are simply not enough psychologists, psychiatrists and social workers, particularly in rural and underserved areas, to meet this need.

“Instead, the vast majority of mental health care in the U.S. will continue to be provided by general practitioners. To support these general practitioners, who often lack training in psychosocial interventions, it is essential that health care systems and payers embrace coordinated team-based care models. Team-based care—which typically involves a general practitioner, nurse and a mental health specialist working together to support the patient—not only generates better clinical outcomes for patients with co-occurring mental and physical health problems, it is also cost-effective for managing such complex health needs. Payers and health care systems need to invest in these types of structural and personnel solutions to complex patient care to genuinely embody the spirit of the Wellstone Act.”

Contact: [email protected]

Kyle Grazier is the Richard Carl Jelinek Professor of Health Services Management and Policy at the School of Public Health and a professor of psychiatry at the Medical School. She is interested in improving access to behavioral health care services for vulnerable populations.

Grazier sees progress and reason for optimism in the new federal rules and also knows the improvements meant to repair the current system of mental health care and insurance will take time.

“While there is a general shortage of behavioral health providers, the challenges of finding care are exacerbated by the lack of affordable and available access,” she said. “Even among those who have private health insurance and despite the state and federal parity laws in the past 15 years, group health plans and health insurers that provide mental health and substance use disorder benefits continue to impose less favorable limitations on those benefits than on medical or surgical benefits.

“For the consumer, the out-of-pocket cost for therapy or medication management can be prohibitive, and much more expensive than equivalently complex or time-consuming medical procedures, even if a provider is in an insurer’s network. The stark imbalance between needing care and receiving care has led to a call to respond to the behavioral health crisis.”

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