Mental health discussion on Twitter in the UK

Research

Beth GranterJanuary 2014

@brilliantnoisebrilliantnoise.com

© 2014 Brilliant Noise All rights reserved

Scope of research

We’ve looked at a sample of discussions about mental health on Twitter in the UK, over the period of one month.

We’ve looked at:

- most discussed topics

- tweets which had the most impact

- organisations / individuals with the most impact

- differences in conversation between genders

- how much people talked about themselves vs others

Key findingsDepression was the most discussed mental health issue followed by insomnia and anxiety. (Slide 25)

Aside from Christmas, most discussed additional factors were stress, alcohol and food. (Slide 42)

Schizophrenia was discussed more by men; Anxiety, eating disorders and panic were discussed more by women. (Slide 68)

Alcohol, autism, dyslexia, bullying, disability, homelessness and race all discussed more by men. Food, abuse/assault and LGBTQ discussed more by women. (Slide 69)

@mindcharity was the organisation with the most impact and made significantly more tweets than any other MH charity account. (Slide 22)

The most popular content was by generic ‘fact’ type accounts. (various)

How charities could use the findingsCharities can be reassured that their focus on depression reflects what people are talking about most.

They might decide to increase their discussion of issues such as insomnia, which were discussed more by others than by the charities themselves.

RE gender differences, charities might compare how the rate of discussion reflects or contradicts statistics of diagnosis, and consider what this means to sufferers.

Other charities might take note of the high volume and impact of tweeting by @mindcharity, and use this as a benchmark to aim for in their own tweeting strategy.

The popularity of MH facts could influence content strategy.

This study reflects a snapshot in time, where the prevalence of some topics will be driven by seasonality and/or the news agenda, whilst others will be consistent. Repeating the study on an ongoing basis could shed more light on these patterns. Charities may want to consider how easily they can respond to current events to raise the profile of key issues at optimum times.

Out of scope

Some of the things you asked us to look at, but which we unfortunately weren’t able to do at this point include:

- the effect of tweeting on people’s mental health

- what people do after tweeting / reading a tweet

Key words / query

Key words / query = the words which need to be mentioned in order to appear in our results.

Over 100 key words were included, mostly from this list on Wikipedia: http://en.wikipedia.org/wiki/List_of_mental_disorders

We also included a list of the Twitter accounts of major mental health organisations in the UK, to capture everything they tweeted and any mention of them.

The full query is in the appendix.

Considerations

Some key words around the topic of mental health are used quite commonly, and not necessarily whilst discussing them in the context of a serious mental health issue. e.g. ‘stress’.

- this means that mentions of ‘stress‘ were only brought in when other terms in the query such as ‘mental health’ were also mentioned. Similarly ‘bereavement’ was not included independently.

- autism, asperger’s syndrome and dyslexia were removed as they are not considered to be mental health conditions (ref. NHS). These were however discussed by people within mental health conversations, so are categorised in this report as related issues.

Our sample covered the following numbers of tweets, all tweeted between 01 December 2013 and 31 December 2013, by people in the UK.

We divided the conversations into:

people talking about mental health, generally or specifically

people talking to mental health organisations directly

what mental health organisations were saying

Tweets can be in more than one category.

Results

191,25021,722

2,576

Topics (free text, uncategorised)

Across mental health conversations, words or phrases which were most commonly used were:

Christmas

Feelings

Missing someone causes insomnia

suffering from depression

Xmas my teachers gave

suffer from insomnia

To mental health organisations

From mental health organisations

Topics (free text, uncategorised)

Xmas

People with mental health

1 in 4

Great

Retweet

Read

Christmas / Xmas

Watch / read

New Year

Young people

Emotional support

NIMHchats

Words and phrases mentioned the most, to and from mental health organisations

Top links (mental health)

Horoscope site mentioning paranoia

Horoscope site mentioning anxiety

MP John Woodcock blogs about depression

Depression animation on Upworthy

Top 6 tips to beat depression article

10 symptoms of depression article

Christmas social anxiety BBC article

Advert for Frankincense to treat depression and anxiety

Depression animation on Upworthy

Photo tweeted by Frankie Boyle

Links which were tweeted the most overall:

Top hashtags and most mentioned tweeter

Mental health To mental health organisations

From mental health organisations

Hashtags and accounts mentioned the most, in general mental health discussion, and to and from MH organisations

Impact - tweets and authors

Tweets with most impact overall

Aside from tweets by @Fact, the top tweets were about the Mandela memorial service sign language interpreter having schizophrenia.

http://twitter.com/BBCBreaking/statuses/411027460214779904https://twitter.com/piersmorgan/statuses/411101780496248832

Tweets with most impact overall

Next top tweets were both by Stephen Fry asking for support for Mind:

http://twitter.com/stephenfry/statuses/414697033199411202http://twitter.com/stephenfry/statuses/414390661279145984

Individual authors with most impact overall

Although filtered to exclude Twitter accounts recognised as ‘organisational’, all of the top authors except @Lesism, @fruitbatwalton and @Sectioned_ only retweeted @Fact, so are likely to be automated, not individuals).

Individual authors with most impact overall

Individual authors with most impact overall

Non-individuals with most impact overall

http://twitter.com/caitlinmoran/statuses/411043726765862913http://twitter.com/Fact/statuses/413504599509581824

Tweets with the most impact mentioning ‘mental health’

http://twitter.com/stephenfry/statuses/414697033199411202http://twitter.com/stephenfry/statuses/413000714311307264

More tweets with high impact mentioning ‘mental health’

Tweets with the most impact by mental health organisations

Mental health organisations with most impact overallLeft to right in order of total combined impact; height of bar represents volume of tweets. e.g. TimetoChange published fewer tweets than @MindFullUK, but the former had more impact

Topics grouped by issue and additional factorsDue to the variety of ways people talk about mental health issues, conversations were categorised by type of mental health issue (e.g. depression) and by other topics discussed in relation to mental health (e.g. money).

Note - mentions can be in more than one category.

Topics grouped by issue

DepressionInsomniaAnxietyOCDBipolarSchizophreniaPanicEating disordersMental health (general)Uncategorised

76,23728,53725,2618,4325,5075,4963,9763,902

22,59534,156

Mental health discussion To mental health organisations From mental health organisations

Topics (grouped by issue & query)

74,54528,53024,960

19,1718,391

5,3405,2123,9323,80716,735

Mental healthDepressionSchizophreniaAnxietyBipolarEating disordersPanicOCDInsomniaUncategorised

Mental healthDepressionAnxietySchizophreniaBipolarEating disordersPanicOCDInsomniaUncategorised

DepressionInsomniaAnxietyMental healthOCDBipolarSchizophreniaPanicEating disordersUncategorised

32211,552267261154904139

716,027

2031404017135320

2,142Schizophrenia and anxiety discussed in similar volumes TO mental health orgs, but anxiety discussed twice as much as schizophrenia BY the orgs. Insomnia and OCD discussed in high volume in general, but in low volume to or by mental health organisations. Eating disorders and Schizophrenia discussed less than other major MH issues in general, but discussed more to and by MH organisations. Most of the conversations to and from MH organisations were not about these specific MH issues, but more varied.

}Topics (grouped by issue)

}

Depression

Depression was overwhelmingly the most common term. Where mental health organisations were not included, a lot of people were using the term quite casually, and likely not intending to discuss it as a serious mental health condition. e.g. “I’m depressed that...” was often used as a general term to denote something someone didn’t like, as an alternative to saying ‘sad’ or ‘unhappy’.

Mood swings, cancer and a story about @JWoodCockMP having depression were discussed.

Depression

Discussion about depression

https://twitter.com/Fact/statuses/417497286009028608

Tweets with most impact about depression

The top 99 tweets by impact score were all by @Fact, an account followed by over half a million people, tweeting facts such as:

All of which received a large number of retweets.

@FactsInYourFace tweeted a large number of similar high reaching tweets.

http://twitter.com/guardian/statuses/408510649804009472 http://twitter.com/OwenJones84/statuses/408535972641382400

Tweets with most impact about depression

Aside from @Facts or @FactsInYourFace, top tweets about depression were:

Insomnia

Insomnia was another very common term, but not when people were talking to mental health organisations. It was commonly used by people to simply describe the fact that they couldn’t get to sleep that night, right then, rather than discussing an ongoing mental health problem.

The fact that people describe this symptom regularly but don’t discuss it with mental health organisations is interesting. Do they use the term too lightly, or not take it seriously, or not consider it a MH issue?

Insomnia

Discussion about insomnia

Tweets with the most impact about insomnia

As with depression, the top tweets by impact score were also all by @Fact and @FactsInYourFace. After this, top tweets were:

http://twitter.com/TimzyHasAnEgo/statuses/408117231420461056http://twitter.com/carakilbey/statuses/408027797685559296

Anxiety

Anxiety was a very common term, and in most cases people seemed to be using it to talk seriously about their own experiences of anxiety.

Depression and panic attacks were discussed alongside anxiety, as well as eating disorders.

That said, the most retweeted tweet about anxiety was a Christmas poem about homework.

Anxiety

Discussion about anxiety

Many of these terms were driven by the retweeting of one poem about homework.

Tweets with the most impact about anxiety

As with depression and insomnia, the top tweets by impact score were also all by @Fact and @FactsInYourFace. After this, top tweets were:

http://twitter.com/BBCNews/statuses/413587314297028608http://twitter.com/TheTumblrPosts/statuses/410179462861316096

Mental health specifically mentioned

Topics grouped by additional factor

*did not include mentions of ‘gay’ due to high volume of homophobic use of the word as an insult. Likewise discussions of race are likely to be higher than reported here due to complexity of terms in conversation.

These additional factors are not mental health issues, but we were interested in how much these factors were discussed alongside mental health discussion.

Topics (grouped by additional factor)

(Christmas excluded)

NB ‘alcohol abuse’ and ‘alcoholism’

were included in main query

(Christmas excluded)

These additional factors are not mental health issues, but we were interested in how much these factors were discussed alongside mental health discussion.

Alcohol/abuse/assault and MH discussed more in general than directly to MH orgs. LGBTQ/money and MH discussed more directly to MH orgs (relatively). Autism discussed more to MH orgs than by MH orgs. Alcohol discussed more by MH orgs than to MH orgs.

Mental health To mental health organisations

From mental health organisations

Topics (grouped by additional factor)

ChristmasStressAlcoholFoodMoneyAbuse/assaultAutismDisabilityBullyingLGBTQHomelessnessRaceUncategorised

ChristmasMoneyStressFoodAutismDisabilityLGBTQBullyingAlcoholHomelessnessAbuse/assaultRaceUncategorised

ChristmasFoodMoneyStressDisabilityAlcoholLGBTQHomelessnessAutismBullyingAbuse/assaultRaceUncategorised

9,922 5,471 3,752 2,068

1,615 689 675 600 491 274 259 172

173,550

2,945 366 347 191 182 114 65 60 50 35 22 6

20,284

445 61

46 44 16 14 10 7 6 5 3 1

2,363

Christmas

Due to the report covering December, Christmas was the most common term. Lots of people talked about feeling depressed and anxious at Christmas.

In particular social anxiety and depression were discussed.

The most retweeted tweet was the same light hearted Christmas poem about homework causing anxiety, which drove most of the key terms around Christmas.

Christmas

Discussions about Christmas and mental health

Many of these terms are driven by retweets of the one homework related poem.

Discussions about Christmas and mental healthThe top tweets about Christmas included the same two top tweets about anxiety. After those, top tweets were:

http://twitter.com/NHSChoices/statuses/417636775805210624http://twitter.com/StanCollymore/statuses/413628066720935936

Stress

Stress was often discussed alongside depression and anxiety.

Approximately a third of mental health discussions which mentioned stress were from ‘fact’ type accounts, or retweets of their tweets.

Stress

Discussion about stress

Tweets with the most impact about stress

As with depression and insomnia, the top tweets by impact score were also all by @Fact and @FactsInYourFace. After ‘fact’ accounts, top tweets were:

http://twitter.com/MindCharity/statuses/410441393497448448http://twitter.com/MindCharity/statuses/410362053384478720

Alcohol

Discussions mentioning alcohol abuse and alcoholism were mainly serious, with a lot of discussion about a news story that charities expect an increase in alcohol abuse.

Domestic abuse and substance misuse also were discussed alongside alcohol.

There were however quite a few sarcastic comments about Christmas drinking which used terms such as ‘alcoholic’ as a joke.

There were significantly more discussions of alcohol abuse from the audience than to or from mental health organisations.

Note that discussions of alcoholism were included in the research without the need to mention additional mental health issues.

Alcohol

Discussions about alcohol and mental health

Tweets with the most impact about alcohol and mental healthThe top tweet was another from @Fact, after which:

http://twitter.com/alaindebotton/statuses/413297126840340482http://twitter.com/guardian/statuses/411714872317980672

Food

Most of the tweets about food and mental health were retweets of ‘fact’ account tweets.

Many of the tweets were about types of food which improved mental health conditions such as depression e.g. bananas.

Also some commentary around people eating more when they are depressed.

Food and mental health

Discussions about food and mental health

Tweets with the most impact about food and mental healthThe top tweets were more from ‘fact’ accounts, after which:

http://twitter.com/hexachordal/statuses/413768624596209664http://twitter.com/laurenofthesea/statuses/415844414486216704

Money

Discussions about money when not directed to or from a mental health organisation were commonly about wanting the Government to spend more money on mental health services.

When in relation to a mental health organisation, discussions around money were usually about fundraising or donating to the charity.

Money

Discussions about money and mental health

Tweets with the most impact about money and mental health(Discussion of ‘poverty’ was categorised as ‘money’)

http://twitter.com/sturdyAlex/statuses/414058930449698816 http://twitter.com/FactsInYourFace/statuses/414359704367030273

Gender

Gender considerationsGender is applied based on the assumed gender of a person’s name.

Where gender is not obvious from the name, the mention is not assigned as any gender.

This means it’s possible that more mentions might be categorised as male or female depending on how obviously gendered the names are. e.g. ten mentions by ‘Alex’ and three mentions by ‘Sophie’ would show as 100% female, even if the Alex mentions were in fact all male.

As such, these results should be treated with caution. What is interesting though, is how different issues vary - that difference is unlikely to be due to how gendered the names are, so more likely to show real gender differences in discussion around a topic.

Gender overall

Gender per issue

Schizophrenia was discussed more by men; could this have been driven by the news agenda at the time? (The Mandela interpreter story)

Anxiety, eating disorders and panic in particular were discussed more by women, but all other topics and overall discussion was by more women than men.

Do these correlate with the different experiences or diagnoses of men/women with different mental health issues?

Gender per other topic discussed in relation to mental health

All

Autism, race, alcohol, homelessness, bullying all discussed more by men. Food, LGBTQ, abuse/assault, money, stress all discussed more by women. Note logarithmic scale.

Gender and discussion of self or otherAll

All discussions were more likely to come from women, but discussions of ‘self’ were particularly more likely to come from women than men.

Do women find it easier to disclose their own experiences/feelings?

We looked at whether people talked about themselves or others the most when talking about mental health. Comments such as ‘I am’ or ‘I feel’ were categorised as ‘self’ and comments such as ‘she is’, ‘he is’, ‘you are’ were categorised as ‘other’.

All

Gender and original tweets vs retweetsAllWe looked at whether people created original tweets, or retweeted

other people’s. Of all the tweets we analysed, 60% were original tweets and 40% were retweets. Whilst women tweeted and retweeted more than men, both tweeted or retweeted at similar proportions.

All

Demographics (beta)

Demographics (beta) considerationsThis data is based on key words in biographies, and is in ‘beta’ mode in Brandwatch at the moment.

As such should be treated with caution.

Mental health organisation tweets have been removed.

This data would be more useful when compared to general Twitter demographics.

Demographics (beta) professions

Professions across all mental health conversations:

Demographics (beta) interestsInterests across all mental health conversations:

Query

Query considerationsKeywords were sourced from this page on Wikipedia: http://en.wikipedia.org/wiki/List_of_mental_disorders

Some words in the list were removed as they were highlighted by professionals as not being mental health issues e.g. Alzheimer’s.

However, it is likely that some other words remaining in the query are not professionally considered to be mental health issues. As we are not mental health professionals, we have, where not advised otherwise, kept the large list from the Wikipedia page, rather than risk making incorrect judgements of our own.

The report could be improved through partnership with a mental health organisation to validate the search terms.

site:"twitter.com" AND

country:uk AND

("mental health" OR"Adjustment disorder" OR

((Adolescent OR adult OR childhood) NEAR/5 "antisocial behavior") OR

"cognitive decline" ORAgoraphobia OR

((Alcohol OR Barbiturate OR Benzodiazepine OR cannabis OR cocaine) NEAR/20 (abuse OR dependence OR withdrawal OR misuse OR addiction)) OR

alcoholism OR"Amnestic disorder" OR"Amphetamine dependence" OR"Amphetamine withdrawal psychosis" ORAnorexia ORamnesia OR"personality disorder" ORAnxiety OR"Anxiolytic-related" OR"Attention deficit" OR

(raw:ADD AND (attention OR deficit)) OR

hyperactivity ORAutophagia ORBibliomania OR"eating disorder" ORBipolar OR"Body dysmorphic" OR"Borderline intellectual functioning" OR "Borderline personality" ORpsychotic OR

Appendix: mental health queryBulimia OR"Caffeine-related disorder" ORClaustrophobia OR"Catatonic disorder" OR schizophrenia OR"sleep disorder" OR"Cognitive disorder" OR"Communication disorder" OR"Conduct disorder" OR"Cotard delusion" ORCyclothymia OR"Delirium tremens" OR"Depersonalization disorder" OR"Depressive disorder" ORDepression OR depressed OR"Derealization disorder" ORDesynchronosis OR"Developmental coordination disorder" OR"Diogenes Syndrome" ORDispareunia OR"Dissociative identity disorder" OR Dysthymia OREDNOS OREncopresis OR"Ekbom's Syndrome" OR "Delusional Parasitosis" OREnuresis ORErotomania ORExhibitionism OR"Factitious disorder" OR"Fregoli delusion" ORFrotteurism OR"Fugue State" OR"Ganser syndrome" OR"General adaptation syndrome" OR"Grandiose delusions" OR"Hallucinogen-related disorder" OR"Hallucinogen persisting perception" OR"Histrionic personality" OR"Hypomanic episode" ORHypochondriasis ORHypochondria OR "Impulse control disorder" OR"Inhalant abuse" ORInsomnia OR

"Intellectual disability" OR"Intermittent explosive disorder"Kleptomania OR"Korsakoff's syndrome" OR"Lacunar amnesia" OR"Male erectile disorder" ORMalingering OR"Manic episode" OR"Mathematics disorder" OR"Medication-related disorder" ORMelancholia ORMisophonia OR"Mood disorder" OR"Mood episode" OR"Morbid jealousy" OR"Munchausen's syndrome" ORNarcissistic OR"Neglect of child" OR"Neuroleptic-related disorder" OR"Nicotine withdrawal" OR"Night eating syndrome" OR"Nightmare disorder" OR"Obsessive-compulsive" OR OCD OROneirophrenia OR"Opioid dependence" OR"Opioid-related disorder" OR"Oppositional defiant disorder" OR "Pain disorder" OR"Panic disorder" OR "panic attack" OR

(Paranoia NOT (game OR playing)) OR

Parasomnia OR"Parkinson's Disease" OR"Partner relational problem" OR"Pathological gambling" ORPerfectionism OR"Persecutory delusion" OR"Pervasive developmental disorder" OR PDD ORPhencyclidine OR"Phobic disorder" OR"Phonological disorder" OR"Physical abuse" ORPica OR"Polysubstance-related disorder" OR

"Post-traumatic embitterment" OR PTED OR"Posttraumatic stress" OR PTSD OR"Primary hypersomnia" OR"Primary insomnia" OR"Psychological factor" ORPsychotic ORPyromania OR"Reactive attachment" OR"Reading disorder" OR"Recurrent brief depression" OR"Relational disorder" ORsenile OR senility ORschizophrenia OR"Rett's disorder" OR"Rumination syndrome" ORSchizoaffective ORSchizoid ORSchizophrenia ORSchizophreniform OR Schizotypal OR"Seasonal affective disorder" OR

((Sedative OR hypnotic OR anxiolytic) NEAR/10 "related disorder") OR

"Selective mutism" OR"Severe mental retardation" OR"Sleep disorder" OR"Sleep terror" ORSleepwalking OR"Social phobia" ORSomatization ORSomatoform OR"Specific phobia" OR"Stendhal syndrome" OR"Stereotypic movement disorder" ORStuttering OR"Substance-related disorder" OR"Tardive dyskinesia" ORTourette OR Tourettes OR Trichotillomania)

site:"twitter.com"

AND (

author: (timetotalk OR mindcharity ORtimetochange ORyoungmindsuk ORrethink_depressionall ORstarwards ORcharitysane ORnsunnews ORmindfulluk ORbeated ORmicprisons ORbwdmind ORls_mind ORbristolmind ORcardiff_mind ORulverstonmind ORandovermind ORmmic_ ORmanchestermind ORleedsmind ORmindwestsussex ORkaleidoscope_pg ORnottsmind ORsunderlandmind ORmindincroydon ORmborostcktnmind ORpfmind ORyaspproject ORsuffolkmind ORhf_mind ORmidessexmind ORtynesidemind ORrb_mind ORwashingtonmind ORflintshiremind ORwelmind1 ORmindbrighton ORlancsmind OR inworksupport OR

Appendix: to or by mental health orgs querymindinharingey ORstockportmind ORmindincambs ORtogmind ORrochdalemind ORmindinenfield ORtelfordmind ORjemfmurphy ORvoicecollective ORshorpshiremind ORwboroughmind ORwestleicsmind ORmattsolentmind ORcolchestermind ORsouthendmind ORtheyorkmind ORminortranx ORrestormelmind ORmindhey ORmatvmind ORwest_essex_mind ORoxfordshiremind ORchmind ORswanseamind ORemergenceplus ORmental_healthy ORendthestigma ORmhf_tweets ORontheborderline ORnimhgov ORmentalhealth_uk ORtogetheruk ORanxietyuk ORrcpsych) OR

timetotalk ORmindcharity ORtimetochange ORyoungmindsuk ORraw:@rethink_ OR raw:@ReThink_ OR raw:@Rethink_ ORdepressionall ORstarwards ORcharitysane ORnsunnews OR

mindfulluk OR(raw:@beatED OR raw:@beated OR raw:@BEATED OR raw:@Beated) ORmicprisons ORbwdmind ORls_mind ORbristolmind ORcardiff_mind ORulverstonmind ORandovermind ORmmic_ ORmanchestermind ORleedsmind ORmindwestsussex ORkaleidoscope_pg ORnottsmind ORsunderlandmind ORmindincroydon ORmborostcktnmind ORpfmind ORyaspproject ORsuffolkmind ORhf_mind ORmidessexmind ORtynesidemind ORrb_mind ORwashingtonmind ORflintshiremind ORwelmind1 ORmindbrighton ORlancsmind ORinworksupport ORmindinharingey ORstockportmind ORmindincambs ORtogmind ORrochdalemind ORmindinenfield ORtelfordmind ORjemfmurphy ORvoicecollective ORshorpshiremind ORwboroughmind ORwestleicsmind ORmattsolentmind OR

colchestermind OR southendmind ORtheyorkmind ORminortranx ORrestormelmind ORmindhey ORmatvmind ORwest_essex_mind ORoxfordshiremind ORchmind ORswanseamind ORemergenceplus ORmental_healthy ORendthestigma ORmhf_tweets ORontheborderline ORnimhgov ORmentalhealth_uk ORtogetheruk ORanxietyuk ORrcpsych)