Mental health discourse and social media: Which mechanisms of cultural power drive discourse on Twitter

The global burden of mental health disorders has increased steadily during the past decade. Today, mental illness is the leading cause of total years lived with disability. At the same time, global mental health policies and budgets fall short of addressing the societal burden as mental health discourse languishes in the shadows due to stigma. As social media have become an increasingly popular source of information, they create opportunities as well as threats for mental health discourse. On the one hand, social media can help to bring awareness to stigmatized topics as they give marginalized members of society the possibility to share experiences and voice their discontent. On the other hand, mental health discourse on social media may lead to stigmatization. To date, little is known about social media mental health discourse and what drives it. This study addresses these research gaps by (1) mapping the mental health discourse on Twitter and (2) analyzing mechanisms of cultural power through which some mental health topics take prevalence over the others. Drawing on Twitter data, this research employs innovative methods of topic modeling, sentiment analysis, and panel data regression analyses. Theoretically, it combines, in a multidisciplinary fashion, concepts such as emotional energy and cognitive focus from sociology and bandwagon behavior from economics. Our findings show that low-cost attention mechanisms are ineffective in fostering online mental health discourse, whereas emotional energy and discursive variability have a positive influence by engaging audiences, creating online solidarity, and speaking to worldviews of audiences from different walks of life. Social media mental health discourse is also shown to be quite diverse and more stigma-neutral than such discourse in traditional media.