High volumes of mental health-related tweets associated with crisis referrals

A study has found that referrals to mental healthcare providers for patients requiring urgent help were significantly greater on days with a higher than average number of tweets mentioning mental health.

This new research was supported by the National Institute for Health Research (NIHR) South London and Maudsley NHS Foundation Trust Biomedical Centre (BRC).

social media and mental health referralsPrevious studies have shown that social media use, portrayal of mental illness in the media and public discussions around mental health may be associated with negative mental health outcomes. However, research to date has primarily focused on high-profile events reported by the news media. Associations with mentions of mental health on social media have remained understudied.

Research published in the Scientific Reports compared the number of tweets containing keywords associated with two important health disorders -  depression and schizophrenia ― with recorded referrals for ‘crisis episodes’ to South London and Maudsley NHS Foundation Trust and Camden and Islington NHS Foundation Trust.

Between January 2010 and December 2014, 48,691 crisis episodes were recorded by South London and Maudsley NHS Foundation Trust. In this period 32,689 crisis episodes were recorded by Camden and Islington NHS Foundation Trust. On days with a higher than average number of tweets mentioning depression, schizophrenia or showing support for either illness, the researchers observed a 5-15% increase in the number of mental health-related crisis episodes referred to the two mental healthcare providers.

Dr Anna Kolliakou, lead author and Clinical Informatics Interface and Network Lead at Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, said:

We’ve all been aware recently that social media use can have a negative impact on adolescents and older adults and our study took a further step to explore associations between conversations on social media related to mental health and those who may be sensitive to this material such as service users or other individuals experiencing mental health issues.
Given the substantial association we found between an increase in proportions of relevant tweets and an increase in crisis episodes, there may be ground for developing an automatic system to monitor these fluctuations on Twitter. This could be beneficial in alerting healthcare professionals about potentially problematic conversations trending online. That way, advice from services could be informed much earlier than it normally would have resulting in more effective consultations with patients.

This study was made possible both through the previous European funding of the PHEME project and through the ongoing support of NIHR for Clinical Records Interactive Search (CRIS) at the Biomedical Research Centre. Importantly we were also able to double-check our findings with the help of colleagues at University College London who have similar mental healthcare information available in north London.

Professor Robert Stewart, Clinical Informatics Lead at the NIHR Maudsley Biomedical Research Centre, said:

This study is one of the first to bring together information from social media and information from mental health services to look at the timing of events on Twitter and the timing of crises experienced by people receiving mental healthcare. This is the sort of study that has been made possible because of information on people’s experiences from routine health services that can be used for research in an anonymised and secure format.

The authors suggest that further research is needed to determine the potential factors underlying these associations and whether social media platforms can be monitored by healthcare services to identify vulnerable groups and predict times of higher risk.

King’s Health Partners is committed to joining up mental and physical healthcare, training and research to improve health outcomes for our patients and service users. Visit our website to find out more about our Mind & Body programme and the vital work we are doing. 

The King’s Health Partners Psychological Medicine and Integrated Care Clinical Academic Group delivers world-class specialist services in mood disorders, eating disorders, mother and baby, psychosexual, neuropsychiatry, memory disorders and HIV in the context of mental health.