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Basch et al

Original Paper

Deconstructing TikTok Videos on Mental Health: Cross-sectional,
Descriptive Content Analysis
Corey H Basch1, MPH, EdD; Lorie Donelle2, PhD; Joseph Fera3, PhD; Christie Jaime1, MA
1Department of Public Health, William Paterson University, Wayne, NJ, United States

2

Arthur Labatt Family School of Nursing, Western University, London, ON, Canada

3

Department of Mathematics, Lehman College, City University of New York, Bronx, NY, United States

Corresponding Author:
Corey H Basch, MPH, EdD
Department of Public HealthWilliam Paterson University
300 Pompton Rd
Wayne, NJ, 07470
United States
Phone: 1 973 720 2603
Email: baschc@wpunj.edu

Abstract
Background: Social media platforms that are based on the creation of visual media, such as TikTok, are increasingly popularwith adolescents. Online social media networks provide valuable opportunities to connect with each other to share experiences
and strategies for health and wellness.
Objective: The aim of this study was to describe the content of the hashtag #mentalhealth on TikTok.
Methods: This cross-sectional, descriptive content analysis study included 100 videos with the hashtag #mentalhealth on TikTok.
All videos that included the hashtag #mentalhealth were analyzed and coded for the presence of content categories. Additionally,
the comments to each video were viewed and coded for content in the following themes: offering support or validation; mentioning
experience with suicide or suicidal ideation; mentioning experience with self-harm; describing an experience with hospitalization
for mental health issues; describing other mental health issues; and sharing coping strategies, experiences of healing, or ways tofeel better.
Results: Collectively, the 100 videos studied received 1,354,100,000 views; 266,900,000 likes; and 2,515,954 comments. On
average, each video received 13,406,930.69 (SD 8,728,095.52) views; 2,657,425.74 (SD 1,449,920.45) likes; and 24,910.44 (SD21,035.06) comments. The only content category observed in most (51/100, 51%) of the videos included in the sample was“general mental health.” The remaining content categories appeared in less than 50% of the sample. In total, 32% (32/100) of thevideos sampled received more than the overall average number of likes (ie, more that 2.67 million likes). Among these 32 videos,
23 (72%) included comments offering support or validation and 20 (62%) included comments that described other mental healthissues or struggles.
Conclusions: With over 1 billion cumulative views, almost half of the assessed TikTok videos included in this study reported
or expressed symptoms of mental distress. Future research should focus on the potential role of intervention by health care
professionals on social media.
(JMIR Form Res 2022;6(5):e38340) doi: 10.2196/38340
KEYWORDS
TikTok; mental health; adolescent; social media; short video apps; content analysis; digital health; online health; visual media;
descriptive content analysis; mental distress; health professional; health care professional

Introduction
Access to accurate and accessible health information, support,
and services are required for effective health carehttps://formative.jmir.org/2022/5/e38340

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decision-making. This applies across the health care continuum
and is inclusive of self-health promotion and participation inshared decision-making with health care provider teams [1-6].
Individuals rely on family, friends, and health care professionals
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for support, yet seek health-related information online at thesame time [7,8]. In general, adolescents live in a hybrid
reality—a mix of offline and online worlds [9]. They are
increasingly seeking information about healthy lifestyles (fitness,diet), gender identity, sexual health, and mental health issues
from online websites, social media platforms, wearable
self-tracking apps, and other adolescents within online
communities [10,11]. However, adolescents are less acceptingof online or wearable apps that require them to input information[7]. Overall, online media and social media apps are seen as
simple to use, unidentifiable, and impartial sources of healthinformation by adolescents [7,12]. Health-related stories frompeers are particularly valued among adolescents [7,13].
Influencers on social media, adolescents who create content,
and microcelebrities are increasingly important resources forhealth-related information and social support [7,14-16].
However, adolescents may find the sheer volume of online
information challenging and are not always confident in theirability to discern accurate information from misinformation or
disinformation [7].
Social media platforms that are based on the creation of visualmedia, such as TikTok, are popular with adolescents. TikTok,a video-based social media platform, has been leveraged as away to disseminate health-related information, and this has been
especially visible during the COVID-19 pandemic [17]. The
vast reach of TikTok worldwide offers a unique approach fordisseminating information to the millions of users ranging fromchildren to adults. As a social media platform, TikTok creators
combine music and dance attached to personal messages thatare widely disseminated [17].
Several studies have been conducted on the health-related
content on TikTok. These studies indicate that a wide range ofissues have been examined, including health promoting andcompromising issues. Examples include, but are not limited to,studies related to COVID-19 mitigation, eating disorders,vaping, climate change, and equity issues [12,18-26].
Specific to mental health information and social support,
researchers determined that youth and young adults appreciatedshared experiences within online discussion forums, citing
accessibility, anonymity, inclusivity, sense of control, andmitigation of stigma as valued resource characteristics [12].
Preference for seeking health information online or throughpeer-to-peer sharing can reflect individuals’ concerns orexperiences with nonaffirming or discriminatory health careproviders [12]. Furthermore, peer-to-peer health information
sharing may fill the gaps in social support from health systems,
health-specific information, and insight into “how to live” withchronic diseases including mental health. In particular, selectTikTok videos may serve as relevant educational resources forhealth care professionals’ education and training [12]. However,research exploring mental health content on TikTok isessentially absent from published research literature.
Online social media networks provide valuable opportunities
to connect with each other to share experiences and strategies
for health and wellness, such as meditation, mindfulness, stressrelief, and those specific to mental health conditions [13]. Mental
health issues are highly prevalent in adolescents. According tohttps://formative.jmir.org/2022/5/e38340

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Basch et al
the World Health Organization, “globally, one in seven
10-19-year-olds experiences a mental disorder, accounting for
13% of the global burden of disease in this age group” [27].
Given these statistics, combined with the popularity of TikTok
use in this age group [28], the aim of this study was to describe
the content of the hashtag #mentalhealth on TikTok.

Methods
Data Collection and Analysis
This cross-sectional, descriptive content analysis study included
videos with the hashtag #mentalhealth on TikTok. The methods
were based on prior research and established methodology[24,29,30]. By using the “discover” function on the TikTokplatform and a hashtag search of #mentalhealth, a sample of thefirst 100 videos was collected. At the time of the study, thehashtag had 25.3 billion views. This was the most viewed
hashtag in this area at the time of the study (January 2022).
Only English-language videos were considered for this sample.
For each video, the date of posting and the number of views,
comments, and likes were documented. All videos that included
the hashtag #mentalhealth were analyzed and coded for thepresence of additional content categories. The content categories
included general mental health (nonspecific disorder), anxiety
or fear, depression, stress, suicide, self-harm, interpersonal
relationships, physical health conditions or variables, child or
adolescent mental health, mental health stigma, statistics andthe prevalence of mental health disorders or issues, biologicaland neurological influences of mental health, missing otherpeople or connections due to COVID-19, personal experience,and coping techniques or treatment.
Additionally, the comments associated with each video wereviewed and coded inductively for content in the following
themes: offering support or validation; mentioning experience
with suicide or suicidal ideation; mentioning experience with
self-harm; describing an experience with hospitalization for
mental health issues; describing other mental health issues or
struggles; and sharing coping strategies, experiences of healing,or ways to feel better. All data were collected, categorized, andorganized by a single reviewer (CJ), and a random number
generator was used to identify a subset of (10%) the videos tobe analyzed by a second reviewer (CB) to determine interrater
reliability. The interrater reliability score (κ=0.97) indicated ahigh level of consensus. Microsoft Excel was used to record,organize, and analyze the data collected.

Ethical Considerations
This study was excluded from institutional ethics board review,as the William Paterson University Institutional Review Board
does not review studies that do not involve human participants.

Results
Overall, the 100 videos studied received 1,354,100,000 views;
266,900,000 likes; and 2,515,954 comments. On average, each
video received 13,406,930.69 (SD 8,728,095.52) views;
2,657,425.74 (SD 1,449,920.45) likes; and 24,910.44 (SD21,035.06) comments. Of the 100 videos, a majority (n=84,84%) were classified as consumer-generated; only 13 (13%)
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Basch et al

were classified as influencer- or verified-user–generated, withthe remaining classified as heath care professional–generated(n=1, 1%), television- or internet-based news (n=1, 1%), andtelevision-based entertainment (n=1, 1%).

these videos. The most common themes observed in the videos’comments sections were “offering support or validation”(61/100, 61%) and “describing other mental health issues or
struggles” (49/100, 49%).

In Table 1, the first column lists the 14 different content
categories of the video data and the second column details how
many of the 100 videos sampled included this content. The tablealso includes the number of views, likes, and comments thatthe videos with these particular features garnered. Relative
percentages from the total are included as well. The content
category “statistics and prevalence of mental health disorders
or issues” was omitted from the table since it was not featured
in any of the sampled videos.

In total, 32% (32/100) of the videos sampled received morethan the overall average number of likes (ie, more than 2.67
million likes). Among these 32 videos, 23 (72%) included
comments offering support or validation and 20 (62%) included
comments describing other mental health issues or struggles.
The remaining themes were included in ≥10 videos: sharedcoping strategies, experiences of healing, or ways to feel better(10/32, 31%); describing an experience with hospitalization for
mental health issues (7/32, 22%); mentioning experiences withsuicide or suicide ideation (6/32, 19%); and mentioning
experience with self-harm (2/32, 6%).

The only content category observed in a majority (51/100, 51%)of the videos sampled was “general mental health.” Theremaining content categories appeared in less than 50% of thesample. “Personal experience” was the next most prevalent
category observed in the videos and it appeared in 40% (40/100)of the sample. The remaining content categories appeared inless than 20% of the sample, with the following 5 content
categories appearing in less than 5% of the sample: anxiety or
fear, physical health conditions or variables, stress, mental healthstigma, and missing other people or connections due to
COVID-19.
Table 2 provides information about the themes noted in thevideos’ comments. This table shows 6 different themes, thenumber of videos with comments that reflected these themes,
and the associated number of views, likes, and comments of

The frequently used words excerpted from the comments sectionof the TikTok platform are shown in Multimedia Appendices1-2. Multimedia Appendix 1 shows the negative sentiments
portrayed in the comments that reflect serious mental healthconcerns, which were expressed in response toparticipant-posted TikTok videos depicting issues of depression,
grief, sadness, anger, loneliness, and trauma. In contrast,
Multimedia Appendix 2 shows social support and collective
optimism in the comments about the posted TikTok videos.
These comments were caring and reflected encouragement,
praise, and acceptance. It is important to note that thesecomments were generally presented in the context of support
from those who allegedly have shared experiences or trauma.

Table 1. Observed content, views, likes, and comments of 100 TikTok videos on mental health.
Content categories

Videos (N=100),

Views (N=1,354,100,000),

Likes (N=266,900,000),

Comments (N=2,515,954),

n (%)

n (%)

n (%)

n (%)

General mental health51 (51)

703,700,000 (51.97)

149,000,000 (55.83)

1,331,622 (52.93)

Personal experience

40 (40)638,900,000 (47.18)

128,400,000 (48.11)

1,093,179 (43.45)

Interpersonal relationships

18 (18)366,200,000 (27.04)

75,100,000 (28.14)

440,502 (17.51)

Depression

13 (13)

213,700,000 (15.78)

39,000,000 (14.61)

294,830 (11.72)

Suicide13 (13)

151,600,000 (11.20)

31,000,000 (11.61)

414,316 (16.47)

Coping techniques or treatment 9 (9)53,700,000 (3.97)

12,400,000 (4.65)

144,074 (5.73)

Child or adolescent mental
health142,700,000 (10.54)

28,700,000 (10.75)

200,305 (7.96)

Biological and neurological in- 8 (8)fluences of mental health

91,600,000 (6.76)

15,700,000 (5.88)

238,355 (9.47)

Self-harm

5 (5)62,600,000 (4.62)

15,000,000 (5.62)

181,375 (7.21)

Anxiety or fear

4 (4)58,600,000 (4.33)

10,600,000 (3.97)

42,000 (1.67)

Physical health conditions orvariables

4 (4)100,300,000 (7.41)

15,900,000 (5.96)

184,800 (7.35)

Stress3 (3)50,900,000 (3.76)

8,300,000 (3.11)

25,100 (1.00)

Mental health stigma

1 (1)11,500,000 (0.85)

2,200,000 (0.82)

6,405 (0.25)

Missing other people or connec- 1 (1)tions due to COVID-19

49,200,000 (3.63)

10,200,000 (3.82)

68,300 (2.71)

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Table 2. Themes noted in the videos’ comments and the associated number of views, likes, and comments.
Theme

Videos (N=100),

Views (N=1,354,100,000),

Likes (N=266,900,000),

Comments (N=2,515,954),

n (%)

n (%)

n (%)

n (%)

61 (61)

884,300,000 (65.31)

178,500,000 (66.88)

1,663,433 (66.12)

Describing other mental health 49 (49)issues or struggles

677,500,000 (50.03)

145,300,000 (54.44)

1,419,131 (56.41)

Sharing coping strategies, expe- 16 (16)riences of healing, or ways tofeel better

301,500,000 (22.27)

64,200,000 (24.05)

448,510 (17.83)

Mentioning experience withsuicide or suicidal ideation

14 (14)

171,400,000 (12.66)

37,700,000 (14.13)

369,724 (14.7)

Describing an experience withhospitalization for mental
health issues

11 (11)

210,000,000 (15.51)

41,500,000 (15.55)

262,565 (10.44)

Mentioning experience with
self-harm

7 (7)87,000,000 (6.42)

17,100,000 (6.41)

187,339 (7.45)

Offering support or validation

Discussion
Principal Findings
It is important to note the reach of the videos included in thisstudy. With over 1 billion cumulative views, almost half of theassessed TikTok videos included in this study reported or
expressed symptoms of mental distress. Other studies haveobserved the expression of mental ill-health within online social
media platforms [31] and expressed concern about potentiallytraumatic and “triggering” TikTok videos as being detrimental
to some viewers [32]. This is especially concerning given thefrequency of screen time among adolescents. Many adolescentsare predominant TikTok participants, and there is a potential
for contribution to poor mental health outcomes from repetitious
and prolonged viewing, especially if traumatic events arefeatured in the videos [32]. Recently, TikTok has acknowledged
the substantial impact of their platform on users’ mental healthand have provided additional resources in support of user safety,
health, and mental wellness [33]. Specific to the issues of mental
health, TikTok has produced well-being guides in partnershipwith the several international mental health organizations to
support and uptake optimal messaging on the TikTok platform[34]. However, there is limited insight into the impact of
traumatic or “triggering” events posted within the online
platform [35], the use and impact of the TikTok mental healthresources, or conversely, the health enhancing impact of positiveand supportive messaging among youth who engage with social
media [36,37]
Over 60% of the videos in this study had associated commentsthat were supportive and validating; this can signify theimportance of the TikTok platform and the hashtag#mentalhealth as a possible “just-in-time” source of social
support and personal validation that is made available without
the need for planning, scheduling, and financial renumeration.
Notably, comments that depict coping strategies were not overly
common; they were apparent in about 10% of the videos withhigh numbers of collective views. Given the seriousness of the
topics, these findings point to the fact that videos alone only
tell part of the story. Health care professionals are active onsocial media and, specifically, TikTok [17,38]. Comp et al [17]https://formative.jmir.org/2022/5/e38340

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noted that TikTok therapists, some with millions of followers,
are actively providing corrective information to mental healthmisinformation and combatting mental health stigma on TikTok.
However, it is important to note that the videos in this sample
were largely posted by consumers and not by health care
professionals. Hence, further research is needed on the extent
to which corrective mental health information is prevalent on
popular mental health hashtags. Further, our findings indicatethat health care professionals, particularly those who aim toprovide corrective information, should be aware of and attend
to both the video content and its related commentary.

Future Implications
Future research should focus on the potential role of intervention
by health care professionals on social media. This would createchanges for clinician practice, including raising issues related
to the ethics of following patients online, concerns related to
fake accounts, the user performance factor assumed as part of
the TikTok platform, and mental health assessment of social
media consumption [31]. As partnerships between health care
professionals and social media platforms emerge, evaluation
on effectiveness and best practices will be essential.
Interestingly, the call for research related to greater
understanding of TikTok health content creators, the integrityof the content, and user reaction and uptake to promote
evidence-based information [35] to TikTok users may becontrary to the current appeal and need for accessible
health-related resources that are different from mainstream
medicine [12].

Limitations
The findings of this study offer insight into the use of TikTok
to discuss mental health issues. However, this study is limitedby the cross-sectional design. Further, the inclusion ofEnglish-only TikTok posts is limiting; videos posted in otherlanguages may contribute to a more comprehensive
understanding of the mental health conversations posted using
the hashtag #mentalhealth. Other hashtags that specify a mental
health illness or experience (suicide, anxiety, or depression)
may have captured different videos than those captured by thegeneric use of hashtag #mentalhealth. Nonetheless, this study
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can serve as a foundation for further research to assess both thevideo content and its associated discussions, which are bothBasch et alimportant components to consider in studying mental healthcontent on TikTok.

Conflicts of Interest
CHB serves as an Editorial Board Member for JMIR; she did not have a role in the review or editorial process for this article.
All other authors declare no conflicts of interest.

Multimedia Appendix 1
Negative mental health sentiments portrayed in the comments associated with 100 TikTok videos.
[PNG File , 1235 KB-Multimedia Appendix 1]

Multimedia Appendix 2
Sentiments of social support and collective optimism portrayed in the comments associated with 100 TikTok videos.
[PNG File , 1466 KB-Multimedia Appendix 2]

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Edited by A Mavragani; submitted 29.03.22; peer-reviewed by T Mathews, A Pal; comments to author 21.04.22; revised version
received 29.04.22; accepted 01.05.22; published 19.05.22
Please cite as:
Basch CH, Donelle L, Fera J, Jaime C
Deconstructing TikTok Videos on Mental Health: Cross-sectional, Descriptive Content Analysis
JMIR Form Res 2022;6(5):e38340
URL: https://formative.jmir.org/2022/5/e38340
doi: 10.2196/38340
PMID:

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