TikTok has rapidly become the fastest-growing social media platform among children and young adults in the modern digital era. However, while platforms like Facebook, Instagram, and Twitter have come under intense academic scrutiny regarding their potential impact on youth mental health, TikTok remains a relatively underexplored area. In a groundbreaking study from Dublin City University, Darragh McCashin and Colette M. Murphy systematically explore TikTok’s role in public and youth mental health.

Despite the ubiquitous nature of TikTok, it has attracted limited academic attention, especially within psychology and psychiatry. McCashin and Murphy dive into this uncharted territory. The research duo first conducted a systematic review of existing studies focusing on TikTok’s role in public health or mental health. The follow-up involved a content analysis targeting TikTok’s use in an Irish context.

Their findings? Varied use of TikTok for several public and mental health purposes, though institutional accounts have been slow on the uptake. McCashin remarks in the study:

“Globally, TikTok is now the fastest growing social media platform among children and young people, but it remains surprisingly under-researched in psychology and psychiatry. This is despite the fact that social media platforms have been subject to intense academic and societal scrutiny regarding their potentially adverse effects on youth mental health and wellbeing, notwithstanding the inconsistent findings across the literature.”

TikTok is a social media company owned by the Chinese tech company ByteDance Ltd., which has led to controversy around the platform in the United States. There have been multiple attempts to block or ban the platform within the U.S. Despite this, as Darragh McCashin and Collette Murphy point out, TikTok continues to grow and is the most widely used platform by children and young people (CYP).

“TikTok allows users to consume and create short videos between 15–60 in length, using various filters, music, and lip-syncing templates,” the authors explain. “TikTok’s unique selling point is that the content presented to an individual is algorithm-driven and tailored to their indicated preferences and previously liked content.”

As with all social media platforms, including Facebook and Twitter (now ‘X’), public health officials and mental health practitioners have been interested in using the platform to disseminate useful information. Past research into the other platforms has continued into this decade. Still, due to the recency of TikTok’s expansion, there is not yet a great deal of information about how it is being used to disseminate this information, if the information being disseminated is accurate, and what possibilities exist within the platform to educate CYP.

Researchers Darragh McCashin and Colette M. Murphy from Dublin City University aimed to delve into data on TikTok’s role in public and mental health, addressing the current knowledge gaps.

To accomplish this, they devised two distinct studies. Study 1 systematically reviewed research on how TikTok disseminates public and mental health information to children and young people (CYP). In contrast, Study 2 revisited this strategy, adding an Irish-specific lens to the data.

Study 1 utilized a specific search strategy that combined key terms from public and mental health with “TikTok.” This search spanned six databases – PsycINFO, PUBMED, Wiley, and the Journal of Medical Internet Research (JMIR) – from 2016 to 2021. The criteria for selection included English language publications that primarily centered on TikTok. Both quantitative and qualitative studies underwent a systematic review process.

While most of the studies were from the USA (n=20), the research also incorporated findings from China, Ireland, Australia, and Canada. Various research methods were employed, including content analysis, thematic analysis, and case studies. Some even adopted mixed methodologies within cross-sectional designs. The studies spanned diverse topics like COVID-19, dermatology, eating disorders, cancer, tics, radiology, sexual health, DNA, and general public health promotion, presenting McCashin and Murphy with a comprehensive scope. However, after a rigorous review, only six studies met their benchmark for “good quality.”

Given TikTok’s recent surge in popularity, there’s a shortage of extensive literature on the platform for in-depth analysis. Compared to other major social media platforms, this research found limited studies available for broader interpretation. Moreover, McCashin and Murphy observed a conspicuous lack of diverse methodologies in existing research. They advocate for a more varied analytical approach in future TikTok studies.

In conclusion, the researchers cautiously pointed out the potential of TikTok as a tool for promoting positive mental and public health messages. Yet, given its widespread use and limited supporting evidence of its impact on CYP, they emphasize caution regarding its possible adverse effects. They noted a significant void in the prevalence of “professionally accredited information” on the platform, indicating an urgent need for more authoritative content.

This means that most of the information comes from laypeople disseminating information and may come from several sources, including inaccurate ones.

“This presents a dilemma to the wider TikTok audience – to what extent can a pre-teen userbase distinguish between reputable mental and public health professional information versus non-professional equivalents?” the researchers write.

“Controlled studies examining relationships between behavioral change and TikTok engagement across different topics will advance our understanding of the precise factors influencing either positive or negative outcomes. More multidisciplinary in-depth studies that blend data science approaches to collecting qualitative data, alongside clinical interpretation, will assist in building best practice guidance for professionals who would like to use TikTok to convey important and likely impactful information to CYP.”

Examinations of the use of social media platforms, especially as the landscape changes so quickly and frequently, are essential both from a public health perspective (ensuring people have accurate information; providing information is updated as needed) and from an ethical perspective (identifying bad actors disseminating insufficient information for personal gain; ensuring ethical controls are in place for practitioners sharing information).

In addition, a recent study found that self-labeling with mental illness diagnosis is rampant within social media, especially on TikTok, which may lead to additional suffering within CYP.

The findings reveal that youth who stopped self-labeling improved their self-esteem, which shows “additional support for the outsight perspective, signaling that self-labels are generally harmful to youth self-esteem, and by extension, shedding them can yield positive effects.”

Challenging negative perceptions, presenting alternative viewpoints, and sharing facts that differ from conventional beliefs are essential for everyone, including children and young people (CYP). Professionals, researchers, and practitioners need to recognize both the risks and potentials of this social media platform.

 

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McCashin D, Murphy CM. Using TikTok for public and youth mental health – A systematic review and content analysis. Clinical Child Psychology and Psychiatry. 2023;28(1):279-306. doi:10.1177/13591045221106608 (Link)