What experts think about TikTok's new mental health features

·9 min read

Many of the TikTok videos using the hashtag begin the same way.

Haunting chords play from Canadian singer-songwriter Patrick Watson’s “Je te laisserai des mots,” which roughly translates from French to “I’ll leave you notes.” On the screen, text appears stating some version of, “It’s national suicide prevention month, so here’s what I would’ve missed if I had been successful.”

What comes next varies. Sometimes, the user makes jokes about hardships. But others are sincere, flashing quick images of smiles at weddings, prenatal ultrasounds, late nights out with friends, the first kiss of a new love, and more.

The videos, which use the #suicidepreventionmonth hashtag, coincided with Suicide Prevention Awareness Month, which takes place every September.

@megannha

in honor of suicide prevention month

♬ yelena belova needs a hug - eliza 💌

The trend picked up just as TikTok announced last week that it would be implementing new resources for those who were struggling with suicidal ideations. The new tools include: An in-app resource list of crisis hotlines around the world to help users in every region; information on how to engage safely with someone who may be in crisis; resources, including the Crisis Text Line helpline, whenever someone searches for a term such as #suicide.

Some mental health experts told NBC News the added resources are a step in the right direction, while others believe links and disclaimers can only go so far in helping people.

Regardless, the consensus among those interviewed is that the decision to make such changes to the app signals a positive shift in how social media platforms are handling the mental health of their users, particularly those who are younger.

“Social media platforms have become a space for our kids and marginalized adolescents … to really express themselves, to identify and relate to one another,” said Phyllis Alongi, the former clinical director for the Society for the Prevention of Teen Suicide, who now works in private practice. “And we don’t want it to be unbalanced. We want to minimize risk and maximize resources.”

Mental health-related videos on TikTok remain popular

TikTok's decision to add resources is in line with the communities of users who have turned to the platform to embrace conversations around mental health.

While not a new category of video by any means, mental health and wellness videos became commonplace on the platform during the pandemic, as people grappled with loneliness and other hardships.

The #MentalHealth hashtag has been viewed more than 16.4 billion times on the app and the #MentalHealthMatters hashtag has been viewed more than 13.5 billion times. Even the misspelled #mentalheath hashtag has been viewed more than a billion times.

TikTok says it’s proud to be a space for young people to have honest and open discussions about their mental well-being, but said that it wants to ensure its platform is hosting these communities safely.

Related: Blogs and accounts whose sole purpose is to mock influencers often target women. However, many of the people lobbing the criticisms are women themselves.

"We're honored people feel safe and comfortable sharing their personal journeys and experiences on TikTok and are proud to partner with experts to provide survivors, friends, and family in our community with access to well-being support and information,” Tara Wadhwa, director of policy for TikTok US, said in a email.

In addition to its new features around discussions of suicide, TikTok also expanded its resources for those who struggle with an eating disorder.

Earlier in the year, TikTok rolled out a feature that would provide resources if someone searched for a term related to an eating disorder.

The platform also added a banner on content that had potentially problematic, yet common hashtags like #WhatIEatInADay that linked back to support resources and information.

Nadia Addesi, a Toronto-based registered social worker, psychotherapist and TikToker with more than 3.1 million followers, said she had one client who struggled to talk about her obsessive compulsive disorder until she saw others talking about their mental health on TikTok.

The app, Addesi said, helped her client finally seek professional help.

"It was not until a video on TikTok made them realize that this was a disorder and they were not alone," she said. "Therefore, yes, I believe [TikTok] is improving lives and even saving lives in some cases."

Providing resources on platforms is a 'responsible' move

TikTok has been a helpful way for young people to feel less isolated, according to experts who say it's especially critical to provide resources, as apps themselves can contribute to the mental health issues of their users.

“Self-esteem and confidence, we know that this is an issue, especially with teenage girls," Alongi said. “Giving kids information about solid resources and having that at their fingertips in the language in which they speak is a preventative measure, and I think it’s responsible on the part of the platform."

A recent Wall Street Journal report about Facebook revealed that the social media giant has found in its research that Instagram, its photo-sharing app, is harmful to a significant percentage of teenagers.

According to a presentation from Facebook, obtained by the Journal, "teens blame Instagram for increases in the rate of anxiety and depression."

“Thirty-two percent of teen girls said that when they felt bad about their bodies, Instagram made them feel worse,” the Facebook researchers reportedly wrote in their findings.

In a response to a request for comment, Instagram directed NBC News to a blog post discussing the Journal story, saying the platform is focused on addressing the negative comparisons it has become associated with. It also states that it is considering nudging users who linger on a certain topic for too long.

"From our research, we’re starting to understand the types of content some people feel may contribute to negative social comparison, and we’re exploring ways to prompt them to look at different topics if they’re repeatedly looking at this type of content," the blog post reads.

Having hard conversations around suicide, eating disorders and mental health on social media, especially with young people in mind, is a necessity, Alongi said — one that more platforms must take on.

“We have to be responsible and I’m so happy we’re talking about it, that we’re having conversations about it,” she said. “If we’re going to have social media platforms and we’re going to speak the language of our adolescents, we are responsible for keeping them as safe as we possibly can.”

But there's still work to be done, experts say

Despite the continued emphasis on mental health resources on TikTok, some experts said they’re skeptical about how many young people will actually utilize them.

Dr. Angela Guarda, the director of the eating disorders program at Johns Hopkins Hospital, expressed concerns that the way in which the resources are presented — a homepage of information, a banner at the bottom of a video and a list of resources when searching for terms related to an eating disorder — are not as engaging as the content on TikTok itself.

“I worry that it’s a bit of a drop in the bucket, It doesn’t captivate the viewer in the same way that the TikTok videos do,” said Guarda, who is also an associate professor of psychiatry and behavioral sciences at the Johns Hopkins School of Medicine.

@madeofmillions

Reply to @lesliefoundhergrail Three things to say to a friend who is having suicidal thoughts 🫂 ##mentalhealth ##nationalsuicideprevention

♬ original sound - madeofmillions

TikTok did create a carousel of content from its creators discussing mental health issues earlier this month, but she suggested that a collaboration between a credible resource like the National Eating Disorders Association, which helped TikTok develop some of its new tools, and influencers with large platforms like Charli D’Amelio, would help get the resources to an even larger audience.

“There certainly might be an argument for TikTok subsidizing the creation of content that would be recovery-oriented or helping more with getting back the kind of content that potentially would captivate the audience, not just a link,” she said.

Guarda suggested that having the algorithm feed recovery-oriented content toward at-risk users would help balance out triggering content and has the potential to be more successful than a link.

If the algorithm is repeatedly showing a person who is in the throes of an eating disorder, “thinspiration” videos, for example, it can drive someone further into their illness, she said.

Even some who use the app to post mental health videos say they feel the platform should do more.

Inna Kanevsky, who has more than 1 million followers on TikTok, said another issue on the platform is mental health misinformation that goes unchecked.

Kanevsky, a professor of psychology at San Diego Mesa College, said she's noticed content on the platform created by laypeople is rife with misinformation about mental health. While she said she uses her platform to debunk those videos, in her experience, the app doesn’t take action when mental health misinformation is flagged.

“If you criticize that content, the content creator might say that you’re bullying them and [TikTok] removes your criticism,” she said.

When asked about Kanevsky's allegation, a TikTok spokesperson told NBC News that "the safety and well-being of our community is our priority, and TikTok follows the advice of health experts as we work diligently to take action on content and accounts that spread medical misinformation. We also provide access to authoritative information on a range of public health topics in our app and at our Safety Center."

Ultimately, some experts and creators said, it's important that people remember videos around mental health and TikTok's new resources are still not a substitute for therapeutic and psychiatric care.

“There are many great mental health advocates who share their personal stories regarding their diagnosis or experiences," Addesi said. "But it is important to remember that they are not mental health professionals, and what they are saying may not be 100 percent accurate in regard to the DSM-5 and criteria for a diagnosis."

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.

If you or someone you know is struggling with an eating disorder, contact the The National Eating Disorders Association at 1-800-931-2237 during select hours, text NEDA to 741741 at any hour in a crisis, or visit NEDA’s website.