JMIR Publications

ABSTRACT

Background:

Mental health-related content has been increasingly visible on Chinese social media among young people, including the expression of negative emotions and personal experiences of mental health issues, treatment and recovery, etc. Such content could reach a wide audience and influence their understanding and responses to mental health issues. However, previous studies have mainly focused on highly sensitive topics such as self-harm and suicide with occasional posts included, or examined discrete stages of content creation, while limited evidence can be found treating content creation as a connected process that involves motivation, creation, and reaction to feedback from the perspective of young creators.

Objective:

This study aims to explore the whole process of repeated content creation covering broader mental health topics, figuring out why Chinese young creators post, how they experience it, and what consequences they perceive.

Methods:

This study purposively recruited content creators aged 15 to 34 years from major Chinese social media platforms who have posted at least 5 posts about emotional distress, psychiatric symptoms,mental health treatment, recovery, psychological counseling, self-harm or suicide within 12 months. Online semi-structured interviews were conducted from December 2024 to March 2026 and analyzed using reflexive thematic analysis.

Results:

A total of 20 women completed interviews lasting 39 to 64 minutes, with a mean (SD) age of 21.8 (3.6) years. Fourteen participants (70.0%) primarily used Rednote. All participants reported at least one mental disorder diagnosis, including depressive disorder (n=10, 50.0%), bipolar disorder (n=7, 35.0%) and an anxiety and depressive state (n=3, 15.0%). Three themes were identified: 1) participants posted to meet emotional needs and made mental illness experience meaningful; 2) audience feedback shaped emotional experiences and subsequent creation and 3) disclosing mental illness required emotional effort and management of offline recognition, conflict, harassment, and unwanted contact.

Conclusions:

Repeated mental health-related content creation can provide connection and sense of value for young creators while also exposing them to unexpected visibility, conflicts and emotional burden through audience feedback. Social media platforms should strengthen appropriate content moderation with greater control over visibility and unwanted interactions, while family members could provide nonjudgmental offline support by acknowledging creators’ online experiences and respecting their disclosure boundaries.