JMIR Publications

ABSTRACT

Background:

Social media, including online health communities (OHCs), is widely used among both healthy people and those with health conditions. Platforms like Twitter, recently known as “X,” have become powerful tools for online mental health communities (OMHCs), enabling users to exchange information, express feelings, and engage socially. Recognized as empowering processes, these activities could empower mental health consumers, their families and friends, and society at large. However, it remains unclear how OMHCs empower diverse population levels and groups.

Objective:

This study aimed to develop an understanding of how empowerment processes are conducted within OMHCs on Twitter by identifying members shaping these communities, detecting empowerment process types aligning with population levels and groups outlined in Strategy 1 of the Integrated People-Centred Health Services (IPCHS) framework by the World Health Organization (WHO), and clarifying members’ tendencies and rationales of involvement in these processes.

Methods:

We conducted our analysis on a Twitter OMHC called #bipolarclub. We captured 2,068 original tweets using its hashtag #bipolarclub between December 19, 2022, and January 15, 2023. After the screening, 547 eligible tweets by 182 authors were analyzed. Using qualitative content analysis, community members were classified by examining the 182 authors’ Twitter profiles, and empowerment processes were identified by analyzing the 547 tweets and categorized according to the WHO’s Strategy 1 (IPCHS framework). Members’ tendencies and rationales of involvement were examined through their contributions to the identified processes.

Results:

The analysis of #bipolarclub community members unveiled 5 main classifications among the 182 members, with the majority classified as individual members (75.8%, n=138), followed by health care-related members (21.4%, n=39). All members declared to experience mental health conditions, including mental health and general practitioner members who used the community as consumers and peers rather than for professional services. The analysis of 547 tweets for empowerment processes revealed 3 categories: individual-level (6 processes, 2 subprocesses), informal carer (1 process for families, 1 process for friends), and society-level (1 process, 2 subprocesses). Additionally, the analysis demonstrated distinct involvement tendencies among members, influenced by their identities, with individual members engaging in self-expression and family awareness support and health care-related members supporting societal awareness.

Conclusions:

The examination of the #bipolarclub community highlights the capability of Twitter-based OMHCs to empower mental health consumers (including those from vulnerable populations), their families and friends, and society, aligning with the WHO’s empowerment agenda. This underscores the potential benefits of leveraging Twitter for such objectives. This pioneering study is the first to analyze how a single OMHC can empower diverse populations, offering valuable guidance for various health care stakeholders and aiding in the development of consumer-oriented empowerment programs utilizing such OMHCs. Also, we propose a structured framework classifying empowerment processes in OMHCs, inspired by the WHO’s Strategy 1 (IPCHS framework).