Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 21, 2025
Date Accepted: Apr 15, 2026
Why Do People Conceal Mental Health Problems? A Qualitative Analysis of TikTok Posts
ABSTRACT
Background:
Concealment of psychiatric symptoms is a barrier to effective mental health treatment, particularly in patients with suicidal thoughts and behaviors (STBs).
Objective:
To understand patient decision making about when to conceal and when to disclose psychiatric symptoms, the current study examined social media content about patient experiences of concealing mental health symptoms. TikTok was chosen because it is the largest growing social media platform and social media provides an open-ended format for people to express their thoughts and feelings on various topics.
Methods:
Ninety-eight videos about concealing mental health were downloaded and qualitatively coded by a team of coders using reflexive thematic analysis.
Results:
Creators reported concealing psychiatric symptoms due to fear of being punished via hospitalization, negative opinions of psychiatric treatment, efforts to manage other people’s feelings and impressions, and feeling alone while struggling with negative emotions.
Conclusions:
Results from this study provide insight into patient motivations for concealing their STBs and offer potential avenues for improving rates of disclosure.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.