Identifying key challenges and needs in digital mental health moderation practices supporting users exhibiting risk behaviours to develop responsible AI tools: the case study of Kooth.

Digital platforms for mental health and wellbeing purposes have become increasingly common to help users exhibiting risk behaviours (e.g. self-harming, eating-related disorders) across all ages, opening new frontiers in supporting vulnerable users. This study stems from a larger project, which explores how responsible AI solutions can up-scale existing manual moderation approaches and better target interventions for young people who ask for help or engage in risk behaviours online. This research aims to better understand the challenges and needs of moderators and digital counsellors, i.e. the ‘behind the scenes’. Through this case study, the authors intend to contribute to the development of responsible AI tools that are ft for purpose and better understand the challenges. The key focus lies on Kooth.com, the UK’s leading free online confdential service offering counselling and emotional wellbeing support to young people in the UK through its online web-based and pseudo-anonymous digital platform

Mediated Meaning: The Representation of Mental Health on Social Media Platforms

Social media users and mental health organisations globally use social media to produce, consume, circulate, and reproduce mental health content. Despite the growing importance of these spaces for mental health discussions, few studies have fully explored the representation of mental health on social media channels. The overall aim of the research was to provide an in-depth critical analysis of communication about mental health on social media platforms and to produce critical knowledge that enables people to question taken for granted assumptions embedded in mental health communication. The study drew on an integrated multimodal critical discourse analytic framework comprising the Foucauldian approach, the Faircloughian approach, and the affordance construct as the theoretical stance and methodological path. This study involved analysis of texts, visuals, and social media affordances to understand how language is used, the type of mental health messages communicated via Reddit, Facebook pages and website forums, the power relations involved in these processes and the implications of these communication aspects for mental health promotion. The study drew on two types of data sets. The first, comprised of nine thousand and ninety-eight social media posts and the second included interview insights of seven social media users and five social media moderators. The social media posts included in the dataset were created between 1st April 2019 and 31st July 2019 and between 1st January 2020 and 30th April 2020 between September 2020 and March 2021. Analysis of social media posts showed seven discourses namely, professional care, a way of life, personal care, gender categorisation, uncertainty, social support, and technology. While there are multiple meanings attached to mental health on social media, this study shows that the medical-therapeutic and self-care discourses from offline contexts prevailed as dominant discourses. I analysed the functional and relational aspects of social media affordances. The interaction of these discursive and non-discursive elements overwhelmingly worked to sustain already existing mental health knowledge. Additionally, the discourses exhibited both dominant and subjugated subject positions. For example, the dominance of visual, textual, and digital intertextuality worked to sustain some discourses over others. Similarly, the discourses' metaphors and genres' emergence largely preserved conventional meaning and dominant subject positions. I identified the institutional and broader socio-cultural practices that could explain the presence and absence of discourses and the communication choices. The governmentality practices of accountability, surveillance, professionalisation, and information seeking and sharing shaped the broader socio-cultural context in which mental health was represented. The taken-for-granted acceptance of some of these discourses served to strengthen the influence of moderators while suppressing user agency. The thesis argues that the representation of mental health on social media platforms is multifaceted and cannot be reduced to positive or negative attributes but should be understood by examining the unequal relations of power among social media corporations, users, and mental health organisations. As a result of these power relations, the diversity of opinions of mental health was constrained to a large extent, with dominant discourses reoccurring across the social media platforms and the periods analysed. Moreover, social media facilitated and constrained the diversity of participation in subtle ways, for instance, through digital intertextuality and social media rules of engagement. Altogether, this study found that the multiplicity of social media platforms did not translate into a diversity of meanings. Accordingly, there is a need to harness social media's potential to amplify more alternative voices regarding mental health. In this regard, I highlight communication strategies and tactics for practitioners involved in promoting mental health. I note that communication strategies, namely awareness raising, community building and interactivity, play a crucial role in disrupting dominant discourses and institutional practices while increasing opportunities to prioritise the interests of individuals.Thesis (Ph.D.) -- University of Adelaide, School of Humanities, 202