Chilman, N

Johnson, S

Lloyd-Evans, B

Morant, N

Wackett, J

English

UCL Discovery

Letter to the EditorAcceptability of Using Social Media Content in Mental HealthResearch: A Reflection. Comment on “Twitter Users’ Views onMental Health Crisis Resolution Team Care Compared WithStakeholder Interviews and Focus Groups: Qualitative Analysis”Nicola Morant1, PhD; Natasha Chilman1,2, MSc; Brynmor Lloyd-Evans1, PhD; Jane Wackett1, BSc, PGCert; SoniaJohnson1,3, DM1Division of Psychiatry, University College London, London, United Kingdom2Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom3Camden and Islington NHS Foundation Trust, London, United KingdomCorresponding Author:Nicola Morant, PhDDivision of PsychiatryUniversity College LondonMaple House, 149 Tottenham Court Rd, BloomsburyLondon, W1T 7NFUnited KingdomPhone: 44 7969688554Email: n.morant@ucl.ac.ukRelated Article:Comment on: https://mental.jmir.org/2021/6/e25742/(JMIR Ment Health 2021;8(8):e32475) doi: 10.2196/32475KEYWORDSTwitter; social media; qualitative; crisis resolution team; home treatment team; mental health; acute care; severe mental illnessOur recently published paper [1] that analyzed tweets aboutmental health crisis teams in the United Kingdom has sparkeddebate and some objections on social media, and we would liketo clarify our position.Our intention in conducting this research was to amplify voicesand perspectives that may not be captured in more traditionalqualitative research. Our findings highlight how, compared toviews obtained using interviews and focus groups [2], Twitterusers reported more negative experiences of mental health crisisservices and described difficulties not identified by morestandard qualitative methods. Social media research enablesaccess to a broader range of voices, as it does not rely onrecruitment via services. This has potential to usefully informservice developments, particularly in highlighting problems ofaccess, engagement, or acceptability, and can help providersbecome more aware of how their services could be improved.In planning this study, we obtained university ethics approvaland followed guidance for social media research [3,4]. Onlytweets from public accounts were included, and we did notrecord Twitter usernames or profiles. To avoid tweets beingtraceable to specific individuals, we paraphrased tweets ratherthan quoting them directly, using forms of words that werecommon across a body of similar material, and avoided usingmaterial about specific personal difficulties or circumstances.Although we took care with our approach and felt we were ableto reflect important concerns about a major service model, thepublication of our paper has raised concerns that we feel otherresearchers should be aware of. The paper has divided opinion,with some social media users from a range of backgroundsstrongly feeling that this form of social media data use isintrusive and that, even though material was in the publicdomain and was paraphrased, obtaining more specific consentwas warranted. Conversations on Twitter may blur public andprivate, especially where it is used to share experiences amonga community that includes people in vulnerable states.Acceptability of research approaches, especially to people withrelevant lived experience is clearly important. We wouldtherefore not ourselves use a similar approach again withoutclear guidance being available that reflects what is acceptableto a fuller range of stakeholders. We recommend to otherresearchers being aware that use of material from public tweetsmay not be found acceptable even where ethical approval hasbeen obtained and guidance followed. We hope this letter cancontribute to the development of consensus and clear guidanceJMIR Ment Health 2021 | vol. 8 | iss. 8 | e32475 | p. 1https://mental.jmir.org/2021/8/e32475(page number not for citation purposes)Morant et alJMIR MENTAL HEALTHXSL•FORenderXon how researchers should navigate the complexity and variety of views that exist about social media content.Conflicts of InterestNone declared.References1. Chilman N, Morant N, Lloyd-Evans B, Wackett J, Johnson S. Twitter users' views on mental health crisis resolution teamcare compared with stakeholder interviews and focus groups: qualitative analysis. JMIR Ment Health 2021 Jun 29;8(6):e25742[FREE Full text] [doi: 10.2196/25742] [Medline: 34185017]2. Morant N, Lloyd-Evans B, Lamb D, Fullarton K, Brown E, Paterson B, CORE Service User and Carer Working groups.Crisis resolution and home treatment: stakeholders' views on critical ingredients and implementation in England. BMCPsychiatry 2017 Jul 17;17(1):254 [FREE Full text] [doi: 10.1186/s12888-017-1421-0] [Medline: 28716022]3. Ethics guidelines for internet-mediated research. The British Psychological Society. 2013. URL: https://www.bps.org.uk/sites/www.bps.org.uk/files/Policy%20-%20Files/Ethics%20Guidelines%20for%20Internet-Mediated%20Research%20%282013%29.pdf [accessed 2021-05-28]4. Ethics guidelines for internet-mediated research. The British Psychological Society. 2017. URL: https://beta.bps.org.uk/sites/beta.bps.org.uk/files/Policy%20-%20Files/Ethics%20Guidelines%20for%20Internet-mediated%20Research%20%282017%29.pdf [accessed 2021-07-29]Edited by T Derrick, J Torous; this is a non–peer-reviewed article. Submitted 29.07.21; accepted 29.07.21; published 17.08.21.Please cite as:Morant N, Chilman N, Lloyd-Evans B, Wackett J, Johnson SAcceptability of Using Social Media Content in Mental Health Research: A Reflection. Comment on “Twitter Users’Views on MentalHealth Crisis Resolution Team Care Compared With Stakeholder Interviews and Focus Groups: Qualitative Analysis”JMIR Ment Health 2021;8(8):e32475URL: https://mental.jmir.org/2021/8/e32475doi: 10.2196/32475PMID:©Nicola Morant, Natasha Chilman, Brynmor Lloyd-Evans, Jane Wackett, Sonia Johnson. Originally published in JMIR MentalHealth (https://mental.jmir.org), 17.08.2021. This is an open-access article distributed under the terms of the Creative CommonsAttribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproductionin any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographicinformation, a link to the original publication on https://mental.jmir.org/, as well as this copyright and license information mustbe included.JMIR Ment Health 2021 | vol. 8 | iss. 8 | e32475 | p. 2https://mental.jmir.org/2021/8/e32475(page number not for citation purposes)Morant et alJMIR MENTAL HEALTHXSL•FORenderX

Intrusiveness and Social Media in Mental Health Research: A Reflection. Comment on "Twitter Users’ Views on Mental Health Crisis Resolution Team Care Compared With Stakeholder Interviews and Focus Groups: Qualitative Analysis"

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Intrusiveness and Social Media in Mental Health Research: A Reflection. Comment on "Twitter Users’ Views on Mental Health Crisis Resolution Team Care Compared With Stakeholder Interviews and Focus Groups: Qualitative Analysis"

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