Spaces of Refuge Series » Creating Social Media Campaigns that Promote Awareness and Support Adolescents’ Mental Health

Hi Anxiety

Creating Social Media Campaigns that Promote Awareness and Support Adolescents’ Mental Health

Katerina Schenke

“If the premise we are working from is how to design safe spaces for youth online, I cannot emphasize enough how much consistency matters. In the same way it would matter for a young person in real life. Because their digital world is real, it is really real to them.” Trina DasGupta

Adolescents have been going online and finding supportive communities since the beginning of the internet. Modern social media platforms like Facebook, Instagram, and TikTok are a continuation of this trend in the way they allow for youth to create spaces where they can develop their own identities among peers and seek reprieve from world events. This has become even more apparent over the last year. The COVID-19 pandemic has challenged young people in ways that are unique to this generation, with fears that their mental health may be negatively impacted while they are physically separated from school and peers. At the same time, the script has quickly flipped from worries over too much screen time to asking how the online world can be leveraged to mitigate and buffer these negative impacts (Odgers & Robb, 2020). In fact, increasingly there is evidence that young people are going online to seek out information about mental health (Rideout et al., 2021) and evidence that there may be positive benefits from online spaces of refuge for youth that can serve as places of self-expression, discovery, and connecting with others who share similar interests.

The Spaces of Refuge series highlights organizations, technologies, and programs that leverage social and digital media to support mental health and wellbeing for vulnerable youth, and embody the following guiding principles:

  1. Meet Youth Where They Are: Too often, experts and adults have designed technologies and programs only to struggle to have youth, particularly minoritized youth, engage with them. Youth populations that innovators are seeking to serve should be involved from the start, with their interests, practices, and lived experience informing and driving the development and deployment of new efforts.
  2. Tailor to Diverse Groups and Ages: Youth are often described as a monolithic group, even though we know that young people’s backgrounds and interests are just as diverse as we see in the adult world. Approaches must be tailored to and draw from the needs and assets of specific populations and communities in order to arrive at equitable solutions.
  3. Build Connections Between Existing Assets: Despite an explosion of apps and online content for mental health, wellbeing, and self-care, the evidence is clear that vulnerable youth are not connecting to these assets. The critical gap in the ecosystem is the connection, translation, and tailoring of expert content and wellbeing resources for vulnerable youth, where and when they need them.
  4. Tap Youth Agency and Peer-to-Peer Support: Youth leadership, knowledge, and lived experience in supporting each other in times of distress; amplifying positive practices; and working against toxicity online are generally not considered in the design of wellbeing apps and interventions, even when they are intended for youth. Tapping youth agency and expertise is critical, particularly with technology-intensive interventions that require youth buy-in and engagement.

In this unique moment, fears around screen time are fading (at least somewhat) and there may be unique opportunities to invest in supportive online spaces for young people. In this case study, we highlight an example of one such space of refuge—an Instagram account called Hi Anxiety. This social media campaign began prior to the pandemic as a series of videos interviewing celebrities about their own experiences with anxiety to help normalize mental health discussions amongst youth. However, over the last year, it has evolved into an account that commissions artists to design posts and deliver much needed content on ways to manage anxiety, responds in real time to collective events and traumatic experiences that are likely impacting youth, engages directly with youth in the comments and direct messages and represents what Hi Anxiety has referred to as a scalable model of digital social emotional learning that other social media accounts can replicate to meet the mental health needs of their followers.

Our team, Youth Connections for Wellbeing, had the unique opportunity to partner with the developers of the Hi Anxiety platform during a year that was marked by increased time online, collective trauma related to racist violence, and health impacts of the COVID-19 pandemic that disproportionately impacted communities of color. This was also a time when most of America’s youth was online versus in school. This case study highlights key insights from this partnership, with reflections from Trina DasGupta—the co-creator, executive producer, and creative director of Hi Anxiety.

The COVID-19 pandemic has shone a bright light on many of the fractures and vulnerabilities in our society, but it has also reinforced the importance of what psychologists, educators, and those supporting young people already know—consistency and communities that care are crucial. DasGupta clearly articulates this point in the opening quote for this article, where, when asked about the biggest piece of advice she would offer to others in setting up a successful social media account, she immediately responded that “consistency is key” and that “posting every day, or multiple times a day” as well as frequently interacting with users in the comments were key strategies for reaching and building a community.

In this post, we illustrate how Hi Anxiety, a digital social impact campaign to help young people better manage everyday anxieties’, exemplifies some of the guiding principles outlined in the inaugural post of the Spaces of Refuge Series. We also highlight some of the lessons learned from developing social media accounts that may inform the design of future social media content campaigns seeking to support youth.

Hi Anxiety History

Hi Anxiety commissioned artwork

Hi Anxiety’s History

Hi Anxiety officially launched in July of 2019 on Instagram and YouTube using a series of videos of celebrities’ personal stories of anxiety and mental health. DasGupta, one of Hi Anxiety’s co-founders, has a background as a content producer, behavior change communications expert and has developed social network campaigns globally. As of writing this article, Hi Anxiety has over 200,000 followers and has posted almost 2,000 times in its 2-year run on the platform. They have successfully featured a number of celebrities and influencers such as Awkafina, Lana Condor, and Odeya Rush speaking honestly about their own struggles with mental health and wellbeing. Unlike many Instagram accounts that focus on wellness and mental health, Hi Anxiety has not had to go it alone. In addition to the wealth of expertise that DasGupta and her team bring to the table, Hi Anxiety has also been able to draw upon the expertise of a number of educational, social media, clinical, and research partners.

Meet Youth Where They Are

Young people are going online for mental health information—as many as 87% of teens and young adults surveyed in 2018 say they have gone online for mental health information (Hopelab & Rideout et al., 2018), suggesting that there is a need for mental health resources and content online. However, allowing youth access to that information may not be as straightforward as simply posting the information online. The algorithms that run in the background on platforms like Facebook, Instagram, and TikTok are not always visible to the user, yet play a hugely important role in what content ultimately reaches users. As DasGupta pointed out: “The challenge with the Instagram algorithm is that it sends more people to your account who are similar to those who are already there. It doesn’t really give you the opportunity to find new people [without spending ad dollars].”

Algorithms are often designed with the goal of creating and sustaining platform engagement—that is, feeding users content they would like to see and will likely comment on and share. This often has the consequence of creating echo chambers, where the same kind of content is being passed around to the same types of individuals. For example, youth already interested in mental health content may be more likely to see suggestions for Hi Anxiety content in their feed than youth who may be in need of mental health and wellbeing services, but do not show up as having previously searched for such content. Indeed, youth may even be aware that algorithms on different social media platforms are designed differently, and might choose one platform over another because of this.

To overcome barriers of access, it is important for content creators to keep in mind that the platforms have a lot of control over how content gets distributed. Creating, delivering and targeting content with contexts powered by AI and recommendation systems requires a new and more thoughtful approach to dissemination than prior campaigns. Additionally, DasGupta pointed out, “these platforms are commercial entities reliant on ad dollars. So to effectively target specific audiences requires both the financial resources and technical know how of how to reach them with an ad campaign, especially in the beginning.” That is, the most successful approaches to reaching the “right youth” at the “right time” will require the analysis of real-time metrics of engagement, as well as strategies that optimize the preferences of the algorithms that underlie these systems. These novel and interactive ecosystems also raise the question of how one should deliver mental health content to youth, if youth are not already in those spaces?

Hi Anxiety commissioned post showing how mental health content is delivered in an aesthetic way

Hi Anxiety is an account that does not look like other sorts of mental health and wellness sites found around online spaces. A viewer is more likely to encounter artwork in soft pastels with self-care tips and inspirational mantras written overtop in flowing and fanciful fonts than overly clinical language in stale colors.

The aesthetics—the look and feel—of content play a role in getting that content out to youth. Marrying clinical expertise and great artwork is key. In our interview, DasGupta noted: “We’ve seen mental health professionals say interesting things [on Instagram] in poorly designed ways.” DasGupta attributes some of the success of Hi Anxiety in reaching a wide audience to the attention to production value and need for commissioned artwork from BIPOC artists. During the pandemic, DasGupta and her team had to pivot from using her production team to film the celebrity videos to asking celebrities to produce these videos themselves. Unfortunately, though, she noticed that these self-produced videos did not perform as well as those with an expert video team behind them. Likewise, instead of relying on resharing content from other mental health accounts, DasGupta and her team commissioned artists to create content for the platform. These two actions, although time and resource intensive, have made a difference in attracting an audience to Hi Anxiety, as evaluated by changes in views, comments, and likes on these later posts.

Tailor to Diverse Groups and Ages

Demographic characteristics of survey respondents for the two surveys launched by the Connected Learning Lab on the Hi Anxiety Instagram account

While Hi, Anxiety had some sense of their audience in mid-2020, they worked with the Connected Learning Lab to conduct two surveys of users on the Hi Anxiety platform (one in August 2020 and one in November 2020). The results of these surveys found that the user base of Hi Anxiety that responded to the surveys skews white, female, and predominantly from English speaking countries even accounting for response biases. However, Hi Anxiety’s audience is international with many followers in the United States, Canada, South Africa, India, and the Philippines—something that Hi Anxiety has deliberately cultivated.

To attract and retain an international audience, DasGupta’s background in designing and marketing social media campaigns plays a role in understanding the platform’s algorithm. She says: “Part of our success is that we understand how to feed the algorithm, how to get more followers, how to do all those things without any money.” DasGupta and her team made a specific decision not to post content that is too specific to the news events in any one country. For example, while Hi Anxiety did post Black Lives Matter-related content, as it was a movement celebrated and recognized around the world, the Hi Anxiety team did not place too much emphasis on posting specifics about the US 2020 election—both to avoid alienating their international followers and to serve as a reprieve from world events. Additionally, DasGupta and her team focused on highlighting BIPOC artists and representations in the posts that Hi Anxiety reshares and commissions.

Hi Anxiety post that is designed to prompt users to think about their social emotional learning and respond in the comments

Build Connections Between Existing Assets

Making connections between existing assets not only refers to taking offline practices directly into online spaces, Hi Anxiety closes the loop and takes these online interactions back offline. When community managers encounter situations where followers may need additional support, community managers will provide followers with resources in the public comments, including links to mental health providers. This referral system was not part of the original design of Hi Anxiety. Instead, Hi Anxiety incorporated their referral system as a result of seeing that mental health became central during the pandemic and that their followers were in need of extra support that could not be offered directly on the platform (link to their Community Training Manual).

Hi Anxiety often refers users to mental health hotlines as well as searching Psychology Today’s database of therapists by zipcode, the National Suicide Prevention Hotline, as well as sharing stories with tips from other accounts. This kind of additional support is not without challenge. DasGupta highlighted in our conversation: “One of the challenges that we have come up with many times in terms of referrals for kids who are under 18 is that they don’t have parental support.” Specifically, youth often have to get parent permission or at least inform their parents that they are interested in seeking mental health help. Many may experience stigma around seeking help for mental health and wellbeing that may be tied to cultural practices or beliefs. As such, providing more bridges between existing assets can be a valuable way to create spaces of refuge.

In building connections between existing assets, DasGupta and her team also relied on the academic literature based in classroom settings. The team originally asked: “Could we take the principles from the classroom and put them on social media?” To address young womens’ anxiety and wellbeing, DasGupta and her team drew on the academic literature and practices around building Social Emotional Learning skills—a term used to describe a collection of skills around an individual’s ability to manage her emotions, develop self awareness, set and achieve goals, and make responsible decisions. The practices found in the academic literature to increase social emotional learning skills were fashioned in the text of Hi Anxiety posts, as wll as incorporated into how Hi Anxiety engaged with youth in the comments. For example, the post above asks users to engage in self awareness and write in the comments section the morning rituals that bring users joy.

Hi Anxiety commissioned post

Tap Youth Agency and Peer-to-peer Support

Hi Anxiety enlists community managers to carefully respond to followers’ comments using a framework they refer to as validate + inquire + refer (also aligned with the Social Emotional Learning framework described above). Their role is to support positive interactions with Hi Anxiety’s followers, and they are directed to acknowledge and affirm the follower’s comment with phrases like “we hear you”, and encourage followers to reflect deeper about themselves with questions such as “what’s something you’re proud of yourself for?” If it seems like followers need additional support beyond what can be given by these prompts, community managers also provide followers with a list of outside resources they can connect to for additional help. These resources are publicly posted in the comment thread so that others may also have access to them.

One consideration in tapping youth agency and peer-to-peer support is being thoughtful about the social media platform that is used to target youth. When Hi Anxiety initially started in 2019, their initial target audience was young women. Instagram was the social media platform to target that demographic because that was where young girls were spending their time online. Fast forward two years, and Hi Anxiety’s target audience now skews slightly older with most of their followers still being under 30 years old, but older than high school aged. Youth who might have previously spent their time on Instagram are now on platforms such as TikTok. Pivoting to new social media platforms requires teams to dedicate time and resources and stay apprised of social media trends among youth.

Next Steps and Lessons Learned

Even prior to the pandemic, concerns over adolescent mental health were high, and young people were going online frequently to search for information and support related to mental health problems. While many people fear that social media is contributing to adolescent mental health problems, many also have argued that social media and related platforms may have a critical role in providing mental health services and supports for young people (Haidt & Allen, 2020) and, more generally, in raising awareness around the importance of self-care, supporting others, and seeking mental health services. The need for mental health services tailored for youth is here to stay. The question for platform developers, content creators, and those invested in creating spaces of refuge for young people, is how to ensure that these spaces are designed in youth-centered and effective ways.

This article describes a framework for creating and supporting the design of spaces of refuge for young people that can support mental health and wellbeing, and illustrates how one campaign, Hi Anxiety, executed many of these principles in their content delivery and design. Hi Anxiety evolved from its initial offering, a platform posting videos of celebrities speaking about their experiences with mental health and anxiety, to the inclusion of a referral model to accommodate the needs of their users, and to a platform that was responsive to the unique needs of young people in this unprecedented historical moment of living through a global pandemic and awakening around racial violence. More generally, the strategies adopted by Hi Anxiety illustrate one way to effectively bridge the gap between offline and online sources of support for youth.

As for next steps, DasGupta and her team know all too well that they need to be prepared to follow youth to where they currently are online—which likely means a transition to TikTok. Similar to offline trends, content creators, parents, and researchers know that meeting youth where they are, and supporting them when they need it, are two key ingredients for success. Online platforms offer those affordances, but also require creative and youth-centered approaches for design and delivery. In April of 2021, Hi Anxiety closed its doors to commissioning and posting new content. However, all of the learnings, information about DasGupta and her team, the Hi Anxiety model, and further resources in replicating their model are available on the Hi Anxiety website.

References

Haidt, J., & Allen, N. (2020). Scrutinizing the effects of digital technology on mental health. Nature, 578, 226–227.

Odgers, C., & Robb, M. (2020). Tweens, teens, tech, and mental health: Coming of age in an increasingly digital, uncertain, and unequal world. Common Sense Media. [Accessed 2020-11-29]. https://www.commonsensemedia.org/research/tweens-teens-tech-and-mental-health

Rideout, V., & Fox, S. (2018). Digital health practices, social media use, and mental well‐being among teens and young adults in the US. Hopelab.

Rideout, V., Fox, S., Peebles, A., & Robb, M. B. (2021). Coping with COVID-19: How young people use digital media to manage their mental health. Common Sense and Hopelab.

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