title: Using social media for support and feedback by mental health service users: thematic analysis of a twitter conversation.
abstract: BACKGROUND
  Internet based social media websites represent a growing space for interpersonal interaction. Research has been conducted in relation to the potential role of social media in the support of individuals with physical health conditions. However, limited research exists exploring such utilisation by individuals with experience of mental health problems. It could be proposed that access to wider support networks and knowledge could be beneficial for all users, although this positive interpretation has been challenged. The present study focusses on a specific discussion as a case study to assess the role of the website www.twitter.com as a medium for interpersonal communication by individuals with experience of mental disorder and possible source of feedback to mental health service providers.
  
  
  METHODS
  An electronic search was performed to identify material contributing to an online conversation entitled #dearmentalhealthprofessionals. Output from the search strategy was combined in such a way that repeated material was eliminated and all individual material anonymised. The remaining textual material was reviewed and combined in a thematic analysis to identify common themes of discussion.
  
  
  RESULTS
  515 unique communications were identified relating to the specified conversation. The majority of the material related to four overarching thematic headings: The impact of diagnosis on personal identity and as a facilitator for accessing care; Balance of power between professional and service user; Therapeutic relationship and developing professional communication; and Support provision through medication, crisis planning, service provision and the wider society. Remaining material was identified as being direct expression of thanks, self-referential in its content relating to the on-going conversation or providing a link to external resources and further discussion.
  
  
  CONCLUSIONS
  The present study demonstrates the utility of online social media as both a discursive space in which individuals with experience of mental disorder may share information and develop understanding, and a medium of feedback to mental health service providers. Further research is required to establish potential individual benefit from the utilisation of such networks, its suitability as a means of service provision feedback and the potential role for, and user acceptability of, mental health service providers operating within the space.
authors.affiliation: Greater Manchester West Mental Health NHS Foundation Trust and University of Manchester, Manchester, UK. andrew.shepherd-4@postgrad.manchester.ac.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Shepherd
authors.affiliation: University of Manchester, Manchester, UK. caroline.sanders@manchester.ac.uk.
authors.forename: Caroline
authors.initials: C
authors.lastname: Sanders
authors.affiliation: University of Manchester, Manchester, UK. michael.doyle@manchester.ac.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Doyle
authors.affiliation: University of Manchester, Manchester, UK. jennifer.j.shaw@manchester.ac.uk.
authors.forename: Jenny
authors.initials: J
authors.lastname: Shaw
mesh_terms: D030141:Feedback, Psychological; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D020407:Internet; D001523:Mental Disorders / Q000523:psychology*; D008605:Mental Health Services; D011369:Professional-Patient Relations; D061108:Social Media; D012944:Social Support