INTRODUCTION:

Mental Health

A person is said to be mentally fit when they’re content with most aspects of their life, are capable of being productive, and contributing to their community. One of the ideas that the research paper focuses on includes raising awareness about mental health issues, which are as significant as physical ailments, but are often sidelined and deemed as not being serious, and even real enough. As responsible citizens of our community, it is essential for us to acknowledge and face these challenges collectively, and lend out a helping hand to those in need, lest we lose out on valuable fragments of our society. Thus, the research paper in question somewhat realizes a great idea as it rightly helps us realize the graveness of the situation.

Despite our precedence in medical science over the rest of the world for the majority of the part, mental health issues have been considerably taboo in India until the past couple of years. Most don’t acknowledge a problem when they see one, fewer treat it with the concern and the medication (both drug and therapy based) it deserves.

As per a recent report by the WHO, one in four people in the world are likely to be affected by a mental disorder at some point in their lives, making mental illness one of the leading causes of ill-health worldwide. About 450 million people in the world are currently suffering. In India alone, about 7.5% of the total population is affected and is in dire need of medical help, with 56 million people diagnosed with clinical depression and another 38 million dealing with anxiety disorders- the two top mental illnesses in the country. It is also critical for giving the disadvantaged a voice in the formulation of local decisions that affect their lives (Pathlavath, 2016). this will help in this process.

However, in recent years, with the advent and subsequent explosion of technology in the subcontinent, mass media tools have been effective in combating the stigma around mental illness, creating widespread awareness by way of advertisements, films, and social media campaigns, that prompt victims to realize the gravity of their mental health..

YouTube as a Medium of Communication:

The YouTube video hosting service constitutes a social networking website on which practically any individual or organization with Internet access can upload videos that can be seen almost immediately by wide audiences. As the world's largest video platform, YouTube has had impact in many fields, with some individual YouTube videos having directly shaped world events.

Video is beyond entertainment:

It has become a critical component in business, politics, communication, social media and even in music. We need video to market and sell products, promote new ideas and share beliefs. Since video appeals to both sight and sound in a quick burst of stimulation, it captures the attention of the viewer immediately and makes a lasting impression. The messaging is concise and easy to understand, reaching people of all demographics.

Ultimately, therein lies the power of video—the ability to effectively share beliefs and impact audiences worldwide from the comfort of their homes to the screens of their smartphones 24 hours per day, 7 days per week

The potential of YouTube to be used as a medium to communicate intrinsic ideas that are essential to our growth must be realized. YouTube being world’s largest video platform has helped in social awareness amongst wide audiences and it’s a fact that it has led to social impact on society, culture, and even world events.

REVIEW OF LITERATURE:

Roots and Causes: According to a WHO report cited in the paper (2012), about 450 billion people suffer from mental health disorders all over the world, constituting for 12% of the global burden of diseases, estimated to be 15% by 2020. Closer back home, for every 1000 people in any given region, 9-102 mental health cases are reported. These mental health issues could be behavioural and/or disaster based, or rooted in depression, stress, and/or anxiety.

In most findings, certain points were categorically evident. For one, higher income countries fared better in the department of mental health than their lesser fortunate counterparts, for the simple reason being that poverty and social and economic deprivation are often one of the most leading causes of depression. Although, if a further analysis was conducted in these lower income countries, say for instance in India, there wasn’t considerable difference between the number of cases reported in urban and rural areas. This was probably because even though the reasons of origination of the mental health issues for the two areas might be drastically different, their weightage would amount to be the same. Adolescents and teenagers are prone to mental health issues too, and these are usually rooted in adjustment problems, peer induced anxiety, atmospheric stress, and narcotics and/or alcohol dependency. The last group and possibly one of the easiest targets too is that of the elderly, who usually develop mental health issues as a result of other age degeneration diseases such as dementia, arthritis, cataracts, etc.

In India itself, about five crore people are affected with mental disorders, making up for around 8% of the total population. How does one expect to better the conditions then? The number one step is that of accepting that we have a serious issue at hand that needs to be dealt with right away. For instance, children and teenagers need activities that foster psychological development from a very early age. Women should be empowered in all spheres of life, and there needs to be a greater amount of social support for the elderly. Mental health services should be available throughout the country and it shouldn’t be a matter of shame to seek professional help. Dialogue process of various stakeholders in the process makes more evident (Pathlavath, 2018).

The Indian Scenario:

The WHO has defined sustainable development goals and elaborated the impact of mental illnesses and suicide on them. The suicide rate in India in 2015 at 15.7/100,000 is higher than the regional average of 12.9 and the global average of 10.6. Suicide is the leading cause of death among those aged 15–29 in India. There remains a massive unaddressed need within the population.

The treatment gap, as measured by the absolute difference between the prevalence of mental illnesses and the treated proportion, has been found to be 76%–85% in less-developed countries. One of the major reasons attributed to such a wide treatment gap is the problem of inadequate resources. In India, inadequacy exists in infrastructure as well as in human resources. Despite improvements in various health indicators, India contributes disproportionately to the global burden of disease. Our health indicators compare unfavorably with other middle-income countries and India's regional neighbours. A large proportion of the population ends up impoverished because of high out-of-pocket health-care expenditures and suffers the adverse consequences of the poor quality of care. Task-shifting to non-specialist community health workers has been recommended as an effective strategy for delivery of efficacious treatments in low-resource settings. Given the dire shortage in numbers of psychiatrists, psychologists, psychiatric nurses, and social workers; piggy-backing on primary care systems and employing innovative force-multipliers are future courses of action.

Media Influences:

It is a known fact that the media influences our train of thought in terms of what we think and how we go about it. Much has been said and written about how mental illnesses are often misrepresented in popular culture, and how that can have a negative impact on the masses. But when it comes to India, we are only just beginning to witness some positive changes with regard how the community perceives mental illnesses.

Attempts have been made to understand how media imparts knowledge and influences the attitudes, behaviors and views of individual. Depictions of people who are mentally ill act as symbols of mental illness as a whole and can also provide viewers with the virtual experience of what a person with a mental illness must be like. Television is a primary example of a tool used to provide people with such vicarious experiences. Heavy exposure to these vicarious experiences may become reality to the viewer through the cultivation theory. New delivery channel to commence and be useful to masses, it is worthwhile to examine various components of its interface with payment systems, technology, security, regulatory aspects and functionality (Anil Kumar Pathlavath, 2013).

A study published in the American Journal of Preventative Medicine in July examined whether young people’s use of 11 social media sites - Twitter, Google+, YouTube, LinkedIn, Instagram, Pinterest, Tumblr, Vine, Snapchat, Facebook and Reddit - correlated with their “perceived social isolation”. To overcome all the limitations to express their rights and issues. The dialogue between the stakeholder gives scope to share the problems and community people advised to rise on specific issues that concerned them (Anil kumar Pathlavath, 2018).

Unsurprisingly, it turned out that the more time people spent on these sites, the more socially isolated they perceived themselves to be. And perceived social isolation is one of the worst things out there, mentally and physically. These lead to symptoms of depression if the site triggered feelings of envy in the user. Most studies examining social media and mental health “aren’t able to determine whether spending more time on social media leads to depression or anxiety, or if depressed or anxious young people spend more time on social media”, they say. “The pathways to mental illness are many and varied, and to suggest mental health problems can be attributed to social media alone would be an oversimplification.

Media Theories

Commonly called new media theory or media-centered theory of composition, media theory focuses on how writing is created, keeping in mind particularly the tools and mediums used in the composition process. New media refers to a range of digital modes of communication, often incorporating a multi-modal mix of the visual or oral in addition to traditional text. Stemming from the rise of computers as word processing tools, media theorists now also examine the rhetorical strengths and weakness of different media, and the implications these have for literacy, author, and reader. YouTube has been recognized as an effect communicative tool to spread social messages, specifically with regard to mental health.

What really matters, argue many development experts, is what happens after people are connected to technology. (Pathlavath, A, K, 2013). Technology must help in the process of development.

Active audience theory argues that media audiences do not just receive information passively but are actively involved, often unconsciously, in making sense of the message within their personal and social contexts. Decoding of a media message may therefore be influenced by such things as family background, beliefs, values, culture, interests, education and experiences. The prevalence of mental health awareness content on YouTube and its response is a direct reflection, or rather summarization of the thought processes of its viewers.

METHODOLOGY:

To answer the primary research question, “Has YouTube helped in mitigating the stigma around mental illness in India?”, the researcher has opted for mixed methodology methods. The following has been kept in mind while making the decision:

● The qualitative approach provides an opportunity to observe subtle details that outline and elaborate on the research problem, while the quantifiable data seeks to justify/ invalidate the observations made during the process in a graphical format.

● With more data in hand, the strengths of both methods are employed and a broader perspective is obtained.

However, certain limitations may ensue:

● If the researcher leans towards one methodology owing to convenience, possibly neglecting the other, results are bound to be biased and inaccurate too.

● While the quantifiable data seeks to provide a singular, definite answer, qualitative methods usually end with varied, subjective analysis, thus leading to an inconclusive research.

Qualitative Research

I) Content Analysis: The most essential method of the research is analyzing the content of various material that is available online with the primary objective of raising awareness and mitigating the stigma around mental illness. These include:

· Videos available on Youtube by popular channels such as “AIB: If People Treated Other Illnesses Like They Treat Depression”, and “The Timeliners: If Anxiety Was a Person”.

· Advertisements of institutions/ brands such as those of “Deepika Padukone: Live, Laugh, Love Foundation”, “Mirinda: Release The Pressure:, and “Levis: Shape My World”.

These will be analyzed on the basis of their subject matter, outreach, and immediate and long-term response.

II) Personal interviews:

The researcher will also be reaching out to mental health professionals (psychiatrists, psychologists, and counsellors) to get well-versed with their perspectives and expert opinions in terms of the effectiveness of the content available of Youtube with regard to mitigating the stigma around mental illness and seeking help.

Quantitative Research

Online Survey:

The researcher has drafted a questionnaire to attest the popularity of mental health campaigns and the way these messages are perceived. The respondents include the youth from urban cities of India.

Data Analysis

Content Analysis of Videos : To achieve a better understanding of the mental health oriented content available via Youtube,a total of five videos were selected based on their popularity and prominence. The researcher then analyzed them based on the following parameters:

● Reach and Response: Number of views, comments, likes, and dislikes.

● Message type: Informative, Responsive, or Persuasive.

● Content Appeal: Emotional, Humour, or Rational..

● Overarching themes.

Video I: “AIB: If People Treated Other Illnesses Like They Treated Depression”

Description: Published on 11th April, 2017, to 1,690,848 views, 52,783 likes, 3,679 dislikes, and 2,788 comments (as of March 2018), this video was released under the banner of popular Indian comedy channel, All India Bakchod. The video showcases a character named Gaurav, who comes down with the disease of Typhoid (which is representative of Depression), and his health issues are trivialized over the pretext of not being real, a jab at people who say the same frequently about mental illness(es).

Content Appeal: The narrative of the video is replete with elements of sarcasm, exaggeration, and irony. Although it prompts the viewers to laugh out loud, the ultimate goal is for them to ponder over the gravity of mental illness, and to the extent that it has been trivialised. Thus, the video makes use of a humour appeal to evoke a response and attempt to retain the primary message in the minds of the viewers.

Message Type: With humour as a predominant element in the video, the message type is responsive, in that it seeks to evoke an empathetic and understanding response from the viewers to create a lasting social impact.

Themes: Metonymy, Sarcasm, Dramatization, Ridicule..

Video II: “The Timeliners | If Anxiety Was A Person”

Description: Published on 10th October 2017, to 301, 849 views, 11,000 likes, 371 dislikes, and 413 comments, the video was released by a lifestyle channel created by Scoop Whoop, called The Timeliners. The video that showcases the struggles of a woman with an anxiety disorder (personified by another character) received a positive response for exploring a common, yet not talked about mental health issue, and getting the message across in a light-hearted way.

Content Appeal: The narrative of this video is influenced by the elements of personification, with the attributes of anxiety presented in a very straightforward and blunt manner. The primary appeal of the video is humour, an attempt to bring an everyday mental health issue.to the forefront by presenting it in a comedic context.

Message Type: The primary message type of the video is responsive. By representing relatable content, the creators wish to communicate the regularity of anxiety in our lives and destigmatize it in the process.

Themes: Personification, Dramatization, Normalization.

Video III: “The Live Love Laugh Foundation: Doobara Poocho”

Description: Published on 10th October, 2016, to 552, 117 views, 2,300 likes, 17 dislikes, and 185 comments, Deepika Padukone’s foundation released a video showcasing different members of the community, teenagers, young adults, middle aged people- both male and female- struggling with depression and hesitantly opening up to their loved ones. It received a mixed response, but was able to get the message of empathy across.

Content Appeal: The primary appeal of the video is emotional, making its viewers realize that mental duress can get to anyone and everyone and that it’s important for their issues to be acknowledged and looked after.

Message Type: The predominant message of the video is persuasive, urging its viewers to look out for their loved ones, and ask them repeatedly about their mental well-being, and eventually taking necessary action.

Themes: Call for Action, Difficult Conversation, Normalization.

Video IV: “Mirinda: Release The Pressure”

Description: Published on 15th February, 2017, to 24,744, 945 views, 50,00 likes, 8,747 dislikes, and 3,344 comments, Mirinda’s marketing campaign and social initiative shot by Shoojit Sircar is the most popular video chosen in the sample. It showcases students writing open letters to their parents with regard to the pressure they face for examinations.

Content Appeal: The primary appeal of the video is emotional, highlighting the societal pressure that builds up in individuals’ lives and is the leading cause of depression and suicidal tendencies in students.

Message Type: The message type is persuasive, urging primarily parents of teenagers to not let their children get stuck in a place of inadequacy and bleakness.

Themes: Confrontational, Behaviour, Regularity, etc.

Video V: “Levi’s: Shape My World | Illeana D’Cruz”

Description: Published on 15th September, 2017, to 261,827 views, 1,278 likes, 67 dislikes, and 34 comments, the video was released by international denim brand, Levi’s as a part of its individualized campaign, Shape My World. This specific video follows Indian model and actress Illeana D’Cruz, as she discusses her struggle with body image issues, being diagnosed with body dysmorphic disorder, and subsequently overcoming it.

Content Appeal: The content of the video is conversationalist and straightforward, and the primary appeal of the video is rational, where the celebrity discusses her insecurities in a matter-of-factly manner.

Message Type: The primary message type of the video is informative, communicating to the viewers the intricacies and struggles that come with body dysmorphic disorders.

Themes: Conversational, Overcoming of Insecurities, Normalization, etc.

Survey

A survey was conducted for the research paper to adjudge the popularity of mental health oriented content (both videos and campaigns) present via Youtube, and to look into how the messages portrayed in these videos are perceived. It was targeted at the youth, and a hundred respondents between the ages 0f 15-29 were approached. These included both male and female respondents from the urban cities of India. It was a quantifiable questionnaire conducted via Google Forms.

Age

Gender

City

FINDINGS AND SUMMARY:

The research has yielded the following findings:

a) Content Analysis

● Mental health oriented content on Youtube primarily makes use of emotional, rational, and humour appeals to get their message across.

● The messages are primarily informative, persuasive, or responsive in nature.

● The dominant themes include initiation of a difficult conversation, normalization of the issue, and a call for action.

b) Survey

● 49.2% of the respondents are familiar with the mental awareness videos available on YouTube.

● Respondents are more likely to participate/ observe textual/ pictorial campaigns rather than video centric content.

● Respondents believe that the primary objective of such campaigns is societal progress.

● Respondents believe that only a specific section is targeted/ affected by such content.

● Respondents believe that such content helps in popularizing platforms to discuss mental health.

● There exists a conflicting opinion on the interpretation of content, some believe it results in a positive discussion, some believe it is superficial in nature.

c) Personal Interviews

● Respondents believe that the underlying motive of such videos is a sense of social responsibility, reflected in from social inclusion, normalization, and creation of safe spaces.

● Respondents believe the primary objective is to create safe spaces, reflected in repeated exposure, market appeals, and de-stigmatization.

● Respondents believe that it leads to the homogenization of data, reflected in oversimplification, stereotypical impressions, and the precedence of creativity over the main issue.

● Respondents believe access to new media is essential, reflected in digital literacy, and a target audience characterized by urban areas and a specific age-group.

● Respondents believe that only awareness of one’s health isn’t enough, some people lack emotional support and funds.

● Respondents believe such campaigns are effective in drastically reducing the stigma around mental health, but only those with financial independency and/or immediate familial acceptance can pursue medical aid.

INTERRELATION:

With three elaborate methodologies at hand, the researcher may conclude about the significance of YouTube in mitigating the stigma around mental illness. Viewers actively take into account the well-meant messages of the video and form subsequent opinions.

With regard to the the collective research, the new media theory holds true in that the content is carefully curated to create an interactive and personalized sense of communication, that resonates better with the viewer for long-time retention. This also relates with the active audience theory, wherein the perceived messages in the broadcast content is directly moulded in the personal, social contexts of the viewers..

Mental health awareness campaigns have yielded positive outcomes. Some of the strategies undertaken to target awareness and address stigma around mental illness include participation by family members, sensitization to treatment and social inclusion. Lack of knowledge about the mental illnesses poses a challenge to the mental health care delivery system. Research has highlighted the role of community-based systems in low-income countries and has also yielded positive results in creating awareness, thereby impacting participation.

Awareness and health literacy are two sides of the same coin. Stigma and discrimination are negative consequences of ignorance and misinformation. There are a few studies which have measured mental health literacy in the Indian context. One study found mental health literacy among adolescents to be very low, i.e. depression was identified by 29.04% and schizophrenia/psychosis was recognized only by 1.31%. Stigma was noted to be present in help-seeking.

These findings reinforce the need to increase awareness of mental health. Mental health literacy is a related concept which is increasingly seen as an important measure of the awareness and knowledge of mental health disorders. Health literacy has been described as “ability to access, understand, and use the information to promote and maintain good health.” Mental health literacy encompasses recognition, causes, self-help, facilitation of professional intervention, and navigating the information highway. Attitudes which hinder recognition and appropriate help-seeking can be counteracted by information which is already readily available in the public domain. There are plenty of examples of awareness positively impacting mental health outcomes.

CONCLUSION:

Depression, which affects one in five people at some point in their life, can be an incredibly isolating illness. Aside from the fact that one of the symptoms of the illness is that communication and socializing is hard, there is a huge stigma in society that stems from a lack of understanding about it.

Although this has created a perfect storm – not a lot of people feel able to talk about it and no one understands it because it isn't being talked about - social media is providing a catalyst and conduit for people to break down perceptions around depression, and finally explain how they feel.

Having a positive conversation about our mental health and celebrating the internet both seem like reasonable propositions. Our mental health is fundamental and basic to the experience of being human, it’s an integral and vital part of all of us, while the internet facilitates instant access to information, opinions and communication with other people all around the world.

Sadly though, such conversations are challenged by the dominant paradigm in mental health and the often negative traditional media coverage of the internet. Too often, mental health equates to mental illness in the public consciousness. Meanwhile, newspaper headlines mournfully pronounce that the “internet is bad for kids’ mental health”. It’s time to get positive about mental health and it’s time to cop on to the fact that the internet is here to stay, embrace it, understand it, help to make it a nicer place.

Over the past few years, various campaigns - spawned by both charities and the public have utilised various innovative campaigns to help open up discussions surrounding mental health.

Hand-held devices and the social media can truly be game-changers in the propagation of effective mental health interventions through focussed amplification, and not just in increasing information. With the greater utilization of big data, the understanding of subtle and distributed patterns over large volumes shall inform decision making.

Considering that most of the earlier strategies to enhance mental health have not succeeded over the past six decades or more in less-developed countries, the time has come to take on a new approach with renewed vigour. Mental health awareness can become both the means and the way of ending this apathy. Progressive government policies based on evidence-based approaches, an engaged media, a vibrant educational system, a responsive industry, aggressive utilization of newer technologies and creative crowdsourcing might together help dispel the blight of mental illnesses.

REFERENCES:

1. Anderson, J. G. (2007). Social, ethical and legal barriers to e-health. International Journal of Medical Informatics, 76 (5–6), 480–483.

2. Anil Kumar Pathlavath, (2018). Video for Change: Adolescent Video Active Girls (VAG) Project. Res. J. Humanities and Social Sciences. 2018; 9(1): 100-106. DOI No: 10.5958/2321-5828.2018.00018.9

3. Anil kumar. P (2013). Effectiveness of television advertisement in the present business scenario. CASIRJ,2013, International Research Journal of Commerce, Arts and Science , 4(3), 55-68, www.CASIRJ.com

4. Barney LJ, Griffiths KM, Jorm AF, et al. Stigma about depression and its impact on help-seeking intentions. Aust N Z J Psychiatry. 2006;40:51–4. [PubMed]

5. Bayar MR, Poyraz BC, Aksoy-Poyraz C, et al. Reducing mental illness stigma in mental health professionals using a web-based approach. Isr J Psychiatry Relat Sci. 2009;46:226–30

6. Boulos, M., Maramba, I., and Wheeler, S. (2006). Wikis, blogs and podcasts: A new generation of Web-based tools for virtual collaborative clinical practice and education. BMC Medical Education, 6 (1), 41.

7. Carleen Hawn, Take Two Aspirin And Tweet Me In The Morning: How Twitter, Facebook, And Other Social Media Are Reshaping Health Care, Health Affairs 28, no.2. doi: 10.1377/hlthaff.28.2.361

8. Cegala, D. J., McGee, D. S., and McNeilis, K. S. (1996). Components of patients’ and doctors’ perceptions of communication competence during a primary care medical interview. Health Communication, 8(1), 1–27.

9. Demyan AL, Anderson T. Effects of a brief media intervention on expectations, attitudes, and intentions of mental health help seeking. J Couns Psychol. 2012; 59:222–9.

10. Flemming, D.A. (2007). Ethical Implications in the Use of Telehealth and Telemedermatology. In press

11. Griffiths KM, Carron-Arthur B, Parsons A, Reid R. Effectiveness of programs for reducing the stigma associated with mental disorders. A meta-analysis of randomized controlled trials. World Psychiatry. 2014 Jun;13(2):161–75. doi: 10.1002/wps.20129. http://dx.doi.org/10.1002/wps.20129. [PMC free article] [PubMed] [Cross Ref]

12. Hye-Jin Paek, Kyongseok Kim, Thomas Hove; Content analysis of antismoking videos on YouTube: message sensation value, message appeals, and their relationships with viewer responses, Health Education Research, Volume 25, Issue 6, 1 December 2010, Pages 1085–1099, https://doi.org/10.1093/her/cyq06

13. Lowrey, W., and Anderson, W. B. (2006). The impact of Internet use on the public perception of physicians: A perspective from the sociology of professions literature. Health Communication, 19 (2), 125–131.

14. Mittal D, Sullivan G, Chekuri L, et al. Empirical studies of self-stigma reduction strategies: a critical review of the literature. Psychiatr Serv. 2012; 63:974–81. [PubMed]

15. Pathlavath, A. K. (2018). Video for Change: Adolescent Video Active Girls (VAG) Project. Research Journal of Humanities and Social Sciences, 9(1), 100-106. DOI No: 10.5958/2321-5828.2018.00018.9

16. Pathlavath, Anil Kumar. (2013). “Development of Mobile Phone Technology in Kenya and India” International Research Journal of Commerce, Arts and Science, 4(3), 55-68.

17. Pathlavath, Anil Kumar. (2017). "Participatory Video Practice: Amplifying Adolescent Girls’ Voice Through Video." Organising Committee: 34. ISBN No. 978-93-5267-935-5

18. Smith, Brian. "Mental Illness Stigma in the Media." The Review: A Journal of Undergraduate Student Research 16 (2015): 50-63. Web.

19. Stefano Pace, (2008) "YouTube: an opportunity for consumer narrative analysis?", Qualitative Market Research: An International Journal, Vol. 11 Issue: 2, pp.213-226, https://doi.org/10.1108/13522750810864459

20. Umefjord, G., Petersson, G., and Hamberg, K. (2003). Reasons for consulting a doctor on the Internet: Web survey of users of an Ask the Doctor Service. Journal of Medical Internet Research, 5 (4), e26.

Received on 27.11.2018 Modified on 19.03.2019

Int. J. Ad. Social Sciences. 2019; 7(3-4):63-70.