Skip to main content
SpringerLink
Log in
Book cover

International Conference on Human-Computer Interaction

HCII 2020: Social Computing and Social Media. Participation, User Experience, Consumer Experience, and Applications of Social Computing pp 87–107Cite as

Understanding Moderation in Online Mental Health Communities

  • Conference paper
  • First Online:

Part of the book series: Lecture Notes in Computer Science ((LNISA,volume 12195))

Abstract

Online Mental Health Communities (OMHCs) enable individuals to seek and provide support, and serve as a safe haven to disclose and share stigmatizing and sensitive experiences. Like other online communities, OMHCs are not immune to bad behavior and antisocial activities such as trolling, spamming, and harassment. Therefore, these communities are oftentimes guided by strict norms against such behavior, and moderated to ensure the quality and credibility of the content being shared. However, moderation within these communities is not only limited to ensuring content quality. It is far more complex—providing supportive spaces for disclosure, ensuring individuals’ privacy, etc.—because of the sensitive population that they cater to. By interviewing 19 moderators across 12 such OMHCs on Reddit, this paper studies the practices and structure of moderation in these communities to better understand their functioning and effectiveness. Our research questions primarily revolve around three major themes—moderation, support, and self-disclosure. We find practices of moderation hierarchy, and several distinctions in motivations and responsibilities of the moderators individually and as a group. We also notice that these communities predominantly encourage emotional support, and provide supportive spaces that encourage self-disclosure on stigmatized concerns. Our findings highlight the necessity of awareness corresponding to (currently lacking) privacy concerns, and raises the importance of the presence of mental health experts (counselors and psychiatrists) in these communities. On the basis of the insights drawn from this work, we discuss the implications and considerations for designing OMHCs.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Notes

  1. 1.

    The mental health condition/community name has been obfuscated to safeguard the identity of the community.

References

  1. Andalibi, N.: Social media for sensitive disclosures and social support: the case of miscarriage. In: Proceedings of the GROUP. ACM (2016)

    Google Scholar 

  2. Andalibi, N., Haimson, O.L., De Choudhury, M., Forte, A.: Understanding social media disclosures of sexual abuse through the lenses of support seeking and anonymity. In: Proceedings of the CHI (2016)

    Google Scholar 

  3. Andalibi, N., Morris, M.E., Forte, A.: Testing waters, sending clues: indirect disclosures of socially stigmatized experiences on social media. PACM HCI, 2(CSCW), 1–23 (2018)

    Google Scholar 

  4. Andalibi, N., Ozturk, P., Forte, A.: Sensitive self-disclosures, responses, and social support on Instagram: the case of# depression. In: CSCW (2017)

    Google Scholar 

  5. Bambina, A.: Online Social Support: The Interplay of Social Networks and Computer-Mediated Communication. Cambria Press, Amherst (2007)

    Google Scholar 

  6. Barak, A., Boniel-Nissim, M., Suler, J.: Fostering empowerment in online support groups. Comput. Hum. Behav. 24(5), 1867–1883 (2008)

    Article  Google Scholar 

  7. Beaudoin, C.E., Tao, C.-C.: Benefiting from social capital in online support groups: an empirical study of cancer patients. CyberPsychol. Behav. 10(4), 587–590 (2007)

    Article  Google Scholar 

  8. Bergstrom, K.: “Don’t feed the troll”: shutting down debate about community expectations on Reddit.com. First Monday 16(8) (2011)

    Google Scholar 

  9. Bishop, J.: Examining the Concepts, Issues, and Implications of Internet Trolling. IGI Global, Hershey (2013)

    Book  Google Scholar 

  10. Burleson, B.R., MacGeorge, E.L., Knapp, M.L., Daly, J.A.: Supportive communication. Handb. Interpers. Commun. 3, 374–424 (2002)

    Google Scholar 

  11. Caplan, S.E., Turner, J.S.: Bringing theory to research on computer-mediated comforting communication. Comput. Hum. Behav. 23, 985–998 (2007)

    Article  Google Scholar 

  12. Chancellor, S., Andrea, H., De Choudhury, M.: Norms matter: contrasting social support around behavior change in online weight loss communities. In: Proceedings of the CHI (2018)

    Google Scholar 

  13. Chancellor, S., Lin, Z.J., De Choudhury, M.: This post will just get taken down: characterizing removed pro-eating disorder social media content. In: Proceedings of the CHI (2016)

    Google Scholar 

  14. Chancellor, S., Nitzburg, G., Andrea, H., Zampieri, F., De Choudhury, M.: Discovering alternative treatments for opioid use recovery using social media. In: Proceedings of the CHI (2019)

    Google Scholar 

  15. Chandrasekharan, E., Pavalanathan, U., Srinivasan, A., Glynn, A., Eisenstein, J., Gilbert, E.: You can’t stay here: the efficacy of Reddit’s 2015 ban examined through hate speech. PACM HCI 1(CSCW), 1–22 (2017)

    Google Scholar 

  16. Chandrasekharan, E., et al.: The internet’s hidden rules: an empirical study of reddit norm violations at micro, meso, and macro scales. PACM HCI 2(CSCW), 1–25 (2018)

    Google Scholar 

  17. Cheng, J., Bernstein, M., Danescu-Niculescu-Mizil, C., Leskovec, J.: Anyone can become a troll: Causes of trolling behavior in online discussions. In: Proceedings of the CSCW (2017)

    Google Scholar 

  18. Chung, J.E.: Social interaction in online support groups: preference for online social interaction over offline social interaction. Comput. Hum. Behav. 29, 1408–1414 (2013)

    Article  Google Scholar 

  19. Cohen, S., Wills, T.A.: Stress, social support, and the buffering hypothesis. Psychol. Bull. 98(2), 310 (1985)

    Article  Google Scholar 

  20. Cozby, P.C.: Self-disclosure: a literature review. Psychol. Bull. 79(2), 73 (1973)

    Article  Google Scholar 

  21. De Choudhury, M., De, S.: Mental health discourse on reddit: self-disclosure, social support, and anonymity. In: ICWSM (2014)

    Google Scholar 

  22. De Choudhury, M., Kıcıman, E.: The language of social support in social media and its effect on suicidal ideation risk. In: ICWSM (2017)

    Google Scholar 

  23. De Choudhury, M., Kiciman, E., Dredze, M., Coppersmith, G., Kumar, M.: Discovering shifts to suicidal ideation from mental health content in social media. In: Proceedings of the CHI (2016)

    Google Scholar 

  24. De Choudhury, M., Sharma, S., Logar, T., Eekhout, W., Nielsen, R.: Quantifying and understanding gender and cross-cultural differences in mental health expression via social media. In: CSCW (2017)

    Google Scholar 

  25. Donath, J.S.: We need online alter egos now more than ever. Wired Mag. (2014)

    Google Scholar 

  26. Dunkel-Schetter, C.: Social support and cancer: findings based on patient interviews and their implications. J. Soc. Issues 40(4), 77–98 (1984)

    Article  Google Scholar 

  27. Ernala, S.K., et al.: Characterizing audience engagement and assessing its impact on social media disclosures of mental illnesses. In: Twelfth International AAAI Conference on Web and Social Media (2018)

    Google Scholar 

  28. Ernala, S.K., Rizvi, A.F., Birnbaum, M.L., Kane, J.M., De Choudhury, M.: Linguistic markers indicating therapeutic outcomes of social media disclosures of schizophrenia. Proc. ACM Hum.-Comput. Interact. 1(CSCW), 43:1–43:27 (2017)

    Google Scholar 

  29. Fabian, B., Baumann, A., Keil, M.: Privacy on reddit? Towards large-scale user classification. In: ECIS (2015)

    Google Scholar 

  30. Forte, A., Andalibi, N., Greenstadt, R.: Privacy, anonymity, and perceived risk in open collaboration: a study of tor users and wikipedians. In: Proceedings of the 2017 ACM Conference on Computer Supported Cooperative Work and Social Computing, pp. 1800–1811 (2017)

    Google Scholar 

  31. Goebert, D., Else, I., Matsu, C., Chung-Do, J., Chang, J.Y.: The impact of cyberbullying on substance use and mental health in a multiethnic sample. Matern. Child Health J. 15(8), 1282–1286 (2011)

    Article  Google Scholar 

  32. Goffman, E.: Stigma: Notes on the Management of Spoiled Identity. Simon and Schuster (2009)

    Google Scholar 

  33. Greene, J.A., Choudhry, N.K., Kilabuk, E., Shrank, W.H.: Online social networking by patients with diabetes: a qualitative evaluation of communication with Facebook. J. Gener. Internal Med. 26, 287–292 (2011)

    Article  Google Scholar 

  34. Grimmelmann, J.: The virtues of moderation. Yale JL & Tech. 17, 42 (2015)

    Google Scholar 

  35. Haimson, O.L., Brubaker, J.R., Dombrowski, L., Hayes, G.R.: Disclosure, stress, and support during gender transition on Facebook. In: CSCW, pp. 1176–1190. ACM (2015)

    Google Scholar 

  36. Helgeson, V.S., Cohen, S., Schulz, R., Yasko, J.: Long-term effects of educational and peer discussion group interventions on adjustment to breast cancer. Health Psychol. 20(5), 387 (2001)

    Article  Google Scholar 

  37. Jhaver, S., Birman, I., Gilbert, E., Bruckman, A.: Human-machine collaboration for content regulation: the case of Reddit automoderator. ACM TOCHI 26, 1–35 (2019)

    Article  Google Scholar 

  38. Jhaver, S., Bruckman, A., Gilbert, E.: Does transparency in moderation really matter? User behavior after content removal explanations on Reddit. Proc. ACM Hum.-Comput. Interact. 3(CSCW), 1–27 (2019)

    Google Scholar 

  39. Jhaver, S., Chan, L., Bruckman, A.: The view from the other side: the border between controversial speech and harassment on Kotaku in action. First Monday 23(2) (2018)

    Google Scholar 

  40. Joinson, A.: Causes and implications of disinhibited behavior on the internet (1998)

    Google Scholar 

  41. Joinson, A.N.: Self-disclosure in computer-mediated communication: the role of self-awareness and visual anonymity. Eur. J. Soc. Psychol. 31, 177–192 (2001)

    Article  Google Scholar 

  42. Joinson, A.N., Paine, C.B.: Self-disclosure, privacy and the internet. The Oxford Handbook of Internet Psychology, p. 2374252 (2007)

    Google Scholar 

  43. Jourard, S.M.: Self-disclosure: an experimental analysis of the transparent self (1971)

    Google Scholar 

  44. Juneja, P., Subramanian, D.R., Mitra, T.: Through the looking glass: study of transparency in Reddit’s moderation practices. Proc. ACM Hum.-Comput. Interact. 4(GROUP), 1–35 (2020)

    Google Scholar 

  45. Kang, R., Dabbish, L., Sutton, K.: Strangers on your phone: why people use anonymous communication applications. In: Proceedings of the CSCW (2016)

    Google Scholar 

  46. Kaplan, B.H., Cassel, J.C., Gore, S.: Social support and health. Med. Care 15(5), 47–58 (1977)

    Article  Google Scholar 

  47. Klein, K., Boals, A.: Expressive writing can increase working memory capacity. J. Exp. Psychol. Gener. 130(3), 520 (2001)

    Article  Google Scholar 

  48. Lawlor, A., Kirakowski, J.: Online support groups for mental health: a space for challenging self-stigma or a means of social avoidance? Comput. Hum. Behav. 32, 152–161 (2014)

    Article  Google Scholar 

  49. Liu, Y., Ferreira, D., Goncalves, J., Hosio, S., Pandab, P., Kostakos, V.: Donating context data to science: the effects of social signals and perceptions on action-taking. Interact. Comput. 29, 132–146 (2016)

    Google Scholar 

  50. Luther, K., Bruckman, A.: Leadership in online creative collaboration. In: Proceedings of the CSCW (2008)

    Google Scholar 

  51. Manikonda, L., De Choudhury, M.: Modeling and understanding visual attributes of mental health disclosures in social media (2017)

    Google Scholar 

  52. Nathan Matias, J.: Going dark: social factors in collective action against platform operators in the reddit blackout. In: Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems, pp. 1138–1151. ACM (2016)

    Google Scholar 

  53. Mattson, M., Hall, J.G.: Health as communication nexus: a service-learning approach (2011)

    Google Scholar 

  54. Naslund, J.A., Aschbrenner, K.A., Marsch, L.A., Bartels, S.J.: The future of mental health care: peer-to-peer support and social media. Epidemiol. Psychiatr. Sci. 25(02), 113–122 (2016)

    Article  Google Scholar 

  55. Newman, M.W., Lauterbach, D., Munson, S.A., Resnick, P., Morris, M.E.: It’s not that i don’t have problems, i’m just not putting them on Facebook: challenges and opportunities in using online social networks for health. In: Proceedings of the ACM 2011 Conference on Computer Supported Cooperative Work, pp. 341–350. ACM (2011)

    Google Scholar 

  56. Norcross, J.C., Lambert, M.J.: Psychotherapy relationships that work III. Psychotherapy 55(4), 303 (2018)

    Article  Google Scholar 

  57. Pavalanathan, U., De Choudhury, M.: Identity management and mental health discourse in social media. In: Proceedings of the WWW Companion (2015)

    Google Scholar 

  58. Pennebaker, J.W.: Writing about emotional experiences as a therapeutic process. Psychol. Sci. 8(3), 162–166 (1997)

    Article  Google Scholar 

  59. Pennebaker, J.W., Chung, C.K.: Expressive writing, emotional upheavals, and health. Foundations of health psychology, pp. 263–284 (2007)

    Google Scholar 

  60. Pew (2018). pewinternet.org/fact-sheet/social-media. Accessed 18 Apr 2018

  61. Potts, H.W.W.: Online support groups: an overlooked resource for patients. He@ lth Inf. Internet 44(1), 6–8 (2005)

    Google Scholar 

  62. Powell, J., Clarke, A.: Internet information-seeking in mental health. Br. J. Psychiatry 189(3), 273–277 (2006)

    Article  Google Scholar 

  63. Pruksachatkun, Y., Pendse, S.R., Sharma, A.: Moments of change: analyzing peer-based cognitive support in online mental health forums. In: Proceedings of the CHI (2019)

    Google Scholar 

  64. Quinn, D.M., Chaudoir, S.R.: Living with a concealable stigmatized identity: the impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health. J. Pers. Soc. Psychol. 97, 634 (2009)

    Article  Google Scholar 

  65. Rodriguez, R.R., Kelly, A.E.: Health effects of disclosing secrets to imagined accepting versus nonaccepting confidants. J. Soc. Clin. Psychol. 25, 1023–1047 (2006)

    Article  Google Scholar 

  66. Saha, K., Chan, L., De Barbaro, K., Abowd, G.D., De Choudhury, M.: Inferring mood instability on social media by leveraging ecological momentary assessments. In: Proceedings of the ACM IMWUT (2017)

    Google Scholar 

  67. Saha, K., Chandrasekharan, E., De Choudhury, M.: Prevalence and psychological effects of hateful speech in online college communities. In: WebSci (2019)

    Google Scholar 

  68. Saha, K., De Choudhury, M.: Modeling stress with social media around incidents of gun violence on college campuses. Proc. HCI 1(CSCW), 1–27 (2017)

    Google Scholar 

  69. Saha, K., et al.: The language of LGBTQ+ minority stress experiences on social media. PACM HCI 3(CSCW), 1–22 (2019)

    Google Scholar 

  70. Saha, K., Sugar, B., Torous, J., Abrahao, B., Kiciman, E., De Choudhury, M.: A social media study on the effects of psychiatric medication use. In: ICWSM (2019)

    Google Scholar 

  71. Seidman, I.: Interviewing as Qualitative Research: A Guide for Researchers in Education and the Social Sciences. Teachers College Press, New York (2013)

    Google Scholar 

  72. Sharma, E., De Choudhury, M.: Mental health support and its relationship to linguistic accommodation in online communities. In: Proceedings of the CHI (2018)

    Google Scholar 

  73. Sharma, E., Saha, K., Ernala, S.K., Ghoshal, S., De Choudhury, M.: Analyzing ideological discourse on social media: a case study of the abortion debate. In: Proceedings of the CSS. ACM (2017)

    Google Scholar 

  74. Shelton, M., Lo, K., Nardi, B.: Online media forums as separate social lives: a qualitative study of disclosure within and beyond Reddit. In: iConference 2015 Proceedings (2015)

    Google Scholar 

  75. Ullman, S.E., Filipas, H.H.: Predictors of PTSD symptom severity and social reactions in sexual assault victims. J. Trauma. Stress 14, 369–389 (2001)

    Article  Google Scholar 

  76. van der Nagel, E., Frith, J.: Anonymity, pseudonymity, and the agency of online identity: examining the social practices of r/Gonewild. First Monday 20(3) (2015). https://doi.org/10.5210/fm.v20i3.5615

  77. Vitak, J.: The impact of context collapse and privacy on social network site disclosures. J. Broadcast. Electron. Media 56, 451–470 (2012)

    Article  Google Scholar 

  78. Wang, Y.-C., Burke, M., Kraut, R.: Modeling self-disclosure in social networking sites. In: CSCW, pp. 74–85. ACM (2016)

    Google Scholar 

  79. Wang, Y.-C., Kraut, R., Levine, J.M.: To stay or leave?: the relationship of emotional and informational support to commitment in online health support groups. In: CSCW, pap, 833–842. ACM (2012)

    Google Scholar 

  80. McLure Wasko, M., Faraj, S.: “It is what one does”: why people participate and help others in electronic communities of practice. J. Strateg. Inf. Syst. 9(2), 155–173 (2000)

    Article  Google Scholar 

  81. Yang, D., Kraut, R., Levine, J.M.: Commitment of newcomers and old-timers to online health support communities. In: Proceedings of the CHI (2017)

    Google Scholar 

  82. Yang, D., Yao, Z., Kraut, R.: Self-disclosure and channel difference in online health support groups. In: ICWSM (2017)

    Google Scholar 

Download references

Acknowledgements

This project was approved by the Institutional Review Board (IRB) at Georgia Tech. We thank Eric Gilbert and Michaelanne Dye for their valuable feedback.

Author information

Authors and Affiliations

  1. Georgia Institute of Technology, Atlanta, USA

    Koustuv Saha, Sindhu Kiranmai Ernala, Sarmistha Dutta, Eva Sharma & Munmun De Choudhury

Authors
  1. Koustuv Saha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sindhu Kiranmai Ernala
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sarmistha Dutta
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eva Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Munmun De Choudhury
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Koustuv Saha .

Editor information

Editors and Affiliations

  1. Towson University, Towson, MD, USA

    Gabriele Meiselwitz

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Saha, K., Ernala, S.K., Dutta, S., Sharma, E., De Choudhury, M. (2020). Understanding Moderation in Online Mental Health Communities. In: Meiselwitz, G. (eds) Social Computing and Social Media. Participation, User Experience, Consumer Experience, and Applications of Social Computing. HCII 2020. Lecture Notes in Computer Science(), vol 12195. Springer, Cham. https://doi.org/10.1007/978-3-030-49576-3_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-49576-3_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-49575-6

  • Online ISBN: 978-3-030-49576-3

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics

Search

Navigation