Tweets Observed During The COVID-19 Pandemic Revealed Increased Mental Health Symptoms

The mental health status of emergency medicine (EM) and resident physicians can, in fact, be explored and determined through social media content posted, according to a study observing the tweets of physicians made before, during and after the COVID-19 pandemic.

The COVID-19 pandemic continues to heighten mental health symptoms and healthcare burnout across the clinical workforce. In particular, COVID-19 continues to impact the mental health of EM physicians and resident physicians on top of the everyday stress, anxiety, depression, and burnout they encounter in the emergency department due to the chaotic environment, high rates of workplace violence, and constant exposure to critical careevents.

In the cross-sectional study conducted by the U.S. Surgeon General and the National Academy of Medicine, researchers sought to address the healthcare workforce highlighting the need to understand and support physicians.

Tweets posted between March 2018 and March 2022 on Twitter by EM physicians and resident physicians were investigated in search for changes in content and language as indicators of their emotional well-being. According to the report, Twitter serves as a large source for users like physicians to share their opinions and is a proxy for the topics and language used related to mental health.

In the investigation, researchers used natural language processing and machine learning to evaluate tweets to identify themes in content and language related to psychological and mental health constructs.

The study focused on the top 10 counties in the U.S. with the largest COVID-19 case counts at the time of the analysis using national data sets. These counties include Los Angeles, California; Maricopa, Arizona; New York, New York; Miami-Dade, Florida; Cook, Illinois; Harris, Texas; San Diego, California; Riverside, California; Broward, Florida; and San Bernardino, California.

Recently published in JAMA Network, results of the study displayed key thematic shifts and increases in language related to anxiety, anger, depression, and loneliness during the pandemic.

Overall, identified were 471 physicians with a total of 198,867 tweets. The top 5 pre-pandemic tweet themes included free open-access medical education, residency education, gun violence, quality improvement in healthcare and professional resident associations.

During the pandemic, themes of tweets related to healthy behaviors during COVID-19, pandemic response, vaccines and vaccination, unstable housing and homelessness, and emotional support for others.

Across the phases of the pandemic, themes changed significantly. Compared with the pre-pandemic period, there was less positive and more negative language used during COVID-19. Estimates of loneliness, anxiety, anger, and depression also increased significantly during COVID-19, the study said.

These results reveal a significant increase in mental health strain among physicians during, before and throughout the pandemic. Findings also suggest social media content can provide insight into emergency medicine physicians’ mental well-being and may reveal signals related to burnout by identifying higher levels of mental health strain and key changes in thematic content.

However, there were limitations that did not fully support data. For example, the study uses social media content from Twitter only, which is biased by those who are actively posting to that platform alone, rather than Facebook or Instagram.

In addition, the study included publicly or easily identifiable EM physicians and residents who either shared their social media usernames or accounts or those who identified themselves on the platform.