Social-Media-Based Mental Health Interventions: Meta-Analysis of Randomized Controlled Trials

Background: Compared with other online mental health interventions, programs delivered through social media apps may require less training and be more acceptable and accessible. During and after the pandemic, both the number of social media users and social-media-based mental health interventions increased. However, no meta-analysis has focused on rigorous social-media-based mental health interventions for general populations. Objective: This preregistered meta-analysis synthesized findings from rigorously designed randomized controlled trials (RCTs) (decent sample size, low attrition, and comparable baseline conditions) to assess whether social-media-based mental health RCTs reduce mental health issues. Methods: A comprehensive search (databases, hand searching, and citation tracking) yielded 11,658 studies. Inclusion criteria required social-media-based RCTs with n≥30 per arm at baseline, differential attrition <15%, baseline differences <0.25 SDs, published after 2005, delivered by nonresearchers, and targeting negative mental health outcomes (excluding one-item measures). Random-effects meta-regression using Hedges g was conducted. Results: Seventeen eligible studies (total n=5624) were included. On average, social-media-based interventions were effective (ES=0.32, P<.001; 95% CI 0.24-0.45; I²=88.10%; τ²=0.13). They reduced anxiety (ES=0.33, P=.04, n=27), depression (ES=0.31, P<.001, n=31), and stress (ES=0.69, P=.02, n=12). Interventions were more effective when participants were >70% female, when programs were human-guided and social-oriented, and when controls were care as usual. Risk of bias and publication bias analyses suggested low risk and robust findings. The main limitation is the small number of included studies (n=17). Conclusions: Social media shows benefits and potential for treating mental health symptoms.