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“ Inbox me, please ”: Analysing comments on anonymous Facebook posts

about depression and suicide

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DOI: 10.1080/14330237.2019.1665903

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 Journal of Psychology in Africa

ISSN: 1433-0237 (Print) 1815-5626 (Online) Journal homepage: https://www.tandfonline.com/loi/rpia20

“Inbox me, please”: Analysing comments on

anonymous Facebook posts about depression and
suicide

Lane Tao & Liezille Jacobs

To cite this article: Lane Tao & Liezille Jacobs (2019) “Inbox�me,�please”: Analysing comments on
anonymous Facebook posts about depression and suicide, Journal of Psychology in Africa, 29:5,
491-498, DOI: 10.1080/14330237.2019.1665903

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Journal of Psychology in Africa, 2019
Vol. 29, No. 5, 491–498, https://doi.org/10.1080/14330237.2019.1665903
© 2019 Africa Scholarship Development Enterprize

“Inbox me, please”: Analysing comments on anonymous Facebook posts about depression and
suicide
Lane Tao* and Liezille Jacobs

Department of Psychology, Rhodes University, Makhanda, South Africa

*Corresponding author email: inbox@Lanetao.com

This study explored Facebook posts for receptive disclosure and discussion of depression and suicidality among
contributors . We utilised an existing data set of Facebook commentary from 445 comments made on 156 anonymous
Facebook posts . A Chi-square analysis revealed that Facebook commenters provided positive support to those sharing their
experiences of depression and suicide ideation . Only a small percentage of the responses (< 3%) were negative reactions .
Our findings suggest that anonymous-to-visible social media communications may provide some form of social support,
which could support e-psychology interventions .

Keywords: anonymity, cyber-disinhibition, SNS, social media, social support, suicidality

Introduction For instance, Fatima’s (2016) discourse analysis on

Research suggests that people display signs of depression
in their social media posting (De Choudhury et al .,
2013; De Choudhury & De, 2014; Guntuku et al ., 2017;
Moreno et al ., 2011) and seek help or discuss experiences
of depression on social media (Burns, Durkin, &
Nicholas, 2009; Shaw & Gant, 2002) . People may be
less forthcoming of their depression and suicidal ideation
to others, in person, out of fear of being stigmatised
(Eisenberg, Downs, Golberstein, & Zivin, 2009;
Pavalanathan & De Choudhury, 2015) . Increasingly,
the internet is one vehicle where people can elect to
anonymously share their mood disorder experiences
(Eysenbach et al ., 2004), with reduced risk for social
ostracism .
Formal mental healthcare is not always accessible
or desirable to those with significant health care needs
(Christensen & Griffiths, 2002; Morahan-Martin &
Anderson, 2000) . The internet can provide “…social
[support] resources that persons perceive to be available or
that are actually provided to them by non-professionals”
(Cohen, Underwood, & Gotlieb, 2000, p . 4), and with
anonymity . Examples are spread over a range of methods,
websites, and time periods . This includes Facebook
(Birnholtz et al ., 2015), Twitter (Cavazos-Rehg et al .,
2016a), Tumblr (Cavazos-Rehg et al ., 2016b), and Reddit
(De Choudhury & De, 2014). Yet, the efficacy of these
platforms to anonymously assist those with mood disorders
is scarcely researched . There is a need for research in
terms of evidence-informed use by professionals and non-
professionals alike .
Birnholtz and colleagues (2015) reported that
anonymous Facebook posts can be useful in helping users
address questions about a range of stigmatised topics,
including mental health . Investigating social media
audience responses to the disclosure of mood disorders
might be timely to help affected people locate informal
social support in the absence of professional services (see
also Dominguez-Whitehead, Whitehead, & Bowman,
2017; Fatima, 2016) .
masculinities noted that “confession pages on Facebook
serve as an outlet for students to give vent to the issues they
cannot otherwise address directly” (p . 82) . The possibility
that internet-mediated resources could provide informal
social support for depression (Shaw & Gant, 2002; Wright
et al ., 2013) suggests that this could be used to address the
pressing problem of supporting distressed people through
readily available social media . These pages may also offer
insights into the effects of anonymity on disclosure and of
visibility on responses .
Goal of the study
We aimed to explore comments made on a Facebook
Page (FBP) where anonymous users submitted posts to
be seen by visible audiences (in other words Facebook
users who are viewing, and responding to content using
their profiles), and not as the post’s anonymous submitter .
Analysis of all the comments was infeasible As such, with
previous research (Birnholtz et al ., 2015; Cavazos-Rehg
et al ., 2016a; Cavazos-Rehg et al ., 2016b; De Choudhury
& De, 2014) finding supportive social media audience
responses to disclosure about depression and suicidality,
an analysis of depression and suicide-related posting on
one such page was conducted .
Our goal was to address the following questions:
• What proportion of audience comments from Facebook
postings in response to those with depression and
suicidal ideation were positive versus negative?
• What is the visible audience saying in response to
Facebook posts about depression and suicidality, and
how often did each coded response appear?
Outcomes from this research could guide social
media and anonymous-but-moderated e-interventions into
depression and suicidality . Additionally, it may contribute
to the body of knowledge on how people use the internet
as a mental health resource .

Journal of Psychology in Africa is co-published by NISC (Pty) Ltd and Informa UK Limited (trading as Taylor & Francis Group)
492 Tao & Jacobs
Method
Data sources
This was a secondary data analysis in which we selected
156 cases from a large sample (N = 14 781) of anonymous
Facebook postings . We sampled cases taking into
account the access restrictions on comments due to the
compartmentalised nature of Facebook data . Facebook
comments are limited to 8 000 characters and the fact that
each post was independent of others meant that posts had
minimal relation to each other .
The corpus was drawn from one public FBP where
anonymous submitters have their posts published by
page administrators to a visible audience . This publishing
mechanic is at the heart of an interaction between an
audience of followers, and a single anonymous submitter .
One page was selected and all posts during a year-
long period between 2017 and 2018 were sampled . The
rationale for selecting one page was to draw more specific
data about the chosen topic from a single locale . Using
posts and comments from one page also allowed for the
content analysis of audience responses to be more focused .
The data was drawn from a page in one locale whose
primary demographic was aged 18 to 25 . The chosen
page was active at time of collection and had over 7 000
followers and over 16 000 published posts .
Instruments
Open source data capture software from Github was used
to collate all posts and comments from the FBP . nVivo
was the first choice, but an update in Facebook’s Graph
API in late 2017 rendered many existing data capture tools
inoperable due to the change of a posts endpoint used for
post retrieval . A third-party data capture program was
located on Github and updated with the new published_
posts endpoint . Initially, only post content was captured .
Comments were later manually captured by locating
posts with comments using permalinks . Any identifiable
information or profile information was omitted . Only
English-language posts and comments were used in the
analysis .
Procedure
A keyword search was used to locate relevant posts in the
corpus . The list of keywords was developed from a list of
words which appeared with high frequency on depression
forums compiled by Ramirez-Esparza and colleagues
(2008) . Their list was chosen because it was compiled from
a quantitative analysis of online forums about depression .
While online forums are not a perfect analogue to
Facebook pages, they are as near as possible given the lack
of data about Facebook pages . The remaining keywords
were identified inductively based on common terms used
to refer to depression and suicide in the researchers’
context . This process of drawing from existing theory and
inductive reasoning to develop effective, context-sensitive
codes, was emblematic of mixed top-down and bottom-up
approaches to generating codes (Willig, 2013) .
All comments were coded using a codebook generated
inductively based on the content of the comment . Inter-
rater reliability was provided by another researcher who
used the codebook to code 20% of sampled data and the
codebook was adjusted using feedback from the inter-rater
reliability exercise until agreement between the codebook
and inter-rater exceeded 80% .
A quantitative approach to the content analysis was
chosen due to the brief nature of Facebook comments
and unrelatedness of posts to each other in our corpus .
Facebook comments are limited to 8 000 characters and
none of our sampled comments reached that limit . The
posts themselves were also independent of each other .
Therefore, it was more practical to code for audience
responses with an emphasis on quantifying and presenting
data, than address qualitative questions in a large,
disconnected sample .
Data collection resulted in a sample of 156 Facebook
posts containing disclosure or discussion of depression
and/or suicide, and 445 comments on those posts . The
content analysis of audience responses addressed the
following question: What is the visible audience saying
in response to posts about depression and suicidality, and
how often did each coded response appear?
Ethical considerations
Ethical clearance for this study was granted by the Ethics
Committee of the Psychology Department of Rhodes
University, tracking number PSY2018/21 .
There were some notable ethical considerations made
during the internet-mediated data collection process . A
core concern is that “participants” or the suppliers of data
often cannot feasibly be contacted for informed consent
as there may be too many participants; or, as in our case,
they are already anonymous . Our data was collected
from a FBP with no privacy settings and thus, visible to
anyone with a browser and active internet connection .
Additionally, the British Psychological Society (BPS)
(2017) notes that there may not always be a reasonable
expectation of privacy when people publish information
online . Furthermore, commenting on Facebook requires
registration and actively volunteering the information
posted in a comment (Wallbridge 2009) . Therefore,
there may not be a reasonable expectation for privacy
on a publicly accessible FBP . However, it should be
acknowledged that this research is not precisely the same
as archive or text research as there are living sources
of data (Samuel et al ., 2018) . Indeed, just because the
data is public is not sufficient reason to use it without
affording further protection to it (Samuel et al ., 2018;
Zimmer, 2010) . Consequently, the researchers took further
efforts to protect participant confidentiality by collecting
no demographic information, and the only identifying
information obtained during data collection consisted of
commenter Facebook names . This data was stored securely
and not used in any part of the analysis . Furthermore, most
instances of user comments used as examples in this paper
were paraphrased to further reduce the likelihood of data
breach . These measures were taken on top of the fact that
the posts were anonymously submitted and not traceable to
individuals, and that the page was publicly visible without
a Facebook account .
 Analysing comments on anonymous Facebook depression and suicide posts
Data analysis
Data analysis was conducted electronically . Data collection
produced a spread sheet containing the data, which were
imported into nVivo 11 . nVivo 11’s ‘Advanced Search’
feature was used to locate posts using the list of keywords .
Relevant posts were imported to another spread sheet with
permalinks . These permalinks were later used to locate
and manually extract comments . The quantitative content
analysis was conducted manually, with all quantities
recorded in spread sheets . The Chi-square analysis was
conducted using Statistica .
Search procedure and coding
The list of keywords used to search the corpus for posts
about depression and suicide included: depress (covering
all variations of the word ‘depression’), suic (covering all
variations of the word suicide), and several other words
that appear with frequency in relation to these topics .
These included: death, dying, die, despair, end, and
kill . The use of keywords and other words with similar
meanings in a context is described by Hsieh and Shannon
(2005) as summative coding . This is useful for locating
context-sensitive variations of terms, as well as the terms
themselves .
Posts containing these keywords were read to
determine if they contained a plausible disclosure of
depression and suicidality, or if they used those terms
in a different context . Inclusion criteria for a post to be
included for analysis were a direct mention of depression
or suicide (that was not a dysphemism) or containing
statements strongly suggesting suicidality . An example of
the latter would be a post containing the text: “I hate this
world so much on some mornings . I want to die but I’m
too afraid to do it myself .”
We sampled a total of 216 posts referencing depression
and suicide in a mental health context, or 1 .46% of posts
in the corpus . Drawing a representative sample from
the corpus and manually reading every item instead of
searching for keywords may have allowed for greater
accuracy, but at the expense of leaving too-small a sample
for the analysis of comments . We opted to focus on the
audience responses, which have not been explored in as
much depth . This required a larger starting sample .
After excluding posts without comments, 156 (72%)
posts remained, each containing a minimum of 1 comment .
These comments formed the basis of the analysis of
audience responses and were coded for comparison to
Birnholtz and colleagues’ (2015) existing work, using
a coding structure similar to theirs (Relevant, Negative,
Other) .
The comments on these posts were retrieved,
individually read, and coded into four broad categories:
• Relevant – Addressing the submitted post in a fashion
that is positive, affirming, or may lead to productive
outcomes for the submitter;
• Negative – Addressing the post in a fashion that is
negative, degrading, or lead to damaging outcomes
for the submitter (including, inter alia, racism,
homophobia, insulting submitters);
493
• Other – Being irrelevant to the post’s topic, such as
comments containing a single emoji without further
information, deleted comments, or spam; and
• Admin – Posts made by the administrator account
were coded separately . The administrators on this page
appear to post a general mental health referral post
containing contact details of local mental healthcare
resources as a comment on many posts with strong
references to mental illness . In that moment, the page
administrators take on the role of audience commenters
and they are treated as such in our data .
A total of 445 comments were counted, with an average
of 2 .85 comments per post (across posts containing
comments) . Deleted/hidden comments were placed into the
Other category, as their contents are unknown . The page
administrators occasionally made comments addressed to
submitters, which contained messages of affirmation and
mental healthcare resources that would be available in the
context the page is centred on . A single comment could
contain multiple codes . For example: “Inbox me . You
are not alone” would be coded as a request to contact the
commenter and as an affirming message.
All administrator comments found in our sample met
the criteria for being relevant, but were coded separately
due to the different position that page administrators hold
compared to other followers .
We conducted a Chi-square test for goodness-of-fit.
This was done to determine how well the observed data
in Relevant, Negative, and Other comments compared
to findings in Birnholtz and colleagues (2015). The data
were converted into proportions out of 1 000 to allow for
rounding to 1 decimal place .
Results and discussion
The major codes and sub-codes are presented in Table 3 to
Table 6, with paraphrased examples of the type of content
fitting that code . Descriptive statistics follow .
We found that 87 .87% of audience comments were
relevant to the submitter, containing potentially useful
information, advice or addressing their post . As indicated
in Table 1, if page administrators’ comments were
removed, then 78 .2% of comments were Relevant . These
results are similar to, or substantially higher than, Birnholtz
and colleagues’ findings (2015) showing that “…2 938
(77 .74%) of comments were plausibly relevant” (p . 2 618) .
When only follower (non-administrator) comments are
counted, the outcome is comparable to the existing data .
However, when administrators’ comments are included, the
proportion of relevant comments is substantially higher .
About 2 .92% of comments in our data were coded
as Negative, and 9 .21% of comments marked as Other
(irrelevant), compared to 5 .4% marked as Negative by
Birnholtz and colleagues (2015) . Negative comments to
anonymous posts in our sample were by far the smallest
minority of posts. A simplified graphical representation of
coded content comments is in Figure 2 .
As indicated in Table 2, the Chi-square analysis
found significant differences between our data and the
expected data . However, we were cautious about using
statistical significance as a gold standard when analysing
subjective data drawn from different contexts. Significant
494 Tao & Jacobs

Broad comment category Major codes Sub-codes

Assurance that
submitter is not alone

General affirmation
Affirming
messages
Messages of solidarity

Religious reference

Request for contact

Contact the
commenter
Commenter willing
to listen to submitter

Administrator referral
to professional services
Relevant comments
Recommendations of
Professional peer-reviewed literature
assistance
Encourage seeking
professional help

Encourage staying in
therapy

Activate social
protectors

Suggest indirect
Responses to
course of action
anonymous posts about
depression and suicide Offer suggestions
on a Facebook page Suggest direct course
of action

Discourage self-
harm

Tagging someone
who may assist

Irrelevant comments Irrelevant comment No sub-codes

Negative comments Negative comment No sub-codes

Figure 1. Coding tree diagram depicting coding process

 Analysing comments on anonymous Facebook depression and suicide posts 495

Table 1. Categorised audience comments on 156 anonymous Facebook posts containing references to depression and suicide
(n = 445) .

Relevant Negative Other Admin

Count 348 13 41 43
M comments per post 2 .25 0 .08 0 .27 0 .28
Max . comments on one post 17 2 9 1
Std . Dev . 2 .48 0 .32 0 .96 0 .45
% of all posts 78 .2 2 .92 9 .21 9 .66

Table 2. Chi-square goodness of fit analysis of audience responses in categories

Observed Expected Difference O–E (O–E)**2/E

Relevant 878 779 99 99 12 .58
Negative 29 54 −25 −24 11 .57
Other 93 167 −74 −74 32 .79
Sum of Squares 56 .946

Table 3. Codes and sub-codes for ‘Affirming Messages’ and ‘Contact the Commenter’ comments

In the comments
Code and sub-code Description/examples (paraphrased) Count
of (x) posts
Affirming messages Messages affirming the submitter’s experiences or words without 75 128
specific instructions or requests.
Assurance that submitter is not alone ‘You’re not alone .’ ‘We’re here for you, you aren’t alone .’ 13 15
‘Nobody is alone in this world .’
General affirmation ‘I think you’re beautiful .’ ‘We care about you!’ ‘Sending you 56 71
love .’
Messages of solidarity ‘I remember what depression was like .’ ‘Yeah, I also couldn’t 31 36
get out of bed when I was depressed…’
Religious reference ‘As-salāmu ʿalaykum, you will make it.’ ‘God is watching over 6 6
you . I trusted Him and I made it through .’
Contact the commenter Messages reaching out to the submitter and asking for contact. 85 215
Commenter willing to listen to ‘I’m here if you need to talk .’ ‘I’ll listen to you – talk to me .’ 47 67
submitter ‘We can talk if you want!’ ‘I’ll be your friend!’
Requesting submitter contact the ‘Inbox me .’ ‘Please get in touch with me .’ ‘Drop me a 81 148
commenter message…’

Table 4. Codes and sub-codes for ‘Professional Assistance’ and ‘Offer Suggestions’ comments

In the comments
Code and sub-code Description/examples (paraphrased) Count
of (x) posts
Professional assistance Comments referring the submitter to professional therapy 56 74
services or peer-reviewed information
Administrator referral to This code includes all posts made by page administrators to refer 37 43
professional services submitters to professional services .
Recommendation of peer-reviewed ‘I have a journal article that might help, here…’ ‘My prof gave 2 2
literature this reading the other day, maybe you’ll like it .’
Encourage the submitter to find ‘Please get professional help for this .’ ‘Please contact the 24 26
professional help counselling services .’ ‘You should phone a hotline .’
Request that submitter stays in ‘Please stay in counselling, it gets better .’ ‘Keep trying the 2 3
therapy therapy…’
Offer suggestions Comments suggesting the submitter take potentially positive 60 114
action
Activate social protectors ‘Maybe talk to your friends .’ ‘Why not chat to a lecturer you 6 6
trust?’ ‘Do you have family you can talk to?’
Suggest indirect course of action ‘If you keep going, things will get better for you…’ ‘Do your 22 36
best .’
Request for submitter to not ‘Please don’t do it…’ ‘Don’t hurt yourself again, it’s not worth 9 11
self-harm it .’ ‘Please don’t do something drastic .’
Suggest direct course of action ‘You should try meditating .’ ‘Ditch that abusive asshole right 34 53
now .’
Tagging someone who can assist ‘[friend] come help?’ ‘[friend] you know about this?’ ‘I know 7 8
that [friend] went through this .’
496 Tao & Jacobs

Table 5. ‘Irrelevant’ and ‘Negative’ comments

In the comments
Code and sub-code Description/examples (paraphrased) Count
of (x) posts
Irrelevant comment Comments that did not address the original post topic . Included emoji 32 41
without context, tagging a friend without context and spam .
Negative comment Comments that devalued the submitter’s experiences or encouraged 11 13
dangerous behaviour . Included commenters encouraging self-harm,
insulting the submitter or accusing them of lying .

Table 6. Major codes with descriptive statistics

Count % of all codes SD

Contact the commenter 215 37 .13 57 .28
Affirming messages 128 22 .10 21 .82
Offer suggestions 114 19 .69 20 .78
Professional asssistance 74 11 .74 19 .74
Irrelevant comment 41 7 .08 –
Negative comment 13 2 .25 –

300

225

150

75

0
Contact the Affirming Offer Professional Irrelevant Negative
Commenter Messages Suggestions Assistance Comment Comment

Figure 2. Simplified graph of coded comment contents

differences were observed in all three categories of
comments (Relevant, Negative, and Other) . We draw
attention to comments coded Negative, where only 2 .92%
of comments in our dataset were coded as such compared
to the expected value of 5 .4% . We were solely concerned
with depression and suicide and it is possible that our posts
received fewer negative comments due to the serious, and
sometimes life-or-death, nature of the content . A stark drop
in the prevalence of negative comments on posts with a
more serious topic than those in Birnholtz and colleagues
(2015) suggests that commenters experience an inhibiting
effect when commenting from publicly visible Facebook
profiles on highly sensitive topics. Further investigation
is needed to determine the exact reason for the drop in
negative comments .
Going beyond simple analysis with Relevant,
Irrelevant, Negative, and Other categories; we were also
interested in the contents of audience responses (see
Tables 3 to 5) . The content analysis of audience comments
addressed 445 comments in 156 posts (M = 2 .85,
SD = 2 .55) . Once coded (see Figure 1), it was found that by
far the most common item were requests from commenters
for the submitter to contact them . Contact requests
appeared 148 times, in 33 .26% of comments . Contact
requests appeared frequently alongside the commenter
expressing a willingness to listen to the submitter about
their experiences . These two categories combined to form
the Contact the Commenter code and comments featuring
contact requests or a willingness to listen to the submitter
appeared in 54 .49% of posts’ comment sections . A request
to contact the commenter alone does not give further
information about what transpires if contact is made,
but the presence of emoji’s (smiles, hearts), affirming
messages, and messages expressing a willingness to listen
suggest that commenters intended to offer assistance . For
example, a comment that reads “Please inbox me . I’ve felt
exactly what you’ve experienced and I want to help, even
if it’s just to talk” involves a commenter requesting that
the submitter contact them while expressing solidarity and
a desire to assist .
Terms used in comments often followed repetitive
formats, possibly due to the narrow topic of the posts and
localised colloquialisms that were popular on the page . For
example, by far the most common phrase used by audience
commenters to ask that an anonymous submitter contact
them was: “Inbox me .” This occurred 88 times in contact
request comments . The phrase “Inbox me” was in wide
circulation during the data collection period as slang for
one person to contact another .
As indicated in Table 3, the second-most common
code was Affirming Messages, which accounted for
22 .10% of all codes and appeared in the comment
 Analysing comments on anonymous Facebook depression and suicide posts
sections of 48 .08% of posts . The next most common
code was Offer Suggestions, wherein commenters made
non-psychological, non-medical, and non-professional
recommendations to the submitter to assist in their
situation and experiences . These types of suggestions
accounted for 19 .69% of the coded items and appeared in
the comments of 38 .46% of posts .
Comments coded as “Negative Comment” were a
minority, with only 13 noted; accounting for 2 .92% of
comments and appearing under 7 .05% of posts . Comments
coded as “Irrelevant Comment” were also few; with 41
comments coded as such (7%) . Negative and irrelevant
comments combined appeared under 27 .56% of posts and
accounted for 9 .33% of coded items . Even when combined,
they did not match the next-highest code (Professional
Assistance) in prevalence (Table 5 to Table 6) .
The presence of such a large number of positive
responses is supported by existing research (Birnholtz
et al ., 2015), which suggests that audience responses
to depression and suicide on the internet are frequently
positive and affirming. Interestingly, followers made
very few referrals to professional services, despite the
availability of such . Followers’ professional referrals
accounted for only 4 .49% of codes, and the Professional
Assistance category accounted for the smallest of the
“Relevant Categories” . Page administrator referrals to
professional services accounted for 7 .42% of all codes
and occurred far more often than follower referrals to the
same . This suggests that the page audience is keener to
contact submitters directly, or providing assistance that is
not professional in nature .
While it is already known that young adults use the
internet to research mental health (Horgan & Sweeney,
2010; Powell & Clarke, 2006), anonymous FBPs offer a
form of support-seeking to submitters . Existing research
suggested that affirmation and support-seeking behaviours
on social media can be beneficial among young people
(Frison & Eggermont, 2015; Moreno et al ., 2011) . In
line with Burke and Develin (2016), we also found that
the positivity of audience responses tended to increase as
the post’s content became more negative . This is visible
in our chi-square analysis of comments, where our posts
were of a more serious nature and received fewer negative
responses than our comparison group .
Audience responses were positive, affirming, and
aimed at helping submitters by offering a wide range of
assistance ranging from conversation to professional
referrals . It is beyond the scope of this project to determine
the impact of these comments on the submitter’s well-
being, but it can be ascertained that the audience is
responding positively and receptively to disclosure about
depression and suicide .
Conclusions
We found that audience commenters on Facebook, in
this situation, responded overwhelmingly positively to
the posts’ submitters, illustrated by their willingness
to show affirmation, offer assistance and advise the
submitter reporting with mood disorder . Social media
could foster environments that are receptive to mood
497
disorder disclosure, and possibly connect affected people
to informal social support .
Authors’ note
The authors received funding from Rhodes University to publish
this paper . The authors would like to thank Rhodes University
for the resources provided to publish this paper .
ORCID
Lane Tao http://orcid .org/0000-0002-8811-6512
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