Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Sarah Lowe


Background: In response to worsening mental health among adolescents, the U.S. Surgeon General issued an advisory on December 7, 2021 calling for action to address the youth mental health crisis. The advisory makes several recommendations, including actions media organizations can take to protect viewers’ mental health. The advisory specifically mentions news coverage that can negatively impact mental health, such as depictions of mental illness and traumatic events including natural disasters, pandemics, and mass violence. High rates of youth consume news on social media, with TikTok as one of the most popular apps for this demographic. Although research indicates that both news and social media are associated with worse adolescent mental health outcomes, there have been no attempts to my knowledge to examine whether news outlets adhere to the U.S. Surgeon General’s recommendations on or off social media.

Aims: This study aims to describe how news media organizations adhere to federal recommendations to protect youth mental health while reporting stories on mental health or illness and collective trauma events, including climate change or weather-related disasters, mass shootings, and the COVID-19 pandemic.

Methods: The study uses a directed content analysis method guided by the U.S. Surgeon General advisory titled “Protecting Youth Mental Health.” The data source is videos published on TikTok by news media organizations within a one-year time frame - the day the advisory was published, December 7, 2021, to December 6, 2022. Using a list of the top news sites in the United States, I selected four news organizations with the highest follower count on TikTok: ABC News, CBS News, NBC News, and Daily Wire. Basic data – including topic, number of likes, and number of comments – were collected for all videos in the specified time period. If videos met the content inclusion criteria, they were coded based on their adherence to advisory guidelines. Analysis includes both descriptive statistics and qualitative methods.

Results: The selected news media organizations published a total of 5,344 videos during the specified time period. Of those videos, 950 (17.8%) covered news related to mental health or illness, climate change or weather-related disasters, mass shootings, and the COVID-19 pandemic. All content had a median adherence rate of 19.5% (range = 0.0 – 83.9 percent). Across outlets, ABC News had a median adherence rate of 34.6% (range= 0.0 – 95.1%), followed by CBS News at 14.3% (range= 0.0 – 100.0%), NBC News at 9.8% (range= 0.0 – 100.0%), and Daily Wire at 7.7% (range= 0.0 – 75.0%). Low adherence rates to U.S. Surgeon General recommendations show that, overall, news media organizations are not protecting youth mental health. Variation was observed in the extent to which videos by exposure type aligned with the Surgeon General recommendations. For mental health and illness videos, 83.9% of news media organization content did not mention harmful stereotypes while only 8.1% of videos included stories of successful recovery. The adherence rate for news coverage of collective trauma events ranged from 0.0% to 76.1%. Across all four platforms, the two recommendations with the highest adherence rate were “fact-based reporting” and “no language that shocks, provokes, or creates a sense of panic” (40.0% - 76.1%). The recommendations with the lowest adherence rate (0.0 – 8.0%) were “include ways the public can make a positive difference” and “include content warnings on distressing content.”

Conclusions: Public health research at the intersection of news and social media can help practitioners understand ways to address the youth mental health crisis. This study is the first to determine if news media organization content on TikTok follows U.S. Surgeon General recommendations to protect youth mental health. Public health leaders can use these findings to inform interventions that ensure media organizations follow U.S. Surgeon General recommendations to protect youth and help end the mental health crisis.


This is an Open Access Thesis.

Open Access

This Article is Open Access