Background Social media is an increasingly dominant platform for communication, especially among adolescents. Statements from professional bodies and a growing body of empirical evidence support a role for social media in improving provider-patient interactions. In psychiatry, particular concerns exist about the suitability of this style of communication. Very limited data are available exploring how patients would like to incorporate social media into their communication with their psychiatric providers.

Background: Social networking sites (SNSs) are increasingly dominant platforms for communication among adolescents. Recently, concerns have been raised about the risks involved with SNS use, particularly among more vulnerable adolescents. Objective: Our goal was to explore the experience of SNS use by adolescents with psychiatric illnesses. We also sought to understand the ways in which these sites may be a useful way to communicate-as well as a potential source of increased stress-for this vulnerable population. Methods: We performed a qualitative study by conducting in-depth, semi-structured interviews with 20 adolescents (mean age, 16 years; 15 female and 5 male participants) attending the Yale Adolescent Intensive Outpatient Program, which includes 3 hours of outpatient treatment 3 or 4 days per week. Results: The participants in our study described multiple ways in which SNSs possessed unique utility as platforms for communication. Participants found that SNSs allowed them to reach out to a broader audience and to "broadcast" feelings of distress without forcing any specific person into a supportive discussion. In addition, SNSs were described as lower-stress means of communication that allowed responses to be carefully formulated; this led to participants sharing information that they would not have shared during face-to-face interactions. However, participants also described anxiety surrounding the pressure to be active on SNSs, and they found it stressful to be exposed to pictures and posts involving former romantic partners. Conclusion: SNSs provide a useful platform for adolescents with psychiatric illnesses to use to communicate, particularly with regard to communicating any feelings of distress. However, there are many ways in which SNSs can increase levels of anxiety, and this aspect may be an important focus of future clinical attention.