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Social media is increasingly used as a source of mental health information for young people, with influencers playing a key role in public health communication. However, little is known about how young people engage with influencer mental health content and the media literacy skills they use to evaluate it. The objective of this study is to explore and evaluate the self-reported media literacy skills and beliefs that young people use when they encounter mental health content on TikTok.

The study uses qualitative, thematic analysis to provide an empirical account of how young people interpret mental health content from influencers on TikTok. Research was conducted via eighteen group (n = 73 participants) and individual interviews (n = 13) with eighty-six participants in the United Kingdom. The analysis focused on self-reported media literacy skills and strategies for navigating influencer-led mental health content.

The study identifies three contextual challenges in young people's responses to mental health content on TikTok: (I) reliability and relatability act as distinct but complementary criteria used to assess influencers and their mental health content; (II) platform beliefs influence willingness to engage with mental health content; and (III) algorithmically driven platform design hinders critical thinking about mental health content.

These findings highlight the sophistication of young people's media literacy skills alongside the significant, contextual barriers, which hinder the use of social media as a channel for mental health support from influencers. Our results suggest that public health campaigns may need to take a more platform-sensitive approach to online communication, acknowledging the ways platform-driven beliefs and design shape how and why young people engage with mental health content.