Telepsychology and digital mental health communication: an exploratory mixed-methods study of tikTok content

Abstract

Background Telepsychology consolidated as a mainstream mental health care modality following the COVID-19 pandemic, supported by evidence of clinical efficacy comparable to in-person therapy and a recognized potential to democratize access to care. Against this evolving clinical landscape, social media platforms have simultaneously emerged as major environments for the public circulation of psychological knowledge. Objective To explore the relationship between scientific evidence on telepsychology and its discursive representation in highly viewed Spanish-language TikTok content, and to identify implications for digital mental health literacy and professional communication practices. Methods An exploratory mixed-methods design with qualitative emphasis integrated a scoping review (PRISMA-ScR) across Scopus, Web of Science, and PubMed (2020–2025; n = 39 articles) and an inductive thematic analysis of TikTok content (N = 50 videos; 1,286,360 total views). Searches were conducted from a newly created TikTok account with no prior interaction history, configured in Colombia, to reduce algorithmic personalization bias. Three exploratory corpus-descriptive indicators—the Telepsychology Gap Index (TGI), Digital Telepsychology Legitimacy Index (DTLI), and Simplified Circulation Index (SCI)—were computed as heuristic comparators. Results The scientific literature consistently supported the clinical viability and democratizing potential of telepsychology. Within the TikTok corpus, 64% of content featured simplified definitions or subjectivist experiential narratives with minimal reference to ethical or regulatory frameworks. Corpus-descriptive indicators revealed a substantial gap between scientific representation and digital circulation (TGI = 0.80), limited presence of clinical foundations in digital discourse (DTLI = 0.36), and a predominance of simplified over technically grounded content (SCI = 1.78). Conclusions Within the analyzed corpus, telepsychology undergoes a process of digital discursive reinterpretation in which communicative accessibility and immediate subjective experience displace clinical precision as central evaluative criteria. These findings underscore the need to strengthen digital mental health literacy and professionals' evidence-based communication skills online. Given the exploratory design, findings are specific to a non-probabilistic Spanish-language TikTok corpus and are not generalizable prevalence estimates. Future research should extend this agenda through larger multilingual samples, additional platforms, computational social science approaches, and longitudinal designs examining how digital representations of telepsychology shape users' expectations and engagement with digital mental health care.