The World Health Organisation defines mental health as “a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” [1]. Those with poor mental wellbeing are at an increased risk of mental illness development and furthermore, have a reduced life expectancy [2, 3].
In the UK, one in four individuals suffer from a mental illness in their lifetime [4]; the majority of which arise before the age of 25 years [5]. 83% of undergraduate students in the UK are between the ages of 16–24 years and are hence considered to be highly vulnerable to mental ill-health [6, 7]. Figures indicate that the prevalence of mental illness among undergraduate students has significantly increased in the last 10 years, demonstrated by a 94% increase in the demand for university counselling services in the last five years alone [8]. Whilst the cause of this increase is currently undetermined, there is speculation in current literature that the advent of social media (SM) may be a contributing factor with a further emphasis on the impact of image-centric SM platforms such as Instagram [9,10,11,12,13,14,15,16,17,18,19,20].
In the UK, 91% of 16–24 year-olds have at least one SM account and spend three hours per day on average on SM sites [21, 22]. Whilst SM affords users the opportunity to disseminate information, increase one’s social capital and communicate with a global audience, current research indicates that SM may have a negative impact on one’s mental wellbeing [11, 20, 21, 23, 24]. Recent research has focused on image centric SM platforms, such as Instagram, as they may be particularly harmful for the body satisfaction, self-esteem and the psychological wellbeing of its users when compared to text based platforms [25, 26]. It is recognised that the visual nature of image-centric SM platforms allows greater opportunities for upward social comparisons (comparisons to others believed to be superior than oneself) which may drive the body dissatisfaction and reduced self-esteem of its users [25, 27, 28].
Fardouly et al., determined that users of visually-focused SM platforms, such as YouTube and Instagram, had greater concerns with their body image compared to those who did not use SM [29]. Furthermore, Engeln et al. concluded that undergraduate women who used Instagram had greater body dissatisfaction and increased negative affect compared to those who used Facebook [25]. Additionally, Boursier et al. established that users with higher levels of body surveillance and appearance anxiety were more likely to post self-images on SM with the aim of achieving positive feedback from peers to gain confidence [30, 31]. Furthermore, Gioia et al. concluded that male adolescents were more likely than females to edit photos and change their body image in order to obtain an ideal appearance for SM [32]. This thus indicates that photo-based SM platforms may be more detrimental to the mental wellbeing of its users compared to text-based platforms due to body dissatisfaction, social comparison, social acceptance and internalisation of the ideal.
Founded in 2010, Instagram is a photo-sharing SM platform allowing users to post photographs and videos onto their profiles [33]. Users interact with one another using ‘likes’ and ‘comments’ and can follow an unlimited number of people [15]. Public engagement with an individual’s post can be increased through the use of captions, geotags and hashtags (#) [15].With approximately 23 million users in the UK alone and 52 million images posted per day, Instagram is the second most popular SM platform after Facebook [29, 34,35,36]. In a 2017 survey conducted by the Youth Health Movement, 1,500 14–24 year olds ranked Instagram as the worst SM platform for their mental well-being, however, it was not determined why this was the case [21]. A recent systematic review concluded that increased Instagram use was associated with greater social comparison, body dissatisfaction and eating disorders amongst its users which may explain the detrimental impact of Instagram on mental wellbeing [27].
Current research indicates that Instagram affects the body satisfaction of its users [16, 29, 37,38,39,40,41]. Tiggemann et al. concluded that Instagram photos of thin women increased body dissatisfaction and appearance comparison among female students compared to photos of average-sized women [37, 38]. Furthermore Cohen et al. report increased body surveillance amongst female Instagram users compared to non-users [39]. Moreover, a qualitative study by Chatzopoulou et al. involving young men engaging with the Instagram fitness community, discovered that those with lower self-esteem were greater motivated to change their body in order to ascertain the ideal body displayed on Instagram [40]. Additionally, users felt discouraged to post self-images if they felt their body did not meet the proposed ideal [40]. A significant association has also been ascertained between the time spent editing photos following exposure to photos of thin women on Instagram and the desire to look better than in real life, indicating an internalisation of the thin ideal [38].
Further to this, research indicates a correlation between Instagram usage and the presence of eating disorder symptoms [15, 17, 29, 42]. Griffiths et al. have established that the use of image-centric SM platforms (such as Instagram) significantly increase the likelihood of eating disorder symptoms among sexual minority men [17]. Additionally, Turner et al. have also found an association between Instagram usage and orthorexia nervosa, a relatively new concept in which individuals are obsessed with healthy eating and is characterised by ‘food anxiety and dietary restrictions’ leading to malnutrition [15, 43]. Further research has also indicated that in pre-adolescent females, increased Instagram usage is significantly associated with an increase in clinically determined eating disorder symptoms [42].
Current research has generally focused on adolescents’ Instagram use with only a limited number of quantitative studies being conducted among undergraduate students, a population with the highest proportion of Instagram use by age, compared to the general public [37, 38, 44]. At present, no research has quantitatively determined the relationship between Instagram and mental wellbeing in UK university students. Moreover, results from current international literature are predominantly determined utilising quantitative methodological approaches, utilising various psychiatric and psychological scales [9,10,11,12,13,14,15,16,17,18,19,20,21, 24, 29, 36,37,38,39, 41, 42]. To the best of the authors’ knowledge, no research has qualitatively explored how and why Instagram has an impact on mental wellbeing, an approach that is likely to reveal deeper insights into participants’ personal experiences with Instagram and which could allow for the discovery of new concepts previously unknown to researchers [45, 46]. Hence, this study aimed to identify UK university students’ understanding of the term ‘mental wellbeing’ and explore university students’ views on the impact of Instagram on their mental wellbeing.