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Live streaming is a form of media that allows streamers to directly interact with their audience. Previous research has explored mental health, Twitch.tv and live streaming platforms, and users' social motivations behind watching live streams separately. However, few have explored how these all intertwine in conversations involving intimate, self-disclosing topics, such as mental health. Live streams are unique in that they are largely masspersonal in nature; streamers broadcast themselves to mostly unknown viewers, but may choose to interact with them in a personal way. This study aims to understand users' motivations, preferences, and habits behind participating in mental health discussions on live streams. We interviewed 25 Twitch viewers about the streamers they watch, how they interact in mental health discussions, and how they believe streamers should discuss mental health on live streams. Our findings are contextualized in the dynamics in which these discussions occur. Overall, we found that the innate design of the Twitch platform promotes a user-hierarchy in the ecosystem of streamers and their communities, which may affect how mental health is discussed. 

Live streaming is a unique form of media that creates a direct line of interaction between streamers and viewers. While previous research has explored the social motivations of those who stream and watch streams in the gaming community, there is a lack of research that investigates intimate self-disclosure in this context, such as discussing sensitive topics like mental health on platforms such as Twitch.tv. This study aims to explore discussions about mental health in gaming live streams to better understand how people perceive discussions of mental health in this new media context. The context of live streaming is particularly interesting as it facilitates social interactions that are masspersonal in nature: the streamer broadcasts to a larger, mostly unknown audience, but can also interact in a personal way with viewers. In this study, we interviewed Twitch viewers about the streamers they view, how and to what extent they discuss mental health on their channels in relation to gaming, how other viewers reacted to these discussions, and what they think about live streams, gaming-focused or otherwise, as a medium for mental health discussions. Through these interviews, our team was able to establish a baseline of user perception of mental health in gaming communities on Twitch that extends our understanding of how social media and live streaming can be used for mental health conversations. Our first research question unraveled that mental health discussions happen in a variety of ways on Twitch, including during gaming streams, Just Chatting talks, and through the stream chat. Our second research question showed that streamers handle mental health conversations on their channels in a variety of ways. These depend on how they have built their channel, which subsequently impacts how viewers perceive mental health. Lastly, we learned that viewers’ reactions to mental health discussions depend on their motivations for watching the stream such as learning about the game, being entertained, and more. We found that more discussions about mental health on Twitch led to some viewers being more cautious when talking about mental health to show understanding. 

As more viewers become interested in watching authentic personalities as opposed to artificial, crafted performances, Twitch streamers have begun to discuss personal issues such as mental health to form a closer bond with their community. This paper seeks to further explore how a live streamer's choice in game affects their viewers' perception of their stream's content. We interviewed 24 Twitch viewers and found that the pace of the game a streamer chooses to stream is a key factor in what viewers expect to see during the stream. These expectations at least partially determine whether viewers want to hear conversations about mental health.