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BACKGROUND: A great deal of work has been devoted to examining the mental health of patients diagnosed with COVID-19 or medical staff who cared and treated patients during the COVID-19 pandemic. But few insights were produced concerning how the pandemic may take a toll on the public\'s mental health who were not contracted with the virus. OBJECTIVE: This study aims to investigate the links between social media use and mental health conditions in the general population based on a national sample (N = 2,185) collected at the peak of China\'s COVID-19 outbreak. METHODS: This study reveals the public\'s mental health conditions by analyzing social media use among those who experienced the first COVID-19 outbreak in the world. A nationally representative sample was collected for this study in China\'s 30 provinces concerning the participants\' social media use, health information support, and psychiatric disorders, i.e., secondary traumatic stress (STS) and vicarious trauma (VT). RESULTS: COVID-19 had taken a severe toll on people\'s mental health who had no history of psychiatric disorders nor being contracted with coronavirus. Social media use did not cause mental health issues, but it mediated the levels of traumatic emotions. While people gained health information support in using social media, an excessive social media use led to elevated levels of stress (ß = .175, P < .001), anxiety (ß = .224, P < .001), depression (ß = .201, P < .001), STS (ß = .307, P < .001), and VT (ß = .688, P < .001). Geo-location and lockdown conditions also contributed to traumatic disorders. People from small cities or towns were more anxious (P = .01) and depressed (P = .008) than those in rural areas. Obtaining more informational support (ß = .165, P < .001) and emotional support (ß = .144, P < .001) on social media increased VT. Peer support on social media increased both VT (ß = .332, P < .001) and STS (ß = .130, P < .001). Moreover, geo-location moderated the relationships between emotional support on social media and VT (F(2) = 3.549, P = .029) and the association between peer support and STS (F(2) = 5.059, P = .006). Geo-location also interacted with information support in predicting STS (F(2) = 5.093, P = .006). CONCLUSIONS: This research contributes to the literature by establishing the association between social media use and psychiatric disorders in the general public when COVID-19 struck, whose causes were complex and multifactorial, including social media use. The findings based on what Chinese people went through can help global citizens and health policymakers to mitigate psychiatric disorders in this and other public health crises, which should be a key component of global pandemic response.
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