Over the recent past, the U.S. Surgeon General has published important Advisories. An Advisory is a public statement that calls the American People’s attention to an urgent public health issue and provides recommendations for how it should be addressed. Among the recent were an Advisory on Protecting Youth Mental Health in 2021, and then two more in May 2023: Healing Effects of Social Connection and Community and an Advisory on Social Media and Youth Mental Health. As students prepare to get back into the school year, social media use is something that pervades the entire calendar year and goes well beyond the confines of the routine in which students involve themselves during the school year.
The Advisory calls attention to the growing concerns about the effects of social media on youth mental health. It explores and describes the current evidence on the positive and negative impacts of social media on children and adolescents, some of the primary areas for mental health and well-being concerns, and opportunities for additional research to help understand the full scope and scale of social media’s impact. The full Advisory can be found at Social Media and Youth Mental Health.
Up to 95% of youth ages 13-17 report using a social media platform, with more than a third saying they use social media “almost constantly.” Although age 13 is commonly the required minimum age used by social media platforms in the U.S., nearly 40% of children ages 8-12 use social media. Despite this widespread use there has been a lack of robust analyses to consider the safety and impact of social media on youth.
Current evidence though indicates that social media may have benefits for some children and have a profound risk of harm to the mental-health and well-being of children and adolescents. Among the factors that have influence on the effects on students include the time they spend on platforms, the type of content they consume or are otherwise exposed to, the activities and interactions social media affords and the degree to which it disrupts activities that are essential for health like sleep and physical activity. Different children and adolescents are affected by social media in different ways, based on cultural, historical, and socio-economic factors. Among the scientific community, social media is thought to have the potential to both benefit and harm children and adolescents.
Adolescents ages 10-19 undergo a highly sensitive period of brain development. Risk-taking behavior peaks and well-being experiences tend to fluctuate greatly. This is also when the mental health challenge of depression emerges. Adolescence is also a time when identities begin to form along with a sense of self-worth. With typical adolescent focus on greater dependence on peers, brain development then is especially susceptible to social pressures, peer opinions, and peer comparison. Particularly notable here are the parts of the brain that regulate impulse control, emotional regulation, and moderating social behavior.
Potential Benefits of Social Media Use Among Children and Adolescents
The ability to form and maintain friendships online and develop social connections are among the positive effects of social media for youth. It provides benefits for some youth by providing a positive community and connection with others who share identities, abilities, and interests. It can provide information and create a space for self-expression. Social media
connections can lessen the effect of stress of youth who are often marginalized, including racial, ethnic, and sexual and gender identities. Social media may support the mental health and well-being of such students. In one study, 7 out of 10 adolescent girls of color reported encountering positive or identity-affirming content related to race across social media platforms. Most of the adolescents report that social media helps them feel more accepted (58%), like they have people who can support them through tough times (67%), like they have a place to show their creative side (71%), and more connected to what’s going on in their friends’ lives (80%). Moreover, social media-based and other digitally based mental health interventions, traditionally done face to face, may also be helpful for some children and adolescents by promoting help-seeking in this digital setting by promoting help-seeking behaviors that can serve as a gateway to initiating mental health care.
Potential Harms of Social Media Use Among Children and Adolescents
An in-depth multi-year study of U.S. adolescents aged 12-15 found that adolescents who spent more than 3 hours per day on social media faced double the risk of experiencing poor mental health outcomes including symptoms of depression and anxiety. As of 2021, 8th and 10th grade students now spend an average of 3.5 hours per day on social media. Other studies described in the Advisory point to social media resulting in greater harm for students already experiencing poor mental health. It resulted in poor sleep, online harassment, poor body image, low self-esteem, and higher depressive symptoms scores with a larger association for girls than for boys.
Potential Risk of Harm from Content Exposure
Extreme, inappropriate, and harmful content continues to be easily and widely accessible by children and adolescents. In some tragic cases childhood deaths have been linked to suicide-and self-harm-related content and risk-taking challenges on social media platforms. This content may be especially risky for children and adolescents who are already experiencing mental health difficulties. A systematic review of more than two dozen studies found that some social media platforms show live depictions of self-harm acts like partial asphyxiation, leading to seizures, and cutting, leading to significant bleeding. In addition, these studies found that discussing or showing this content can normalize such behaviors, including through the formation of suicide pacts and posting of self-harm models for others to follow. Social media may also perpetuate body dissatisfaction, disordered eating behaviors, social comparison, and low self-esteem, especially among adolescent girls. Among adolescent girls of color, one-third or more report exposure to racist content or language on social media platforms at least monthly. Finally, social media platforms can be sites for predatory behaviors and interactions with malicious actors who target children and adolescents (e.g., adults seeking to sexually exploit children, to financially extort them through the threat of actual distribution of intimate images, or to sell illicitly manufactured fentanyl).
What Parents and Caregivers Can Do
Create a family media plan. Agreed-upon expectations can help establish healthy technology boundaries at home-including social media use. For more information on creating a family media plan, visit AAP Media Plan (healthychildren.org)
Create tech-free zones and encourage children to foster in-person friendships. Since electronics can be a potential distraction after bedtime and can interfere with sleep, consider restricting the use of phones, tablets, and computers for at least one hour before bedtime and through the night. Consider keeping family mealtimes and in-person gatherings device-free to build social bonds and engage in two-way conversation. See the American Academy of Pediatrics (AAP) guidelines for media use.
Model responsible social media behavior. As children often learn behaviors and habits from what they see around them, try to model behavior you would like to see. Parents can limit their own use and be mindful of social media habits (including when and how parents share information or content about their child) and model positive behavior on their social media accounts.
Teach kids about technology and empower them to be responsible online participants at the appropriate age. Learn more about the benefits and risks of social media and get guidance from the experts at AAP's Center of Excellence on Social Media and Youth Mental Health Center of Excellence on Social Media and Youth Mental Health (aap.org) and from the American Psychological Association’s Health Advisory on Social Media Use in Adolescence. American Psychological Association Health Advisory on Social Media Use in Adolescence (apa.org)
Report cyberbullying and online abuse and exploitation. Talk with your child about their report options and provide support, without judgment, if he or she tells or shows you that they (a) are being harassed through email, text message, online games, or social media or (b) have been contacted by an adult seeing private images or asking them to perform intimate or sexual acts. You or your child can report cyberbullying to the school and/or the online platform, or your local law enforcement. Visit CyberTipline, Take it Down CyberTipline (missingkids.org) or contact your local law enforcement to report any instances of online exploitation.
Work with other parents to help establish shared norms and practices and to support programs and policies around healthy social media use. Such norms and practices among parents facilitate collective action and can make it easier to set and implement boundaries on social media use for children.
What Children and Adolescents Can Do
Reach out for help. If you or someone you know is being negatively affected by social media, reach out to a trusted friend or adult for help. For more from experts, visit AAP’s Center of Excellence on Social Media and Youth Mental Health. Center of Excellence on Social Media and Youth Mental Health (aap.org). If you or someone you know is experiencing a mental health crisis, contact the 988 Suicide and Crisis Lifeline by calling or texting 988 for immediate help.
Create boundaries to help balance online and offline activities. Limit the use of phones, tablets, and computers for at least 1 hour before bedtime and through the night to enable sufficient and quality sleep. Keep mealtimes and in-person gatherings device-free to help build social bonds and engage in two-way conversations with others.
Develop protective strategies and healthy practices such as tracking the amount of time you spend online, blocking unwanted contacts and content, learning about and using available privacy and safety settings, learning and utilizing digital media literacy skills to help tell the difference between fact and opinion, and ensuring you are connecting with peers in-person. See this for healthy social media use created for and by young people. Tip Sheet on Social Media Use and Mental Health | Youth Engaged 4 Change
Be cautious about what you share. Personal information about you has value. Be selective with what you post and share online and with whom. If you aren’t sure if you should post something, it’s usually best if you don’t. Talk to a family member or trusted adult to see if you should.
Protect yourself and others. Harassment that happens in email, text messaging, direct messaging, online games, or on social media is harmful and can be cyberbullying. It might involve trolling, rumors, or photos passed around for others to see-and it can leave people feeling angry, sad, ashamed or hurt. If you or someone is the victim of cyberbullying or other forms of online harassment or abuse:
Don’t keep online harassment or abuse a secret. Reach out to at least one person you trust, such as a close friend, family member, counselor, or teacher, who can give you the help and support you deserve. Visit https://www.stopbullying.gov/ for helpful tips on how to report cyberbullying. If you have experienced online harassment and abuse by a dating partner, contact an expert as Love is Respect Healthy relationships for young adults | love is respect for support or if your private images have been taken and shared online without your permission, visit Take it Down (ncmec.org) to help get them removed.
Don’t take part in online harassment or abuse. Avoid forwarding or sharing messages or images and tell others to stop. Another way is to report offensive content to the site or network where you saw it.