The U.S. Sur­geon General’s 2023 Social Media and Youth Men­tal Health advi­so­ry out­lines the lat­est sci­en­tif­ic evi­dence regard­ing social media’s effects on youth men­tal health. The report rec­om­mends actions that pol­i­cy­mak­ers, tech­nol­o­gy com­pa­nies, par­ents and oth­ers can take to ensure the online safe­ty of young peo­ple. Here are key find­ings from the advisory.

CUR­RENT LEV­ELS OF TEEN SOCIAL MEDIA USE

Vir­tu­al­ly all teens (95%) ages 13 to 17 use social media, with more than 1 in 3 report­ing that they use it  “almost con­stant­ly.” While most U.S. social media plat­forms require users to be at least 13 years old, near­ly 40% of kids ages 8 to 12 use social media. The advi­so­ry also noted:

• Ado­les­cents who use social media more than three hours per day face twice the risk of expe­ri­enc­ing poor men­tal health outcomes.
• A recent sur­vey found that eighth and 10th grade stu­dents spend an aver­age of 3.5 hours per day on these platforms.

NEG­A­TIVE EFFECTS OF SOCIAL MEDIA ON MEN­TAL HEALTH AND WELL-BEING

Numer­ous stud­ies show that high­er lev­els of social media use among chil­dren and ado­les­cents are linked to adverse effects, includ­ing depres­sion and anx­i­ety, inad­e­quate sleep (which can dis­rupt neu­ro­log­i­cal devel­op­ment and lead to depres­sion and sui­ci­dal behav­iors), low self-esteem, poor body image, eat­ing dis­or­der behav­iors and online harass­ment. These risks are greater for girls ver­sus boys and for those already expe­ri­enc­ing men­tal health issues. Addi­tion­al risks include:

• Near­ly 2 in 3 ado­les­cents are  “often” or  “some­times” exposed to hate-based con­tent on social media.
• Stud­ies have found a con­nec­tion between social media cyber­bul­ly­ing and depres­sion among young people.
• Teen girls and LGBTQ youth are more like­ly to expe­ri­ence cyber­bul­ly­ing and online harass­ment, which can lead to neg­a­tive emotions.

ADO­LES­CENCE IS A VUL­NER­A­BLE PHASE OF DEVELOPMENT 

The mount­ing evi­dence regard­ing social media’s adverse effects on youth is espe­cial­ly con­cern­ing giv­en that ado­les­cence is a crit­i­cal peri­od of devel­op­ment, when dif­fer­ent areas of the brain begin to inte­grate and the pre­frontal cor­tex devel­ops at an accel­er­at­ed pace. In this phase, the brain is espe­cial­ly open to learn­ing and grow­ing, and teens may have inten­si­fied sen­si­tiv­i­ty to the nature of social media, accord­ing to the Sur­geon General’s advi­so­ry. Ado­les­cence also involves pro­found phys­i­o­log­i­cal changes — these young peo­ple are simul­ta­ne­ous­ly nav­i­gat­ing increas­ing auton­o­my, form­ing their iden­ti­ties, devel­op­ing rela­tion­ships and more. Thus, the poten­tial effects of social media dur­ing this vul­ner­a­ble phase war­rant par­tic­u­lar attention.

ARE THERE BEN­E­FITS TO USING SOCIAL MEDIA?

In some cas­es, social media can pro­vide social sup­port from peers or oth­ers, which may be espe­cial­ly ben­e­fi­cial for mar­gin­al­ized young peo­ple, such as sex­u­al and gen­der minori­ties. For instance, accord­ing to the Sur­geon General’s advi­so­ry, social media may boost the men­tal health of LGBTQ youth by fos­ter­ing con­nec­tions with peers, facil­i­tat­ing iden­ti­ty devel­op­ment and enabling social support.

Research also indi­cates that social media-based men­tal health inter­ven­tions may be use­ful tools for kids and teens, and they may help young peo­ple learn to seek help or pro­fes­sion­al care when need­ed. In this sense, social media plat­forms could serve as a gate­way to men­tal health care or at least online social sup­port as a buffer against stressors.

HOW TO PRO­TECT TEENS ON SOCIAL MEDIA

While social media offers ben­e­fits for some, grow­ing evi­dence of its poten­tial harm to many chil­dren and youth has led the Sur­geon Gen­er­al to issue an urgent, cross-sec­tor call to action:

FOR POL­I­CY­MAK­ERS

• Strength­en pro­tec­tions to ensure greater safe­ty for chil­dren inter­act­ing with all social media plat­forms, such as devel­op­ing age-appro­pri­ate health and safe­ty stan­dards, requir­ing a high­er stan­dard of data pri­va­cy for chil­dren and strength­en­ing and enforc­ing age minimums.
• Ensure tech­nol­o­gy com­pa­nies share data rel­e­vant to the health effects of their platforms.
• Sup­port increased fund­ing for future research on both the ben­e­fits and harms of social media use and oth­er tech­nol­o­gy and dig­i­tal media use for chil­dren, ado­les­cents and families.

FOR TECH­NOL­O­GY COMPANIES

• Con­duct and facil­i­tate trans­par­ent and inde­pen­dent assess­ments of the impact of social media prod­ucts and ser­vices on chil­dren and adolescents.
• Pri­or­i­tize user health and safe­ty in the design and devel­op­ment of social media prod­ucts and ser­vices to min­i­mize harm to chil­dren and adolescents.
• Cre­ate effec­tive and time­ly sys­tems and process­es to inves­ti­gate requests and com­plaints from young peo­ple, fam­i­lies, edu­ca­tors and others.

FOR PAR­ENTS AND CAREGIVERS

• Cre­ate a fam­i­ly media plan with agreed-upon expec­ta­tions to estab­lish healthy social media bound­aries at home.
• Cre­ate tech-free zones and encour­age in-per­son inter­ac­tions, which may involve lim­it­ing use of devices around bed­time and meal­times, pri­or­i­tiz­ing fam­i­ly rela­tion­ships and build­ing social bonds.
• Mod­el respon­si­ble social media behav­ior, as chil­dren often learn from what they see around them.

Over­all, pol­i­cy­mak­ers, tech com­pa­nies, researchers, fun­ders, fam­i­lies, advo­cates and oth­ers must work togeth­er on mul­ti-pronged strate­gies to cre­ate safe and healthy social media envi­ron­ments for young people.

The Annie E. Casey Foundation was created more than 100 years ago, a nonprofit that has created an enduring legacy of service of children and families in America. It is devoted to developing a brighter future for children and young people with respect to their educational, economic, social, and health outcomes.

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By Liz Carey
The Daily Yonder

For the first time in 20 years, mental health and addiction are more pressing health concerns than getting access to basic healthcare, according to a survey of rural stakeholders.

Rural Healthy People 2030, released by the Southwest Rural Health Resource Center, surveyed a national sample of people “working to improve the lives and health of rural Americans,” to determine the most important issues facing rural residents. Participants included people working in health care, public administration, education, human services, and other fields.

In 2010 and 2020, the biggest issue in the survey was access to health care.

While access to health care remained one of the top five issues according to survey respondents, researchers said, the growing impact of mental health and addiction took the number one and two spots on the list regardless of age, race, region or occupation.

“For the past two decades, health-care access has been, far and away, the most important topic no matter how we cut the data,” said Timothy Callaghan, one of the survey authors. “The fact that mental health and addiction came out ahead of health-care access this time… certainly surprised us, but when you start thinking about the context of the past decade and the context of the pandemic in which you launched the survey, the findings are a bit less surprising.”

Callaghan said the rise of the opioid epidemic prior to the COVID-19 pandemic, and the growing recognition of the lack of mental health resources in rural America since the pandemic may be part of the reason. But changes in health care through the Affordable Care Act may have improved health-care access, bringing other issues to the top of the list, Callaghan said.

According to the U.S. Department of Health and Human Services, nearly 20 million people signed up for insurance as part of the Affordable Care Act during open enrollment this past year. During 2022, 35 million people signed up for insurance during the open enrollment period, 21 million of whom were part of Medicaid expansions.
 
Still the fact that mental health and addiction rose to the top across all categories was striking, he said.

“You’re going to see small changes in characteristics over the course of decades,” he said. “But the extent to which mental health and addiction have risen and were so consistently selected by stakeholders, demonstrates how big those issues really are.”

Stakeholders may have been focusing on what were the most pressing needs given the moment, Callaghan said. The survey was presented to stakeholders 2021. Partnering with rural health organizations like the National Rural Health Association, the Centers for Disease Control and Prevention, the American Hospital Association, and the National Association of Rural Health Clinics, the research center sent out links to the survey and asked stakeholders to comment. In addition, the center sent the survey to people who had filled out the survey in previous decades and asked stakeholders to identify others they felt may be able to provide insight.

According to the Pew Research Center, an estimated 40% of American adults suffered from increased mental health issues during the pandemic. A survey done by the Kaiser Family Foundation and CNN found that 90% of the American public felt the country was facing a mental health crisis. Adults across the country during the pandemic reported increased symptoms of anxiety, depression, hopelessness and sadness and suicidal ideation, as well as increased drug and alcohol use.
 
In all, 1,291 respondents answered at least one of the questions between July 2021 and February 14, 2022.

“I think part of (the rankings) could be that a lot of the rural stakeholders participating understood that we’re looking at 10-year trends,” he said. “Our data didn’t allow us to identify specifically why, for example, vaccination isn’t in the top 20 even though we might have expected it to be, due to the pandemic.”

Major concerns besides health-care access in previous surveys included heart disease and stroke, diabetes, and nutrition.

Callaghan said as a country we’ve made significant strides in those areas. A report by the research center to the Federal Office of Rural Health Policy found that rural America has made progress on some leading causes of death.

“We’ve seen some pretty considerable gains in heart disease deaths,” Callaghan said. “We still do have a gap between urban and rural America, but there have been some pretty considerable gains.”

Callaghan said it’s not clear if that is because rural health-care providers are better at managing the disease, or educating patients about the diseases, or if other topics have just become more important.
For now, Callaghan said, the study reveals where the focus of rural health systems should be, according to rural health stakeholders.

“We now have a better sense of the areas that are particularly in need of rural health investment,” he said.

“We now know that addressing addiction and addressing mental health issues have become increasingly important to rural experts over the past decade and while health-care access remains important… we nonetheless have to start prioritizing the issues that are most important which are addiction and mental health.”

The Daily Yonder

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