In 2024, the U.S. Surgeon General called for social media warning labels in light of the current youth mental health crisis. The research findings presented in this section of “Handbook of Children and Screens: Digital Media, Development, and Well-Being from Birth Through Adolescence” support the claim that children’s increased digital media use has a significant impact on mental health. The direction of these associations, however, is inconsistent. As highlighted by the authors, not all youth have profoundly negative experiences with social media. This is because personal factors, such as identity, play a role in youth susceptibility to these harms. In particular, cisgender girls, marginalized youth, youth from low socioeconomic backgrounds, and youth with pre-existing mental health susceptibilities are more likely than other groups to experience psychological harm with digital media use. These personal factors influence youths’ motivations to use digital media, the content they engage with, and how they respond to that content. In this way, digital media use can both contribute to and protect against mental health challenges. An overview of the current research findings for digital therapeutics and their effectiveness in youth is provided at the end of this section of the handbook.
Recommendations
The following recommendations are excerpts from the "Digital Media and Mental Health" section of the “Handbook of Children and Screens: Digital Media, Development, and Well-Being from Birth Through Adolescence." This open access publication is free to download in full or by individual chapters via the links provided following the recommendations below.
- Discuss screen use and mental health in routine child wellness visits.
- Provide parents/caregivers with relevant resources.
- Develop, standardize, critique, and disseminate evidence-based evaluations, preventions, and interventions for media-related mental health challenges.
- Prioritize interventions for diverse and marginalized groups.
- Stay updated on digital therapeutics and use a consistent framework for evaluating and adopting these tools.
- Set clear boundaries for and have regular, open discussions about media use.
- Ensure children 12 years and under do not use social media and consider disallowing use for young teens.
- Prioritize face-to-face social interaction.
- Watch for problematic behaviors, such as changes in mood or erratic behaviors.
- Model desired behavior.
- Monitor and self-regulate social media use with healthy tech guides.
- Eliminate social media use for school communication.
- Train school affiliates to manage students’ problematic social media posts.
- Implement individually tailored social media literacy programs in the classroom that mitigate mental health concerns.
- Require social media companies to:
- Develop and implement human-centered designs that address developmental considerations, promote health, and mitigate harm.
- Adapt privacy algorithms to accommodate children under 13.
- Have their products evaluated by psychological experts.
- Enforce objective means for age verification and limit feature availability to young children.
- Raise the minimum age for social media use to 16.
- Build infrastructure to help underserved communities access digital treatments.
- Require full transparency of funding sources and data sharing for regulatory approval of new pediatric digital health interventions.
- Invest in research on adolescent social media use and mental health concerns.
- Partner with key informants and stakeholders.
- Establish clear and effective policies for mental health-related posts and provide resources to at-risk users.
- Promote positive stories related to mental health recovery.
- Ensure technologies do not perpetuate existing inequities.
- Include media use measures in youth-focused mental health research.
Digital Media and Mental Health Section Chapters
Introduction to the Section on Digital Media and Mental Health
Paul Weigle, MD
Social Media and Youth Mental Health: A Departure from the Status Quo
Sarah M. Coyne, PhD, César Escobar-Viera, MD, PhD, Mesfin A. Bekalu, PhD, Linda Charmaraman, PhD, Brian Primack, MD, PhD, Reem M.A. Shafi, MBBS, Patti Valkenburg, PhD, Kofoworola D.A. Williams, PhD, MPH
Youth and Anxiety in the Digital Age: Present Status and Future Considerations
Merlin Ariefdjohan, PhD, MPH, Jacqueline Nesi, PhD, Benjamin Mullin, PhD, Matthew Pesko, MD, Sandra Fritsch, MD, MSEd
Social Media and Depressive Symptoms
Jean M. Twenge, PhD, Dale Peeples, MD, Reem Shafi, PhD, MBBS, Elroy Boers, PhD, Lauren Hale, PhD, Paul Weigle, MD
Media Influences on Self-harm, Suicidality and Suicide
Kaylee P. Kruzan, PhD, Jacqueline Nesi, PhD, Jessica L. Hamilton, PhD, Carol Vidal, MD, PhD, Jean Twenge, PhD, Dale Peeples, MD, Thomas Niederkrotenthaler, PhD
Social Media Use, Body Image Concerns, and Disordered Eating Among Adolescents
Sophia Choukas-Bradley, PhD, Anne J. Maheux, PhD, Jennifer Stevens Aubrey, PhD, Linda Charmaraman, PhD, Megan Maas, PhD, Jacqueline Nesi, PhD, L. Monique Ward, PhD, Chia-Chen Yang, PhD
Who is Most at Risk?: Identifying Risk for Mental Health Problems Related to Social Media
Jessica L. Hamilton, PhD, Kaylee P. Kruzan, PhD, Hannah Szlyk, PhD, Jazmin Reyes-Portillo, PhD, Candice Biernesser, PhD, CSW, Michaeline Jensen, PhD, Jamie Zelazny, PhD, MPH, RN, Brian Primack, PhD, John Torous, MD, Paul Weigle, MD
Digital Therapeutics in Child Psychiatry: Harnessing Technology to Treat Pediatric Mental Health
Meredith Gansner, MD, Nicholas C. Jacobson, PhD, Lisa A. Marsch, PhD, and Randy Kulman, PhD
Problematic Use of the Internet: Summary and Recommendations
Summary and Recommendations found in the "Handbook of Children and Screens: Digital Media, Development, and Well-Being from Birth Through Adolescence," Part One: Research Concerning Cognitive, Physical, Mental, and Psychosocial Impacts on Children, Problematic Use of the Internet Section (pages 173-209)
Race, Racism, and Digital Media: Summary and Recommendations
Summary and Recommendations found in the "Handbook of Children and Screens: Digital Media, Development, and Well-Being from Birth Through Adolescence," Part Two: Research on How Media Influence Relationships, Family, Culture, and Society, Race, Racism, and Digital Media Section (pages 263-316)
Gender, Sexuality, and Digital Media: Summary and Recommendations
Summary and Recommendations found in the "Handbook of Children and Screens: Digital Media, Development, and Well-Being from Birth Through Adolescence," Part Two: Research on How Media Influence Relationships, Family, Culture, and Society, Gender, Sexuality, and Digital Media Section (pages 317-370)
Youth Digital Wellbeing: Summary and Recommendations
Summary and Recommendations found in the "Handbook of Children and Screens: Digital Media, Development, and Well-Being from Birth Through Adolescence," Part One: Research Concerning Cognitive, Physical, Mental, and Psychosocial Impacts on Children, Youth Digital Wellbeing Section (pages 211-259)
Cyberbullying and Digital Cruelty: Summary and Recommendations
Summary and Recommendations found in the "Handbook of Children and Screens: Digital Media, Development, and Well-Being from Birth Through Adolescence," Part Two: Research on How Media Influence Relationships, Family, Culture, and Society, Cyberbullying and Digital Cruelty Section (pages 427-463)
Media Policy: Summary and Recommendations
Summary and Recommendations found in the "Handbook of Children and Screens: Digital Media, Development, and Well-Being from Birth Through Adolescence," Part Two: Research on How Media Influence Relationships, Family, Culture, and Society, Media Policy Section (pages 465-514)
Adolescent Health, Body Image, Eating Disorders and Media Use | Jason Nagata, MD, MSc
Mental Health Apps, ChatBots, and Digital Therapy for Kids: What You Need to Know
The escalating adolescent mental health crisis has been met with a new array of digital solutions--how are these new digital resources shaping the future of mental health care for youth?
Which social media features harm youth mental health?
Which social media features affect kids’ mental health? Why are kids more vulnerable to these features than adults? What changes can social media platforms make to reduce these harms?
Parent Media Use, Technoference, and Its Effects on Children | Brandon McDaniel, PhD
Boys, Health, and Digital Media
Digital media's effects on boys' health and development: a guide from the experts
Video Gaming 101: Healthy vs Problematic Gaming
A guide from the experts to youth video gaming for parents and educators.