There is not enough evidence to determine whether social media is safe enough for children and adolescents when it comes to their mental health, according to a new opinion from the US Surgeon General.
Tuesday’s opinion notes that while there are some benefits, social media use carries “a high risk of harm” for children. It calls for more research into the impact of social media on young people’s mental health, as well as action from policy makers and technology companies.
The 25-page advisory comes as a growing number of states look to tighten regulations on social media platforms, including efforts in Montana to ban TikTok.
General surgeon advice is designed to draw attention to pressing public health problems and make recommendations on how to address them, the new report notes. Previous advice has focused on the mental health of young people more broadly, disinformation about health and the use of the antidote naloxone, opioid overdose.
“We are in the middle of a youth mental health crisis and I am concerned that social media is adding to the harm children are experiencing,” Surgeon General Dr. Vivek Murthy to CNN.
“For too long we have placed the entire burden of social media management on the shoulders of parents and children, despite the fact that these platforms are designed by some of the most talented engineers and designers in the world to maximize the amount of time our children spend to it,” he said. So that’s not a fair fight. It is time we had the backs of parents and children.”
The opinion includes a review of the available evidence on the effects of social media on young people’s mental health, noting that social media use among children is “almost universal”: up to 95% of children aged 13 to 17 reports social media use, with more than a third saying they use it ‘almost constantly’. And while 13 is usually the minimum age to use social media sites in the US (an age that Murthy says is too young), the advisory notes that nearly 40% of children ages 8 to 12 also use the platforms.
“We must acknowledge the growing body of research into potential harms, increase our collective understanding of the risks of using social media, and take urgent action to create safe and healthy digital environments,” the advisory said.
The report cites several ways that social media can harm young people’s mental health, noting that adolescence is a particularly vulnerable time for brain development. It describes studies that found correlations between social media use and depression and anxiety, as well as poor sleep, online harassment and low self-esteem, especially for girls.
A study of 6,595 American adolescents ages 12 to 15 found that those who spent more than three hours a day on social media were twice as likely to experience symptoms of depression and anxiety as non-users, the report notes. It also cites studies that found reducing social media use led to improvements in mental health.
Social media use poses a risk of exposure to dangerous content, including images of self-harm, “which can normalize such behavior,” the advisory says. It also cites 20 studies that found a significant association between social media use and body image concerns and eating disorders.
Murthy told CNN that the three most common things he hears from kids about social media are: “First, it makes them feel worse about themselves; second, it makes them feel worse about their friendships; but number three, they can’t get rid of it.
Overuse of social media can disrupt important healthy behaviors, including sleep, the advisory warns, noting that platforms are often designed to keep users engaged with push notifications, autoplay and infinite scroll features, and algorithms that use the user’s data to content recommendations. It cites some researchers’ belief that social media exposure, with over-stimulation of the brain’s reward centers, “can activate pathways similar to addiction.”
The summary of the advice on potential risks of social media use for young people’s mental health runs to five pages; the description of the potential benefits only takes half a page. It notes that social media can provide positive community and connection with others, which can be especially important for children who are often marginalized. It cites studies demonstrating the mental health benefits of using social media for lesbian, gay, bisexual, asexual, transgender, queer, intersex and other youth through peer engagement, and “identity-affirming content” related to race that positively was for adolescent girls of color. Finally, it notes that social media can be helpful in connecting some children with mental health services.
The advice includes recommendations for families struggling with social media use, including creating family media plans, encouraging children to develop personal friendships and modeling good social media behavior.
Murthy said it’s something he and his wife have discussed for their children, who are now 5 and 6.
Their plan is to delay using social media until at least after high school; to try to find other families to work with who are similarly inclined, “because there is strength in numbers”; and to reassess when the kids are in high school to see if better safety standards have been put in place “and are actually being enforced,” he said.
“None of this is easy for parents to do,” he acknowledged. “That’s why we’re pushing so hard for this advice to make the urgent case for action.”
Murthy says he hopes the report will spur multi-level action, such as more research and funding for it, policy changes, and especially more transparency and action from tech companies.
“Independent researchers tell us all the time that they struggle to get full access to the information they need from tech companies about the health effects on children,” he said.
He said social media companies should be held to similar standards of child protection as other industries.
“We’re taking this approach to safety first with other products children use, from medicines to car seats to toys,” Murthy said. “We have to do that here too.”