HJNO Jul/Aug 2023

38 JUL / AUG 2023  I  HEALTHCARE JOURNAL OF NEW ORLEANS   Healthcare Briefs Surgeon General: Effects Social Media Use Has on YouthMental Health United States Surgeon General Vivek Murthy, MD, released a new Surgeon General’s Advisory on Social Media and Youth Mental Health, as a PDF. While social media may offer some benefits, there are ample indicators that social media can also pose a risk of harm to the mental health and well-being of children and adolescents. Social media use by young people is nearly univer- sal, with up to 95% of young people ages 13-17 reporting using a social media platform and more than a third saying they use social media “almost constantly.” With adolescence and childhood represent- ing a critical stage in brain development that can make young people more vulnerable to harms from social media, the Surgeon General is issuing a call for urgent action by policymakers, technol- ogy companies, researchers, families, and young people alike to gain a better understanding of the full impact of social media use, maximize the ben- efits and minimize the harms of social media plat- forms, and create safer, healthier online environ- ments to protect children. The Surgeon General’s Advisory is a part of the Department of Health and Human Services’ (HHS) ongoing efforts to support President Joe Biden’s whole-of-govern- ment strategy to transform mental healthcare for all Americans. “The most common question parents ask me is, ‘Is social media safe for my kids’. The answer is that we don't have enough evidence to say it's safe, and in fact, there is growing evidence that social media use is associated with harm to young people’s mental health,” said U.S. Surgeon Gen- eral Vivek Murthy, MD. “Children are exposed to harmful content on social media, ranging from violent and sexual content, to bullying and harass- ment. And for too many children, social media use is compromising their sleep and valuable in- person time with family and friends. We are in the middle of a national youth mental health cri- sis, and I am concerned that social media is an important driver of that crisis – one that we must urgently address.” Usage of social media can become harm- ful depending on the amount of time children spend on the platforms, the type of content they consume or are otherwise exposed to, and the degree to which it disrupts activities that are essential for health like sleep and physical activ- ity. Importantly, different children are affected by social media in different ways, including based on cultural, historical, and socio-economic fac- tors. Among the benefits, 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%). However, social media use can be excessive and problematic for some children. Recent research shows that adolescents who spend more than three hours per day on social media face dou- ble the risk of experiencing poor mental health outcomes, such as symptoms of depression and anxiety; yet one 2021 survey of teenagers found that, on average, they spend 3.5 hours a day on social media. Social media may also perpetuate body dissatisfaction, disordered eating behaviors, social comparison, and low self-esteem, espe- cially among adolescent girls. One-third or more of girls aged 11-15 say they feel “addicted” to certain social media platforms, and over half of teenagers report that it would be hard to give up social media. When asked about the impact of social media on their body image, 46% of adoles- cents aged 13-17 said social media makes them feel worse, 40% said it makes them feel neither better nor worse, and only 14% said it makes them feel better. Additionally, 64% of adolescents are “often” or “sometimes” exposed to hate-based content through social media. Studies have also shown a relationship between social media use and poor sleep quality, reduced sleep duration, sleep difficulties, and depression among youth. While more research is needed to determine the full impact social media use has on nearly every teenager across the country, children and adolescents don’t have the luxury of waiting years until we know the full extent of social media’s effects. The Surgeon General’s Advisory offers recommendations stakeholders can take to help ensure children and their families have the infor- mation and tools necessary to make social media safer for children: • Policymakers can take steps to strengthen safety standards and limit access in ways that make social media safer for children of all ages, better protect children’s privacy, support digital and media literacy, and fund additional research. • Technology companies can better and more transparently assess the impact of their products on children, share data with independent researchers to increase our collective understanding of the impacts, make design and development decisions that prioritize safety and health — includ- ing protecting children’s privacy and better adhering to age minimums — and improve systems to provide effective and timely responses to complaints. • Parents and caregivers can make plans in their households such as establishing tech- free zones that better foster in-person rela- tionships, teach kids about responsible online behavior and model that behavior, and report problematic content and activity. • Children and adolescents can adopt healthy practices like limiting time on platforms, blocking unwanted content, being careful about sharing personal information, and reaching out if they or a friend need help or see harassment or abuse on the platforms. • Researchers can further prioritize social media and youth mental health research that can support the establishment of stan- dards and evaluation of best practices to support children’s health. In concert with the Surgeon General’s Advisory, leaders at a few of the nation’s medical organi- zations have expressed their concern on social media’s effects on youth mental health: “Social media can be a powerful tool for con- nection, but it can also lead to increased feelings of depression and anxiety – particularly among adolescents. Family physicians are often the first stop for parents and families concerned about the physical and emotional health of young peo- ple in their lives, and we confront the mental health crisis among youth every day. The Ameri- can Academy of Family Physicians commends the Surgeon General for identifying this risk for Amer- ica's youth and joins our colleagues across the health care community in equipping young peo- ple and their families with the resources necessary