CNN
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When the US surgeon general, Dr. Vivek Murthy pushed for a smoking-style warning on social media last week, calling the mental health crisis among young people an emergency that calls for action without waiting for “perfect information”.
Even among experts, questions remain about the exact role social media plays in the mental health of children and adolescents. The authors of a comprehensive new review of research on social media and mental health say key information is still missing to know whether prevention programs and interventions will work.
In the study, published Monday in the medical journal JAMA Pediatrics, researchers reviewed nearly 150 studies on the relationship between social media and adolescent mental health. They found a general link between anxiety and depression in teenagers and time spent on social media platforms, as well as a link between the types of activities and content they interacted with. However, the level of impact varied enough to suggest that the findings should not be generalized to the population as a whole.
The researchers found that very few studies assessed the relationship between social media use and teens experiencing mental health symptoms at clinical levels — where they are seeking health services or have an active diagnosis, for example — further clouding the findings.
There is a “real risk that we are wrongly generalizing the results from the general population to young people with mental health problems,” wrote the study authors, from the University of Cambridge in the United Kingdom and Stellenbosch University in South Africa.
“In a world increasingly saturated by digital technology, we cannot afford to design prevention programs, interventions and regulations without knowing that they work for everyone, especially those who are most vulnerable.”
Another analysis of existing research, published by the National Academies of Sciences, Engineering and Medicine in December, also highlighted key questions that remain to be answered.
“There is insufficient evidence to say that social media causes changes in adolescent health at the population level,” according to a news release from the independent organization about the report. And “despite years of research, evidence clarifying exactly how social media affects health is limited.”
While science suggests there is a link between social media and mental health, there is often a lack of clarity as to whether social media is affecting an individual’s mental health or whether an individual’s mental health is affecting their use of social media, said Dr. Sandro Galea, chairman of an ad-hoc The National Academies Committee that authored the research analysis and the dean of Boston University’s School of Public Health.
Future research should focus on tracking trends over time—tracking the mental health of the same children before and after exposure to social media to see what effects it has—and digging into more specific measures that capture how they’re used. social media, he said.
For Murthy, the urgency of the youth mental health crisis is overwhelming – and there is enough evidence to act now. In a New York Times op-ed, Murthy advocated for a warning label that would regularly remind parents and teens that social media has not been proven safe among other interventions.
Murthy cited two key reports in support of a warning label: a 2019 study that found teenagers who spent more time on social media faced an increased risk of anxiety and depression, and a survey from 2022 in which nearly half of teenagers said that social media makes them feel worse about their bodies.
“One of the most important lessons I learned in medical school was that in an emergency, you don’t have the luxury of waiting for perfect information. You evaluate the available facts, you use your best judgment and you act quickly,” Murthy wrote in his essay. “The mental health crisis among young people is an emergency – and social media has emerged as a significant contributor.”
Many experts agree that the surgeon general is starting an important conversation and that the need for more information should not lead to inaction, but a social media warning label will require nuance in language and implementation. It will also require Congress to act to make it a reality.
“The Surgeon General is identifying something he sees as a public health challenge and thinking about ways to act to mitigate the challenge. Through that lens, I think he’s doing exactly what a surgeon general should be doing,” Galea said. “Public health action, not infrequently, has to happen in the absence of complete or perfect data.”
The National Academies Committee specifically recommended against a ban on social media. Despite the potential harms – such as unhealthy social comparisons and distraction from other important healthy behaviors such as sleep, exercise and studying – social media can also benefit young people by helping to foster connection with friends and family, and with online support communities.
But there’s an important distinction between benefits and security, Murthy said Friday on The Daily, a New York Times podcast.
“It is important to look broadly at the issue of research. What we’re trying to figure out first and foremost is the answer to the question that parents are asking us, which is, ‘Is social media safe from my kids?’ And if you ask the researchers, ‘What do the safety data tell us? Where is the data that tells us these platforms are safe?’ That data is not there. So there is no proof of safety. There is growing evidence of harm,” he said.
“There are some benefits, but getting some benefits does not justify forcing children to endure significant harm.”
However, social media is not the same as cigarettes. Smoking has a much stronger and more direct link to negative health effects, and quitting is not the ultimate goal of social media.
Instead, a social media warning label should be more like those on bicycles and vehicles, said Pamela Wisniewski, an associate professor of human-computer interaction at Vanderbilt University whose research focuses on media relations. social, privacy and online security. for teenagers.
“The key is to focus on solutions that empower young people and give them choices and opportunities to maximize the benefits of using social media while minimizing the risks, as opposed to taking the restrictive and surveillance-based approaches that are too entrenched in fear,” she said. . The goal should be to ensure appropriate use, not just focus on risks and harms.
There is an expectation that products that children interact with are tested for safety, and a warning label on social media can send a clear message that there are “many safety gaps,” said Dr. Jenny Radesky, medical director of the American Academy of Pediatrics Center of Excellence for Social Media and Youth Mental Health.
“We expect baby formula to be tested for bacteria, toys to be tested for lead paint and that there are safety regulations for everything from cribs to cars. “These safety rails that prioritize the well-being of children in digital products don’t exist in the US,” she said.
However, warning labels are brief and nuance can get lost in the “noise of the Internet,” Radesky said. “Family conversations to support healthy media use take a lot of time and need to happen consistently.”
For the surgeon general, a warning label is part of a holistic strategy to reduce the dangers social media poses to US youth. Systematic design changes from platforms and legislation to support these changes remain a priority.
“To be clear, a warning label would not by itself make social media safe for young people,” he wrote. “These damages are not a failure of will and parenting; they are the result of releasing powerful technology without adequate safeguards, transparency or accountability.”
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