Youth Mental Health

Clinicians who treat adolescent patients hear nonstop about formidable challenges created by the proliferation of social media.

“As a father of teenagers, I see daily the role social media plays in the lives of our youth,” says child psychiatrist Harsh K. Trivedi, MD, MBA, president and chief executive officer of Sheppard Pratt.

When United States Surgeon General Vivek Murthy, MD, issued an advisory on social media and youth mental health in May 2023, the topic was not unfamiliar. Casual observation corroborates what he shared: Up to 95% of young people ages 13 to 17 report using a social media platform such as YouTube, TikTok, or Instagram. One-third of that group uses it “almost constantly,” he said. U.S. teens average 4.8 hours per day engaging with social content on popular platforms, according to a Gallup survey.

The Centers for Disease Control and Prevention reports that 42% of high schoolers say they experience symptoms of depression or feeling sad or hopeless. One study found that teens who spend more than three hours per day on social media are at heightened risk for depression and anxiety.

“Social media is not going away, and no one has declared that its use is ‘all bad or all good,’” says Dr. Trivedi. “A lack of transparency about the dangers of social media apps presents another urgent challenge that exists for parents, schools, lawmakers, and clinicians.”

Examine both sides of social media

These powerful tools are not “all bad.”

“Social media can provide benefits for some youth by providing positive community and connection with others who share identities, abilities, and interests,” Dr. Murthy says.

Psychiatrists recognize that adolescent and teenage years are a highly sensitive period for brain development, particularly as it relates to social interactions, says child psychiatrist Rajeev Krishna, MD, PhD, MBA, chief of medical staff at Sheppard Pratt. “Teenagers are making the transition from being a child of the family to being an independent adult, which predisposes them to focus on peer and social relationships rather than internal family relationships. Social media taps directly into this need, not just for peer connections, but peer affirmation.”

Social media can provide access to incredibly valuable support networks but can also create opportunities for a host of negative consequences from seemingly inescapable bullying to normal teenage mistakes devastating a peer network. “How do you cope when you are an insecure teenager and your 400+ ‘friends’ are now making fun of you?,” questions Dr. Krishna.

Furthermore, these platforms have evolved so rapidly that there is a huge generational gap. Parents who grew up in an era of flip phone text messaging can struggle to help their children navigate a world they don’t understand themselves, and the solution of “just put the phone down and ignore it” falls on understandably deaf ears when recognizing that they are actually asking the teenager to cut themselves off from their entire world.

How psychiatrists can take action

The surgeon general’s campaign is a promising start, but clinicians—and society—must go much, much further.

Says Dr. Trivedi, “Sheppard Pratt is a critical part of the solution. We offer the most comprehensive continuum of youth mental health services in Maryland, with the greatest ability to quickly scale what we do to have population-level impact. We have the expertise and resources to work with agencies across the state to connect every child to high-quality, affordable, culturally competent mental healthcare.”

One clinician can’t do it all, but united as a profession, we can make positive changes by utilizing the avenues afforded to us. Those include lobbying at the state and federal level, participating in advocacy work, and supporting American Psychiatric Association initiatives. The list of “to-dos” is long, but they provide a sensible framework for change.

To help curb the intensity of social media’s impact, clinicians must advocate for expanding school-based mental health resources and trauma-informed care practices; routine screening for adverse childhood experiences in our healthcare settings; and building specialized community-based programs that support the entire family. The onus is not solely on clinicians: Employers also need to demand far better from their commercial health plans. And lawmakers should work to establish statewide care-coordination centers to lead an efficient process to help young children and teens access appropriate levels of care. More states can follow California’s lead to limit use of smartphones in schools.

“Just as we talk with patients about alcohol or drug use, we can talk to patients and their families about the true risks and potential benefits of social media,” Dr. Krishna says. “We can’t banish technology—it’s everywhere in our children’s lives. But we can play a key role in helping young people understand and manage it.”

“The youth mental health crisis requires a broad response from schools, parents, and lawmakers to help our young people thrive. We all must be the ‘warning label’ to protect our youth,” emphasizes Dr. Trivedi.