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The Internet and social media now impact almost every aspect of people’s lives and have altered social interactions and ways of being. Many young people use the Internet and social media in a way that is detrimental to their mental health, with the potential of developing symptoms traditionally associated with addiction. Despite this desperation to use the Internet and social media, a recent study showed that the more time young people spend on social media, the less happy they feel about everything except their friendships. More speci cally, they felt less happy about school and school work, their appearance, their family, and life in general. It appears that girls are more a ected than boys. It is important however that we don’t blame the medium but the message. There are positive messages out there on social media, which can help young people with mental health di culties but also some very harmful messages and practices can be found online too. This talk will explore ‘The risks and bene ts of social media on the mental health of adolescents’.

Published in: Healthcare
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  1. 1. The risks and benefits of social media on the mental health of adolescents Dr. Jon Goldin Consultant Child and Adolescent Psychiatrist MCU
  2. 2. Overview • Context • Prevalence of social media • Clinical Examples • DSH • Anorexia Nervosa • Child Protection • Possible solutions/positive examples • Conclusion
  3. 3. Look familiar?
  4. 4. Why children use social media • Communication • Self-esteem • Expression • Confidence • Popularity • Entertainment • Sense of belonging • To ‘keep up’/receive information
  5. 5. Global context • Significantly increased use of electronic/social media amongst adolescents • YP spend on average 6 hours/day online and 25% of those surveyed have lost sleep thinking about things on the internet • School reading lists and assignments, planning social events, research, social networking • Pornography, stalking, cyber-bullying, internet gambling, researching weapons and suicide methodology
  6. 6. Social Media • Facebook, Instagram, tumblr, Twitter, Snapchat, all open to children 13 and up • Many accessible to younger tech-savvy ‘tweens’ • The average time spent online by 3-4 year olds has increased to 8 hours 18 minutes a week, whilst 12-15 year olds spend over 20 hours a week online (Growing Up Digital, 2017). • The number of young people counselled by Childline over cyber bullying has doubled in five years, whilst the number of calls received from children affected by grooming rose by 10% to 3150 last year (NSPCC, 2016).
  7. 7. Social Media – current trends • Instagram – v popular, large user numbers • Snapchat – ‘The whole point is you can say what you want and then it’s gone’ • Twitter – ‘Photos, Videos, DM - Best of them all in one place’ • – Can lip-synch pop videos, option of doing it ‘live’, risky • Pinterest – ‘All you do is pin pictures on a board’ • Facebook – ‘It’s uncool because it’s pointless….for old people’ • WhatsApp – Often with family members, end to end encryption • YouTube – more on iPads, for videos • Jargon– ‘Streaks’, ‘Deep Likes’, ‘Ghosting’ • Emojis – ‘More than three seen as a little immature nowadays’ • ‘Social Media is a blessing and a curse’ - 17 yr old girl
  8. 8. Mental Health Trends • Smartphones came in in 2007 (first iPhone) • Increase in prevalence of depression and anxiety in YP over past 10 years • More teens saying they feel lonely and hopeless • Significant increase in numbers of girls aged 12-14 taking their own lives • Less time being spent in face to face interactions with families/friends
  9. 9. Other Concerns • Over half of schoolchildren would not tell their parents if they were upset by something online • Survey of 10,000 pupils in Britain aged 6-18: 90% would tell their teacher if upset by sth face to face but only a third would turn to them if upset by sth online • Children suffering in silence • Increase in depression, anxiety, DSH, ED’s amongst YP. • 44% increase in CAMHS referrals past 4 years
  10. 10. Education Policy Institute (EPI) report, 2017 • Over a third of UK 15 year olds are ‘extreme internet users’, spending > 6 hours online outside of school • 95% of 15 year olds in UK use social media before or after school in 2015 • 12% of children who spend no time on social media have symptoms of mental ill health • 27% of children who are on social media > 3 hrs/day have symptoms of mental ill health (ONS, 2015)
  11. 11. However…. • Must not confuse correlation with causation • Currently no evidence from neuroscience studies that typical internet use harms the adolescent brain • In terms of social interaction and empathy, adolescents’ use of social media can enhance existing friendships and the quality of relationships (for some more than others) • If used to avoid social difficulties, reduced wellbeing. If used to deal with social challenges, outcomes improve. (Bell et al, BMJ, 15.8.15)
  12. 12. Advantages of access to internet/social media • Need to learn to access the online space thoughtfully and responsibly • A central part of contemporary life, which YP may depend on for communication and interaction ‘You can keep up to date with friends who you don’t always see’ 16 year old boy • Availability of knowledge, information about the world, current affairs etc
  13. 13. Disadvantages of access to internet/social media • Cyber-bullying – ‘People say a lot more behind a computer screen than they would in real life’ • Age-inappropriate content • Location services • Grooming/child protection issues • Inappropriate content eg pro-Ana sites, DSH, ‘How to kill yourself’
  14. 14. Instagram et al • Royal Society for Public Health (RSPH) 2017 report called #StatusofMind • Surveyed 1500 young people aged 14-24 • Instagram, snapchat, Facebook and Twitter all showed negative affects on YP mental health • YouTube found to have the most positive impact • Link between isolation and social media use • Filters and photo editing particularly detrimental, YP need to know about these altered images • Worse if more than 2 hours/day spent on social media • YP need to learn how to cope with social media, can also be positives, danger of blaming the media for the message
  15. 15. Social Anxiety • Isolation – social media encourages this and reduces ‘real-world’ contact eg in parks, shopping centres etc • YP focussed on making large numbers of superficial connections, concerned re how they are perceived, rather than making close friendships which are protective for mental health • Social anxiety associated with physical symptoms of anxiety, panic attacks and substance abuse • FOMO. Compulsion to check smartphone.
  16. 16. Girls suffer under pressure of online 'perfection', poll finds • Quest to create the image of a “perfect” life on social media is affecting the wellbeing of one in three girls • Poll of more than 1,000 YP by UK charity Girlguiding found 35% girls aged 11-21 said their biggest worry online was comparing themselves and their lives with others • Parents failed to recognise this as a problem • Girls included grooming, how photographs they took could be altered or used out of context online, and threats from strangers. A third also worried about how they looked in photos • Sense of self bound to numbers of ‘likes’ received. • Culture of narcissism c.f. Donald Trump!
  17. 17. Deliberate self-harm • Voyeurism/exhibitionism • Glamorises/romanticises self-harm? • Adolescents seek feeling of belonging and being ‘understood’ that such websites can provide • Competition between peers/’badge of honour’ • Advice re ‘how to do it’ • Suicide pacts/people meeting on line • Education/increased awareness
  18. 18. Tallulah W • 15 year old girl who died in 2012 after being run over by a train at King’s Cross • She had posted self-harm images on networking site Tumblr, had 18,000 followers. • Her mother spoke of her daughter being involved in a "toxic digital world". • Created a fantasy cocaine-taking on-line character • Online life kept separate from rest of life, makes it harder for healthcare professionals to intervene effectively
  19. 19. Anorexia Nervosa • ‘Thinspiration’ • Competition/peer encouragement/‘tips’ • Reduced sense of isolation but often unhelpful peer group • Doctored images, ‘photoshop’ leads to further reduction in self-esteem and subsequent self- harm risk • Some helpful websites eg Beat
  20. 20. Pro-Ana websites • ‘The pro-Ana lifestyle forever’ • Wear a rubber band around your wrist and snap it when you want to eat. Food = pain. • ‘PLEAS SOMEBODY BE MY ANA BUDDY’, attempt to reduce loneliness, isolation, feel ‘connected’ • The ‘rules’, numerous tips • Should these be taken down? But impossible to fully control….
  21. 21. ‘Recovery’ websites • Broad range on the internet • ‘You can live your life free from an eating disorder. Recovery is possible’. • ‘Stories of Hope’ • Mentors and mentees may be paired to promote recovery from Eating Disorders, peer support • Sometimes OTT: ‘If you want to eat everything in your kitchen, then go do so, because if your body is asking for the entire content of your kitchen, then your body needs it’.
  22. 22. Child Protection (1) • Inappropriate exposure to indecent images • ‘Sexting’, disinhibition because ‘anonymous’ • Cyber-bullying eg private images being circulated more widely • Suicides of gay teenagers, homophobia, videos have gone viral, leading to extreme shame, humiliation
  23. 23. Child protection (2) • Grooming (eg • Easy to pretend you are someone you aren’t • Anonymity • Location services
  24. 24. ‘Sexting’ • ‘Sexting’ has become part of the ‘normal’ flirting ritual for many young people. But sexting carries significant risks. Images which are supposed to remain private are often shared with a much wider audience, and can be used to bully and control. • Young people must be better aware of the risks they face, with almost a third of 15 year olds admitting to having sent a naked photo of themselves online (OFCOM, 2016). • Sexting is also influenced by pornography, which is now accessed on-line by a high proportion of boys, and which can introduce inappropriate expectations into young people’s relationships. • Child sexting cases have doubled in past two years and police investigate 17 cases/day • It was recently disclosed that, over a three year period, there were 5,500 alleged sexual offences recorded in UK schools. This included over 600 alleged rapes and nearly 4,000 alleged physical sexual assaults. • We need to help young people address the risks through open discussion and education.
  25. 25. Possible solutions? • Family-friendly filters on devices but young people often know more than adults about disabling these • The new national curriculum aims to teach children aged five to 16 about internet safety in a sensible, age-appropriate way. Education important. • Parents need to try to view world through their child’s eyes. • Website providers need to police their sites more closely? Better legal framework? • Searches related to depression and self-harm, may be intercepted with users directed to counselling and resources that can offer support • Maintain certain boundaries eg no social media in bedroom/after a certain time. See e.g. • Instant support eg apps like @TalkLifeApp
  26. 26. Government response to risk • Responsibilities placed on internet and online commercial providers was enlarged by The Digital Economy Act 2017, which aims to protect children from viewing pornographic and inappropriate content that may cause harm. • The Act mandates introduction of robust age verification controls for pornographic content.
  27. 27. Big White Wall • A safe online community of people who are anxious, down or not coping who support and help each other by sharing what’s troubling them, guided by trained professionals. • Available 24/7, Big White Wall is completely anonymous so users can express themselves freely and openly. • Professionally trained Wall Guides ensure the safety and anonymity of all members. Option of live support. • 95% of members feel better, 73% share an issue for the first time, 80% self-manage their difficulties.
  28. 28. Information and Online Resources • Childnet International • UK Safer Internet Centre includes a ‘Parents’ Guide to Technology’ • Digizen advice on cyberbullying • Kidsmart includes ‘Early Surfers’ Zone’ for 3-7 year olds • To make a report: CEOP (if concerns re online grooming or sexual behaviour online) or Internet Watch Foundation
  29. 29. Conclusion • ‘The Genie is out of the bottle’ • Adults need to understand seriousness of some of the internet content out there and what young people may be exposed to • Can’t turn back time, need to inform ourselves, educate, monitor, discuss openly • Appropriate boundaries important eg up to 2 hours/day on social media and not in bedroom at night • Mental health can be harmed but also can be helpful aspects. Focus on the message rather than the medium. • Can be good to ‘disconnect to connect’
  30. 30. Thank you for listening • • Twitter: @DrJonGoldin