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’.
The risks and benefits of social
media on the mental health of
Dr. Jon Goldin
Consultant Child and Adolescent
• Prevalence of social media
• Clinical Examples
• Anorexia Nervosa
• Child Protection
• Possible solutions/positive examples
Why children use social media
• Sense of belonging
• To ‘keep up’/receive information
• 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
• Facebook, Instagram, tumblr, Twitter, Snapchat,
ask.fm 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,
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
• Twitter – ‘Photos, Videos, DM - Best of them all in one place’
• Musical.ly – 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
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
• 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
• 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
• 44% increase in CAMHS referrals past 4 years
Education Policy Institute (EPI) report,
• Over a third of UK 15 year olds are ‘extreme
internet users’, spending > 6 hours online outside
• 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,
• Must not confuse correlation with causation
• Currently no evidence from neuroscience studies
that typical internet use harms the adolescent
• 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)
Advantages of access to
• 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
Disadvantages of access to
• 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’
Instagram et al
• Royal Society for Public Health (RSPH) 2017 report called
• 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
• Isolation – social media encourages this and
reduces ‘real-world’ contact eg in parks, shopping
• 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
• Social anxiety associated with physical symptoms
of anxiety, panic attacks and substance abuse
• FOMO. Compulsion to check smartphone.
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
• Sense of self bound to numbers of ‘likes’ received.
• Culture of narcissism c.f. Donald Trump!
• 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
• 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
• 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-
• Some helpful websites eg Beat
• ‘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
• 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’.
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
Child protection (2)
• Grooming (eg musical.ly)
• Easy to pretend you are someone you
• Location services
• ‘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,
• 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
• 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
• 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
• 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. ourpact.com
• Instant support eg apps like @TalkLifeApp
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
• The Act mandates introduction of robust age
verification controls for pornographic content.
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
• 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.
Information and Online Resources
• Childnet International www.childnet.com
• UK Safer Internet Centre
www.saferinternet.org.uk includes a ‘Parents’
Guide to Technology’
• Digizen www.digizen.org advice on cyberbullying
• Kidsmart www.kidsmart.org.uk 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 www.iwf.org.uk
• ‘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
• 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’
Thank you for listening
• Twitter: @DrJonGoldin
Social Media is everywhere
Impact on family life…
Business! Mint and Gum….
Edwards (2013) 9 users driven to suicide on ask.fm
On 6 August 2013 it was reported that Hannah Smith, a 14-year-old girl from Leicestershire, England, had killed herself, and that her father blamed her death on bullying responses she had received on the site. He called for tighter controls against social networking sites like ASKfm, saying that he had seen the abuse his daughter had received and it was wrong that it was anonymous.
The Smith family calls were echoed by the parents of Goosnargh, Lancashire teenager Joshua Unsworth, who was reported to have been "cyberbullied" on the site prior to his suicide. The company responded by stating it was 'happy to help police'.
Better policed since then
Deep Like – accidentally favoriting an old post on Instagram when scrolling back through someone’s feed, a major faux pas apparently
Ghosting – when you get ignored online
Acc to Jean Twenge, Psychology Professor at San Diego State University, the number of US teenagers spending time with friends nearly every day dropped by more than 40% between 2000-2015, with rates of loneliness sharply increasing.
Uhis et al (2014) ‘Five days at outdoor education camp without screens improves preteen skills with nonverbal emotion cues’
Non-screen activities eg sports associated with greater happiness, screen activities correlated with lower happiness
Spending time with family and friends associated with greter ahppiness so doing this less is a bad sign
One study where people gave up FB for a week and had better wellbeing than those who had not.
Uhis et al (2014) The Impact of Media Use and Screen Time on Children, Adolescents, and Families
American College of Pediatricians – November 2016
A clear association between excessive social media use and symptoms of mental ill health
False reality Friedman 1999 – ‘fosters a false sense of connection and intimacy, exempting us from the real work required to build intimacy’.
Can shrink attention span, important to ensure closeness and concentration when talking to friends in real life.
Ruth Marvel, deputy chief executive of Girlguiding, said girls had spoken of the “increasing pressure to live the ‘perfect’ life online and the negative impact this is having on their wellbeing”, adding: “We need to listen and take girls’ voices seriously to protect their happiness, wellbeing and opportunities in life, both online and offline.”
The Labour MP Jess Phillips said the results were “worrying” and that “perfection is nothing more than a marketing tool”.
“Improving how girls and women feel about themselves isn’t just important to stop hurt feelings, as some may claim,” she added. “It matters because women trying to reach some unattainable goal of how our faces, bodies, homes and lifestyles should be seeps into real life and sees women feeling inferior in the workplace and in their personal relationships.”
Fellow Labour MP Karen Buck said: “There is much that is positive about modern communications technology and social media, and it’s not likely that this tide is going to be turned back any time soon.
“However, there is also evidence, which this report adds to, that social media can fuel anxiety and depression, as people are drawn to constant comparisons with often idealised versions of the lives, and bodies, of others.
“Though boys are certainly not immune, the pressure on girls to look a certain way is particularly intense,” Buck added. “We should be building a culture of resilience in young people, encouraging open discussion and helping young people challenge the distorting effects of social media.”
Half of UK girls are bullied on social media, says survey
Charity says girls face specific types of abuse and calls for more to be done to tackle sexism in online world
Of the 11- to 21-year-olds polled, 36% said their biggest worry online was grooming, defined as when someone lies about their age or who they are to get closer to a child. They also expressed concern about threats from strangers.
The Girls’ Attitudes Survey found that fewer than half (47%) of those questioned felt their parents understood the pressures they faced online. The majority said they believed their parents were most worried about the threat of online grooming (59%).
Rhiannon Lambert, a Harley Street nutritionist, said that in the past year twice the usual number of children and young teenagers had come to her saying they felt inadequate after comparing themselves to others online.
“They are … thinking they are not healthy enough, or asking why they are not getting strong enough or not putting on weight,” Lambert said. “They look on Instagram and follow fitness accounts and want to look like the people who post pictures.
“It’s becoming the norm to aspire to be a figure on social media now – people [are] growing up to want to be influencers and that is now a job role ... I am not sure if parents are fully aware of the pressure people face and it must be difficult to understand waking up every day and scrolling through a feed of images.”
Dr Louise Theodosiou, from the Royal College of Psychiatrists, said: “The ready availability of internet-connected devices means that for most children and young people, communicating online is a standard part of life. That’s why it’s so important to address both the positive and the negative effects of the internet.
Are smartphones really making our children sad?
US psychologist Jean Twenge, who has claimed that social media is having a malign affect on the young, answers critics who accuse her of crying wolf
“For many young people, the internet can be a safe way to develop friendships, express opinions and gain valuable information – for example, about their emotional wellbeing. But we must also find ways to teach children how to keep themselves safe online, acknowledging the dangers of grooming and the use of pictures. The publication of this data will hopefully pave the way towards parents and daughters starting a valuable dialogue about their online lives.”
Tom Madders, director of campaigns and communications at the charity YoungMinds, said: “Young people now face the pressure of creating a personal brand from a young age, and seeking reassurance in the form of likes and shares.
“With feeds full of idyllic holiday photos or groups of friends, it can be hard not to compare yourself to others or feel like you should be living the ‘perfect life’. While it’s important to recognise and teach young people against dangers online, it’s also really important to acknowledge that social media can have an impact on young people’s wellbeing or exacerbate feelings of being left out.
“What young people see on social media doesn’t reflect real life, and we need to do more to help young people build resilience to the pressures of being online.”
Encouragement to ‘catch the bus’…(commit suicide)
Essentially, to catch the bus is to commit suicide.
Earlier this year during a period of morbidity, I spent a lot of time browsing the alt.suicide.holiday Usenet newsgroup, or, as its members affectionately call it, ASH. A place of discussion for those contemplating suicide, new members are generally greeted with a hearty "Welcome to ASH, sorry you're here." Often misunderstood and demonized, ASHers have become a little insular over the years and even developed their own vernacular. Psychiatrists are Pdocs, to come out of the closet is to confess to somebody that you're suicidal and to catch the bus (or sometimes train) is to kill yourself. That last one has always been my favorite. You see, ASHers like to think of their group as "a bus stop where several people have decided to stop and chat before deciding on whether or not to get on the bus," which is generally a good way to describe it.Anyway, this brings me to my point here: while browsing the newsgroup one night, I found the most melancholy, resigned thing I think I'll ever read.
Its almost time to catch the train. I want to clean up my room first so no one else has to go through that depressing process, you know? Basically a series of events have put me with no other option. Debt, University grades, etc. I think Ill go with the car in garage deal.That looks most painless, pretty quick. Now I just have to write a note. Even death requires an essay.
Lemma (2010) wrote about cyberspace offering adolescents struggling with their bodily changes a virtual universe where the actual corporeal self is left behind and the self-representation is reinvented at will.
Patient who allowed himself to be photographed naked by another 10 year old boy then photo texted to rabbi…rabbi’s wife informed mother
Another patient 13 year old girl sent explicit pics of herself to an adult, seeking attention, affirmation…
Musically – public ‘live’ option
Over 18s more likely to send naked selfies than young people but is especially risky for YP.
Forces in England and Wales recorded 6238 underage sexting offences in 2016-17, peak age investigated is 14. reports received from children as young as 10.
Sharing and processing these images is against the law.
While these are ‘alleged’ and not proven, the figures indicate a serious level of inappropriate behaviour among young people.
Create a Brick
Express your feelings by creating a Brick using pictures and images. Self assessment, online guided support courses, access useful information, make friends
Clare Lilly, NSPCC safer Internet lead "The genie is out of the bottle."