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Opinion U.S. surgeon general: I am concerned about social media and youth mental health

High School Students use their mobile phones. (iStock)
6 min

Vivek H. Murthy is the surgeon general of the United States.

“It’s a different kind of love, the love you have for your children,” my father would often say when I was growing up. When I became a parent and found myself hovering over my children’s cribs late at night to make sure they were okay, I understood. Nothing is more important than keeping our kids safe and giving them every chance to grow and thrive. As they reach adolescence, this means paying attention to how social media can affect their health and well-being.

When I travel around the country talking with parents, the No. 1 question they ask me has to do with social media: “Is it safe for my kids?” Nearly 70 percent of parents say their job is harder now than it was for parents 20 years ago, mainly because of technology and social media.

Nearly all teenagers in the United States (95 percent) use social media platformstwo-thirds use them daily and more than one-third “almost constantly.” Parents tell me they watch their children retreat to their bedrooms and spend hours alone with their screens, exposed to an endless feed of flawless bodies and unrealistic ideals that make them feel ashamed and damage their self-esteem. Their kids, still too young to watch R-rated movies, are too often encountering inappropriate sexual and violent content on social media.

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I am issuing a surgeon general’s advisory on social media and youth mental health to summarize what is known and not known about the benefits and harms of social media. The bottom line is we do not have enough evidence to conclude that social media is sufficiently safe for our kids. In fact, there is increasing evidence that social media use during adolescence — a critical stage of brain development — is associated with harm to mental health and well-being. In light of the ongoing youth mental health crisis, it is no longer possible to ignore social media’s potential contribution to the pain that millions of children and families are experiencing.

The advisory lays out steps that policymakers, technology companies, researchers, parents and children themselves can take to make social media safer for kids.

To be sure, some children might benefit from social media use. It allows them to connect easily with friends and family, express themselves freely, and find support when they are struggling. This can be especially true for marginalized youths, including those in the LGBTQ+ community. Though the data shows these children are also more likely to experience cyberbullying.

But while some children experience benefits from using social media, increasing evidence suggests that social media use is associated with a risk of harm to youth mental health. They are commonly exposed to extreme, inappropriate and harmful content, and those who spend more than three hours a day on the platforms face double the risk of experiencing poor mental health outcomes, including depression and anxiety. This is especially troubling when you consider that teenagers spend an average of 3½ hours a day on social media.

Many children are also exposed to relentless bullying online. Nearly 6 in 10 adolescent girls say they’ve been contacted by strangers in ways that make them feel uncomfortable. And nearly half of adolescents say social media makes them feel worse about their bodies.

Studies have also linked youth social media use with reduced sleep, poor sleep quality and depression. In fact, about 1 in 3 adolescents report using screen media, typically social media, until midnight or later on weekdays. Inadequate sleep during adolescence is linked to depression, altered brain development and other problems.

This is particularly concerning because adolescence is such a crucial time for brain development, a time when children are most susceptible to social pressures, peer opinions and peer comparisons — all of which are dramatically magnified on social media.

For too long, parents have borne the entire responsibility of managing social media use. Certainly, there are steps parents and their children can take to set boundaries. But they shouldn’t have to do this alone. Most social media platforms are designed to maximize user time and engagement, so that ultimately teenagers and their parents are pitted against some of the world’s most talented engineers and product developers. This is not a fair fight.

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What’s more, because platforms have not given researchers access to the data they need to better evaluate the effects of social media on kids, parents don’t know the full extent of the dangers or how to protect their children.

In contrast, manufacturers of physical products — from medications to car seats, toys to cars — are required to meet safety standards. Consumers are not expected to evaluate the safety of these products on their own. The same should be true of social media.

What’s needed is a safety first approach that requires companies to share the responsibility for protecting children.

Policymakers can establish age-appropriate health and safety standards that protect against exposure to harmful content and limit features designed to manipulate our children into excessive and unhealthy use of social media. They can require technology companies to disclose data on health effects and strengthen and enforce age minimums. Many platforms now require users to be at least 13 years old but do little to enforce it. And, given the totality of the evidence, I have come to believe that 13 is too young for our kids to be on social media.

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For their part, technology companies can design health and safety protections into their products, and they should be transparent with the public, including with independent researchers and parents, about what the data tells us about how social media is affecting our kids.

Social media has fundamentally changed the way children communicate, build relationships and see themselves and the world. Just last week, our daughter asked my wife and me about posting a picture on social media. She is just 5 years old. Given everything we know, my wife and I do not plan to allow our children to use social media in middle school. (We know this is easier said than done.) We’ll reassess in high school based on the maturity and development of our children and whether effective safety standards have been put in place to protect adolescents.

For too long, parents and kids have done their best to manage the potential harms of social media with limited information and support. They shouldn’t have to do it alone. It is time for us to take action to protect the health and well-being of our children.