The impact of social media on children: who is responsible for making sure they're safe?

Over 90% of teenagers now use some form of social media

An increasing number of children are using social media: in 2021, 64% of tweens reported watching online videos every day, while 38% use social media, an increase from 31% in 2019. Among teenagers the number is nearly 100%, and there is growing evidence that this can have a negative effect on the mental health of these populations.

At Vator's Future of Behavioral and Mental Health last month, a panel of experts took a dive into how social media is changing the way children communicate, the responsibility of tech companies to mitigate some of the potential harm, as well as the role that parents need to take in setting a good example for their kids.

The panel was moderated by Bambi Francisco, Vator's founder and CEO, and Dr. Archana Dubey, Chief Medical Officer at HP, with panelists Rebecca Egger, co-founder and CEO of Little Otter; Divya Shah, Director of Consumer Privacy at Meta; Ed Gaussen, founder and CEO of Mantra Health; Catherine Saxbe, Child & Adolescent Psychiatrist; and Helen Joyce, Director of Advocacy at Sex Matters. 

Saxby was the first one to bring up social media, and how it affects the normal child and adolescent development, as well as their self image and self worth.

"I have seen a lot of platforms and a lot of forums that are selling themselves as communities and connection that actually create a lot more distance and a lot more self consciousness, a lot more questioning. I have talked to so many adolescents who have had what they thought were friends online, who then turned out to be people who are not who they say they are because when people go online, you choose your avatar, you choose your persona. And so, I see an entire generation of children who are having what they would call relationships and friendships with just a fantasy persona, and they themselves are not completely honest and sincere," she said.

"I see the toll that this takes on kids and how it affects their ability, or inability, to relate to the people in real life and how the social media platforms can actually replace our face to face relationships where we learn to tolerate being left out or feeling bad or someone being mean to us, which we seem to want to take away from the experience of adolescence. We want to protect our children from feeling like they've been excluded; of course we do, but that is also a normal part of adolescence and being able to feel discomfort and to feel unwanted, and yet to survive that, that's what builds resilience and that's what creates mature adults."

Dubey brought up the fact that pills and therapeutics have to be tested and go through trials before they are handed to a patient to know what effect it will potentially have on them, but that we put a smartphone and social media in the hands of our young adults whose brains are still forming without knowing what exactly the effect will be.

"Nearly 94% of kids in that age group, especially the teens and adolescents, use YouTube or TikTok or Meta or other kinds of social media on a regular basis. And, on a parallel side, we see this escalating rise of suicidality, suicide ideation. The new Pew Research actually looks at the usage patterns and then also nearly 30% increase in suicidality, which is a staggering number for 15 to 20 year old kids," she said, asking Saxby if this is the "new normal that we are going to live with."

Saxby's response was that it's “normal” in terms of being common, but it is definitely not “normal” in terms of healthy mental development.

"That's not how humans evolved to relate to one another. Actually, we have an incredible ability through all of our senses, to pick up on voice, body language, expression, micro expression, changes even in things like the muscular tension in a person's face. We were made to have face to face communication with one another and so our communication as human beings is so much more than just words on the screen," she said. 

In fact, she counted that the majority of people's communication with each other is subtext and nonverbal, so losing that really means losing a sense of how we relate to each other as human beings.

"The basis of all relationships is trust and respect and if you don't feel like you can tell where somebody is coming from emotionally when you're talking to them, then you don't build that rapport that leads to meaningful, long term relationships. And most everything is very superficial and it's just quite literal and since it's very hard to convey any tone of voice when you're writing."

That's why people now have to resort to emojis or "one dimensional little cartoon pictures," as a way to let people know what they mean "because we can't actually pick up on any of the nuances in just texting."

Meta's Shah agreed, saying that, "Texting, or even having a smartphone in your hand, at the age of eight or nine is going to be a challenge we all face as a society," but also brought up some of the potential positives of social media, including making people feeling connected online, and allowing them to find their community.

"There are many scenarios where we've seen teenagers, adolescents going through gender identity issues, where they found a community online, where they've connected and they found support. So, when you step back and think about technology and the evolution of technology, when the internet first came out there was a lot of scare as well around that. Technology is that just that, it's a medium, it can be used for the good, bad and the ugly, and that is what we're seeing with social media, that it can be used for the good, bad and ugly. The challenge for us is how do we balance the good and make sure we prevent the bad, so that balance is really hard to strike," she said.

Part of the issue, she noted, is striking a balance between protecting people, especially children, teens, and adolescents, while also maintaining user privacy. 

"I work in privacy and my constant battle is, how do I balance the privacy of youth online with safety of youth online, and monitoring of youth online? These are conflicting and contradictory, but very valuable, tenants of how we want social online behavior to happen. We do want to value the privacy of everyone in the world across the globe but we need to start monitoring for signals and trying to identify what the kid or the youth is going through, whether they're going through mental issues, what kind of content they are exposed to, what conversations they're exposed to, we start interfering with their privacy," said Shah.

"How do we strike the balance? Is striking the balance the responsibility of governments, regulators of tech companies, or parents? That is a big debate happening. Who regulates who? If we, as tech companies, start to intervene, then are we taking a stance and what happens? Do we want to get into that business? This has always been a very challenging line for us to draw and hold."

In terms of some of the things that Meta currently does to help mitigate risk, she brought up the company's Restrict feature, which asks people making public posts if they actually want to post that thing, citing research that shows that if people are asked to stop before doing something, they're more likely to think through that action. In addition, the company also tries to obfuscate or blur certain triggering images that talk about suicide or talk about body shaming or body image issues.

"This is just the beginning of what we're trying to do, we can do a lot more here, but we definitely need to partner with the experts in the space and even public policymakers, regulators, to try to see what is the best path forward in terms of striking that balance between the youth and the kids being able to leverage the goodness of a social media platform, the connectivity, but also not get influenced by the negative aspects of it. So, there is work to be done but it's not all bad. That is the challenge that we face on a day to day basis," Shah said.

Mantra's Gaussen, whose company works cohesively with university counseling centers, also defended social media to a degree, saying that "social media has become this go to place for everyone to blame the mental health crisis that's happening amongst our youth but I just think it's a little bit too easy."

While he did say social media acted as an accelerator, and that there needs to be some accountability on social media companies at the government level and in partnership with clinicians, he also said there are other trends and drivers that are equally as important when it comes to youth mental health, such as COVID.

"The pandemic has accelerated the effects of loneliness, anxiety, and trauma amongst the young adult population and that's something that we've seen a tremendous amount of in terms of the population that we're treating. Imagine going from effectively the most social experience that you could possibly go through, which is going on a college campus, to overnight being confined in your room where you're at risk of being infected or infecting others. And without an ability to go see your parents really as well, because you might put them at risk, too. That, over the last two years, has probably been one of the biggest drivers," he said.

"Another one that we're seeing as a big trend is also climate change. It's emerging as one of the leading presenting issues of anxiety in the young adult population but Gen Z is a generation that is extremely conscious, socially, about things like climate change, which as a presenting issue, as a subfield within political psychology, is starting to grow in terms of figuring out what are the right types of evidence-based therapies to treat that. And then there's also been a lot of the social injustice."

The real issues come about when those things are combined with social media, and the pressures that that puts on kids to engage with these larger issues. 

"All of that, when combined with social media that's surfacing, you need to engage in climate change, support you to engage in the Black Lives Matter movement, there's a lot of just general pressure as well on the generation that genuinely cares, is educated, but is also feeling, you could call it like a positive peer pressure, and that situation of wanting to make a change, but how much can I really impact by using my platform? That, in and of itself, is creating anxiety," said Gaussen.

Ultimately, like Shah, he believes social media can have a positive or negative impact, depending on how it's used, but there needs to be accountability and moderation.

"My sense is that there's obviously a huge amount of benefit from the communities that can be found on social media platforms in terms of emulating some of the benefits you might see in group therapy. I also think that it could really go both ways," he said.

"You can find yourself in a suicide support group, and you have someone that comes in there and says the wrong things as part of a group. That's why that the use of communities and social media for the benefits of mental health need to be evidence-based and clinically guided as well. And so, whether that comes from social media companies or digital health companies that are trying to build community features, it's really, really important to think through moderation, whether that is with a human in the loop or through artificial intelligence technology, and likely you'll need both."

The last to weigh in on this topic was Egger, who squarely put the onus on parents to teach their children how to properly engage with technology. 

"The biggest impact that social media and phones are having on children are parents engaging with these resources instead of their children. Kids are saying, 'mommy's working on the phone,' they're pretending to pick up the phone, they're trying to get their parent’s attention. The biggest thing that we can do to improve a child's mental health is to spend time with them and play with them one on one, face to face. That is what we should be doing. And, yes, these young children are playing with their phones, but they're imitating their parents. They're following what their parents are doing and more and more parents are spending their downtime on these different apps, on their phone, not engaging directly with their kids," she said.

"I also want to make sure that in this conversation, we look at what is the responsibility of parents to show good habits and good behavior, because that's where this education comes from."

It's not just the child's responsibility to regulate themselves, Egger said, but for their family to manage and support their overall mental health and interact with each other and show what is good behavior, while also agreeing with Gaussen that there are many other things, on top of social media, that affect mental health in young people. 

"Social media definitely has a big impact on it and kids are seeing things and learning stuff that's been happening, but mental health issues, just like anything else in the population, they existed before the pandemic, they exist now, and it's about how do we better treat these issues? How do we make sure that we identify them as early as possible, and make sure that we support our kids, because if it wasn't social media, as Ed was saying, it's climate change, it’s the pandemic, there's so many other factors that will continue to exacerbate it," she said.

You can see the video of the panel here. Or you can listen to the audio here. 

(Image source: imagekit.io)