United States Surgeon General’s Advisory highlights social media’s effects on youth mental health

Today, United States Surgeon General Dr. Vivek Murthy released a new Surgeon General’s Advisory on Social Media and Youth Mental Health. While social media may offer some benefits, there are ample indicators that social media can also pose a risk of harm to the mental health and well-being of children and adolescents. Social media use by young people is nearly universal, with up to 95% of young people ages 13-17 reporting using a social media platform and more than a third saying they use social media “almost constantly.”

With adolescence and childhood representing a critical stage in brain development that can make young people more vulnerable to harms from social media, the Surgeon General is issuing a call for urgent action by policymakers, technology companies, researchers, families, and young people alike to gain a better understanding of the full impact of social media use, maximize the benefits and minimize the harms of social media platforms, and create safer, healthier online environments to protect children. The Surgeon General’s Advisory is a part of the Department of Health and Human Services’ (HHS) ongoing efforts to support President Joe Biden’s whole-of-government strategy to transform mental health care for all Americans.

The most common question parents ask me is, ‘is social media safe for my kids’. The answer is that we don't have enough evidence to say it's safe, and in fact, there is growing evidence that social media use is associated with harm to young people’s mental health. Children are exposed to harmful content on social media, ranging from violent and sexual content, to bullying and harassment. And for too many children, social media use is compromising their sleep and valuable in-person time with family and friends. We are in the middle of a national youth mental health crisis, and I am concerned that social media is an important driver of that crisis – one that we must urgently address.” 

Dr. Vivek Murthy, U.S. Surgeon General..

Usage of social media can become harmful depending on the amount of time children spend on the platforms, the type of content they consume or are otherwise exposed to, and the degree to which it disrupts activities that are essential for health like sleep and physical activity. Importantly, different children are affected by social media in different ways, including based on cultural, historical, and socio-economic factors. Among the benefits, adolescents report that social media helps them feel more accepted (58%), like they have people who can support them through tough times (67%), like they have a place to show their creative side (71%), and more connected to what’s going on in their friends’ lives (80%).

However, social media use can be excessive and problematic for some children. Recent research shows that adolescents who spend more than three hours per day on social media face double the risk of experiencing poor mental health outcomes, such as symptoms of depression and anxiety; yet one 2021 survey of teenagers found that, on average, they spend 3.5 hours a day on social media. Social media may also perpetuate body dissatisfaction, disordered eating behaviors, social comparison, and low self-esteem, especially among adolescent girls. One-third or more of girls aged 11-15 say they feel “addicted” to certain social media platforms and over half of teenagers report that it would be hard to give up social media. When asked about the impact of social media on their body image, 46% of adolescents aged 13-17 said social media makes them feel worse, 40% said it makes them feel neither better nor worse, and only 14% said it makes them feel better. Additionally, 64% of adolescents are “often” or “sometimes” exposed to hate-based content through social media. Studies have also shown a relationship between social media use and poor sleep quality, reduced sleep duration, sleep difficulties, and depression among youth. 

While more research is needed to determine the full impact social media use has on nearly every teenager across the country, children and adolescents don’t have the luxury of waiting years until we know the full extent of social media’s effects. The Surgeon General’s Advisory offers recommendations stakeholders can take to help ensure children and their families have the information and tools necessary to make social media safer for children:

• Policymakers can take steps to strengthen safety standards and limit access in ways that make social media safer for children of all ages, better protect children’s privacy, support digital and media literacy, and fund additional research.
• Technology companies can better and more transparently assess the impact of their products on children, share data with independent researchers to increase our collective understanding of the impacts, make design and development decisions that prioritize safety and health – including protecting children’s privacy and better adhering to age minimums – and improve systems to provide effective and timely responses to complaints.
• Parents and caregivers can make plans in their households such as establishing tech-free zones that better foster in-person relationships, teach kids about responsible online behavior and model that behavior, and report problematic content and activity.
• Children and adolescents can adopt healthy practices like limiting time on platforms, blocking unwanted content, being careful about sharing personal information, and reaching out if they or a friend need help or see harassment or abuse on the platforms.
• Researchers can further prioritize social media and youth mental health research that can support the establishment of standards and evaluation of best practices to support children’s health.

In concert with the Surgeon General’s Advisory, leaders at six of the nation’s medical organizations and the National Parent Teacher Association have expressed their concern on social media’s effects on youth mental health:

Social media can be a powerful tool for connection, but it can also lead to increased feelings of depression and anxiety – particularly among adolescents. Family physicians are often the first stop for parents and families concerned about the physical and emotional health of young people in their lives, and we confront the mental health crisis among youth every day. The American Academy of Family Physicians commends the Surgeon General for identifying this risk for America's youth and joins our colleagues across the health care community in equipping young people and their families with the resources necessary to live healthy, balanced lives.”

Tochi Iroku-Malize, M.D., MPH, MBA, FAAFP, President, American Academy of Family Physicians

Today’s children and teens do not know a world without digital technology, but the digital world wasn’t built with children’s healthy mental development in mind. We need an approach to help children both on and offline that meets each child where they are while also working to make the digital spaces they inhabit safer and healthier. The Surgeon General’s Advisory calls for just that approach. The American Academy of Pediatrics looks forward to working with the Surgeon General and other federal leaders on Youth Mental Health and Social Media on this important work.”

Sandy Chung, M.D., FAAP, President, American Academy of Pediatrics

With near universal social media use by America’s young people, these apps and sites introduce profound risk and mental health harms in ways we are only now beginning to fully understand. As physicians, we see firsthand the impact of social media, particularly during adolescence – a critical period of brain development. As we grapple with the growing, but still insufficient, research and evidence in this area, we applaud the Surgeon General for issuing this important Advisory to highlight this issue and enumerate concrete steps stakeholders can take to address concerns and protect the mental health and wellbeing of children and adolescents. We continue to believe in the positive benefits of social media, but we also urge safeguards and additional study of the positive and negative biological, psychological, and social effects of social media.”

Jack Resneck Jr., M.D., President, American Medical Association

The first principle of health care is to do no harm – that’s the same standard we need to start holding social media platforms to. As the Surgeon General has pointed out throughout his tenure, we all have a role to play in addressing the youth mental health crisis that we now face as a nation. We have the responsibility to ensure social media keeps young people safe. And as this Surgeon General’s Advisory makes clear, we as physicians and healers have a responsibility to be part of the effort to do so.”

Saul Levin, M.D., M.P.A., CEO and Medical Director, American Psychiatric Association

The American Psychological Association applauds the Surgeon General's Advisory on Social Media and Youth Mental Health, affirming the use of psychological science to reach clear-eyed recommendations that will help keep our youth safe online. Psychological research shows that young people mature at different rates, with some more vulnerable than others to the content and features on many social media platforms. We support the advisory's recommendations and pledge to work with the Surgeon General's Office to help build the healthy digital environment that our kids need and deserve.”

Arthur Evans, Jr., Ph.D., Chief Executive Officer and Executive Vice President, American Psychological Association.

Social media use by young people is pervasive. It can help them, and all of us, live more connected lives – if, and only if, the appropriate oversight, regulation and guardrails are applied. Now is the moment for policymakers, companies and experts to come together and ensure social media is set up safety-first, to help young users grow and thrive. The Surgeon General’s Advisory about the effects of social media on youth mental health issued today lays out a roadmap for us to do so, and it’s critical that we undertake this collective effort with care and urgency to help today’s youth.”

Susan L. Polan, Ph.D., Associate Executive Director, Public Affairs and Advocacy, American Public Health Association 

Every parent’s top priority for their child is for them to be happy, healthy and safe. We have heard from families who say they need and want information about using social media and devices. This Advisory from the Surgeon General confirms that family engagement on this topic is vital and continues to be one of the core solutions to keeping children safe online and supporting their mental health and well-being.” 

Anna King, President, National Parent Teacher Association.

In December 2021, Dr. Murthy issued a Surgeon General’s Advisory on Protecting Youth Mental Health calling attention to our national crisis of youth mental health and well-being. Earlier this month, he released a Surgeon General’s Advisory on Our Epidemic of Loneliness and Isolation, where he outlined the profound health consequences of social disconnection and laid out six pillars to increase connection across the country, one of which being the need to reform our digital environments. The new Surgeon General’s Advisory on Social Media and Youth Mental Health is a continuation of his work to enhance the mental health and well-being of young people across the country.

The full Surgeon General’s Advisory can be read here.