If you don’t already know that there’s a national adolescent mental health crisis in the United States, all you have to do is to scroll your news feed to see a plethora of articles sounding the alarm. The following list is a small sample of what I found in a brief search through current news:
- School violence and threats of school violence
- Pandemic-related academic and/or mental health concerns
- Internet safety/Bullying and Cyberbullying
- Self-Injury/Self-Harm/Suicide
- Stress/Anxiety/Depression
- Social media’s effects on adolescent mental health
- Addictions: drugs, alcohol, gambling, gaming
On October 19th 2021 child and adolescent mental health was declared a national emergency by the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, and the Children’s Hospital Association (read full declaration HERE).
According to the press release, “This worsening crisis in child and adolescent mental health is inextricably tied to the stress brought on by COVID-19 and the ongoing struggle for racial justice and represents an acceleration of trends observed prior to 2020. Rates of childhood mental health concerns and suicide rose steadily between 2010 and 2020 and by 2018 suicide was the second leading cause of death for youth ages 10-24.”
Adolescence has always been a time of upheaval and change, a time when important and difficult lessons are presented, a time when rules and assumptions are challenged. These general challenges have been present throughout the generations, but today’s adolescents face a host of difficulties that their parents and grandparents never even dreamed of.
The internet and social media have provided both blessings and curses, and have inevitably changed the landscape of growing up; therefore, I have narrowed the focus of this article to the effects of the internet and social media on adolescent mental health. The virtual world permeates every facet of modern life it’s woven into our lives, and directly or indirectly relates to many issues adolescents face today.
There are many positive aspects to the internet and social media: convenience, connection, entertainment, and the ability to research any topic, any time. However, there are also many pitfalls in the digital age, and adolescents are particularly affected by the downside.
Adolescents today typically live their lives in public, online, for all the world to see (and to make fun of). When I was in high school, in my incredibly short-lived career in the drama club, I once infamously knocked a desk off of a stage making my grand entrance. (Yes, I am that clumsy!). My friends and I laughed it off, and I took a bit of good-natured teasing for a while, but today, someone would likely record such an incident on a smartphone and posted online for everyone to laugh at and make mean-spirited comments.
For instance, Twitter is notorious for pile-ons, where the target is decimated by a mob for daring to make a mistake, to do something embarrassing, or to disagree with someone. These mobs are brutal, typically actively trying to get the target in trouble, fired, humiliated, ostracized, arrested, or worse. Similar events occur on all social media platforms. Such bullying is difficult for even the most stable adult to handle, but, for an adolescent, it can feel like the end of the world.
Additional internet and social media dangers include, but are not limited to:
- catfishing (the process of luring someone into a relationship through a fictional online persona)
- phishing (when the victim receives fraudulent messages designed to lure them into revealing private information)
- cyber-stalking (when harassment/stalking starts or occurs online)
- cyber-bullying (when bullying that takes place online)
- sextortion (when the victim is threatened and/or coerced into sending explicit images online);
- human trafficking (when force, fraud, and/or coercion are used in order to obtain some type of labor or commercial sex act)
- kidnapping/sexual abuse (when individuals posing as minors use popular social media or social networks to lure victims for kidnapping and/or sexual abuse)
- “pro-ana” websites/communities (which promote pro-anorexia thoughts and behaviors)
In addition to the overt dangers, other more common issues also present challenges to everyone, and especially adolescents, including, but not limited to:
- fear of missing out (FOMO)
- negative comparisons of our bodies/lives with the idealized and often heavily edited versions of other people’s bodies/lives on social media
- feelings of exclusion if unfriended/blocked on social media (or when it becomes obvious from peers’ posts that others were invited to a party that they were not)
- obsession with checking/scrolling social media to the exclusion of real-life connections and activities
Warning signs of mental health issues may include, but are not limited to:
- Changes in emotions such as increased anger, crying, irritability, lashing out, etc.
- Changes in daily living activities (eating, sleeping, personal hygiene, general habits, etc.)
- Other unexplained and/or unusual changes (such as a fixation on weapons or an obsession with another person/group/activity/website)
- Behavioral difficulties in the home, school, and/or community
- Social withdrawal
- Withdrawal from activities that were previously enjoyed
- Excessive, changing, or inappropriate use of social media and/or other internet sites
- Declining academic functioning
- Increased school absences or tardiness
- Secrecy
- Drug and/or alcohol use
Tips to offer parents and school personnel if they are concerned about an adolescent’s mental health:
- If any situation is an emergency (such as if the student is a danger to self and/or others, or if there’s some other imminent danger), calling 911 immediately is needed. Make sure that everyone involved with the situation is being supervised and are safe while waiting for the response.
- Parents and school personnel can help adolescents by being aware of the warning signs of potential mental health issues. Parents should talk to their children about internet usage and safety, and should be aware of any problems or changes. Similarly, school personnel should be alert to changes and potential warning signs.
- Consultation with the student’s physician is recommended if the student appears to be depressed, withdrawn, anxious, and/or is having other emotional or physical symptoms. Medical consultation is recommended if the student is having issues with sleep (too much or not enough) or eating (again, too much or not enough). Parents and school personnel should communicate their observations and concerns and work together.
- Parents and school personnel should make sure that adolescents know who is a safe and trusted adult to reach out when needed, and should be aware of and be able to use resources as-needed for the situation. *Please see the Resources list, below, for a start.
- Schools often have ongoing counseling groups that target specific issues or skills (for instance, social skills, stress management, anger management, organization skills, study skills, etc.), which are typically run by the school social worker, the school counselor, or the school psychologist. Individual counseling sessions are another possibility when appropriate. Parents should reach out to their schools to ask about the availability of services.
- If needed, students can be referred for a psychological evaluation by either parents or school personnel if the concerns are affecting the student’s academic progress and/or the student’s social, emotional, behavioral, or adaptive functioning. The specific referral processes differ from state to state and from district to district, but the basic special education referral process is described in this article.
- Another potential option for students who need help is called a 504 Plan, which is described in this link.
In summary, adolescents today face a myriad of challenges. Parents, communities, and schools need to communicate and, ideally, form alliances for the overall well-being of students. Schools need to best use their mental health experts (school psychologists, school social workers, school counselors), and, of course, schools would benefit from more funding to provide more mental health professionals and services. Access to and coordination of services with community providers (physicians; clinical psychologists and other mental health providers; psychiatrists; and other community resources) are also needed for comprehensive care.
Resources:
- Understanding Problematic Internet Use: https://www.childrenscolorado.org/doctors-and-departments/departments/psych/mental-health-professional-resources/primary-care-articles/internet-addiction/
- General NIMH Resources for Adolescent Mental Health: https://www.nimh.nih.gov/get-involved/education-awareness/shareable-resources-on-child-and-adolescent-mental-health
- Youth.gov: Adolescent Mental Health Resource: https://youth.gov/youth-topics/youth-mental-health
- Trevor Project: https://www.thetrevorproject.org/
- National Suicide Prevention Lifeline: https://suicidepreventionlifeline.org/; 1-800-273-8255
- Crisis Text Line – text HOME to 741741
- How to talk about school violence and mental health: https://www.charlotteobserver.com/news/local/education/article256733757.html
- Online Safety/Human Trafficking: https://www.dhs.gov/blue-campaign/online-safety
- Internet Safety Tips for Teens: https://teens.webmd.com/features/teen-internet-safety-tips
- NetSmartz: https://www.missingkids.org/netsmartz/home
- Cyberbullying: https://www.stopbullying.gov/cyberbullying/what-is-it
- Cyberstalking: https://www.justice.gov/ovw/stalking
- Information on “pro-ana”: https://www.webmd.com/mental-health/eating-disorders/anorexia-nervosa/features/pro-anorexia-web-sites-thin-web-line
- Safe and Sound Schools: https://www.safeandsoundschools.org/
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References
Odgers, C. L., & Jensen, M. R. (2020). Annual Research Review: Adolescent mental health in the digital age: facts, fears, and future directions. Journal of child psychology and psychiatry, and allied disciplines, 61(3), 336–348. https://doi.org/10.1111/jcpp.13190
Abi-Jaoude, E., Naylor, K. T., & Pignatiello, A. (2020). Smartphones, social media use and youth mental health. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 192(6), E136–E141. https://doi.org/10.1503/cmaj.190434
Restrepo, A., Scheininger, T., Clucas, J. et al. (2020). Problematic internet use in children and adolescents: associations with psychiatric disorders and impairment. BMC Psychiatry 20, 252. https://doi.org/10.1186/s12888-020-02640-x
George, M. J., Russell, M. A., Piontak, J. R., & Odgers, C. L. (2018). Concurrent and subsequent associations between daily digital technology use and high‐risk adolescents’ mental health symptoms. Child development, 89(1), 78-88. https://doi.org/10.1111/cdev.12819
Grist, R., Cliffe, B., Denne, M., Croker, A., & Stallard, P. (2018). An online survey of young adolescent girls' use of the internet and smartphone apps for mental health support. BJPsych Open, 4(4), 302-306. https://doi.org/10.1192/bjo.2018.43
van den Eijnden, R., Koning, I., Doornwaard, S., van Gurp, F., & ter Bogt, T. (2018). The impact of heavy and disordered use of games and social media on adolescents’ psychological, social, and school functioning, Journal of Behavioral Addictions, 7(3), 697-706. https://akjournals.com/view/journals/2006/7/3/article-p697.xml
