What the surgeon general’s advisory says about social media for kids

Excessive social media use as a child may lead to a higher risk of poor mental health, U.S. Surgeon General Vivek H. Murthy wrote in an advisory issued Tuesday.

In the 25-page advisory, Murthy said there isn’t enough evidence to determine whether social media is “sufficiently safe” for children and teenagers. This comes amid an ongoing mental health crisis for teens and children, as adolescent rates of anxiety and depression continue to surge.

“It is no longer possible to ignore social media’s potential contribution to the pain that millions of children and families are experiencing,” Murthy wrote in an op-ed for The Washington Post.

Up to 95 percent of teenagers are on some form of social media, and a third say they’re on social media “almost constantly,” according to the report. And those who spend more than three hours a day on these platforms face “double the risk of experiencing poor mental health outcomes including symptoms of depression and anxiety.”

‘Inappropriate content,’ trouble sleeping

The report details potential benefits of online communities, such as the ability for some teens to connect with others who have similar identities or interests. It acknowledges that time spent on social media can affect children and teenagers in different ways but highlights the following concerns:

- Children are commonly exposed to “extreme, inappropriate content” while on social media.

- Social media can perpetuate feelings of body dissatisfaction, especially among adolescent girls.

- These sites can become havens for predatory behaviors. Nearly 6 in 10 girls say they’ve been contacted by a stranger online “in ways that make them feel uncomfortable.”

- Social media may be overstimulating the brain in ways comparable to addiction.

- Excessive use of social media has been associated with problems sleeping and difficulty paying attention.

Murthy asked technology companies to do a more effective job at assessing the potential harms to children and providing the “underlying data” for others to review the ways these platforms may be affecting adolescents.

The advisory also calls on elected officials to protect children from accessing “harmful content” such as videos, photos or text referring to violence, substance abuse or sexual exploitation. It also suggests enforcing age minimums, a move that experts have encouraged.

“The most important thing that could be done is enforce age minimums,” said Jean Twenge, professor of psychology at San Diego State University and the author of “iGen” and “Generations,” books that examine how the smartphone has affected America’s youngest generations.

“Let’s enforce the existing minimum of 13,” Twenge said, referring to the age minimum often used by social media platforms in the United States. “Even better, raise the minimum age to 16. I think that would make the biggest difference.”

In his op-ed for The Post, Murthy wrote that he and his wife plan to not allow their children to use social media in middle school. But they plan to reassess the rule 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.”

‘Common sense’ recommendations

Jacqueline Nesi, an assistant professor of psychiatry at Brown University who studies the ways in which social media affects teenagers, said the report makes some “common sense” recommendations that she hopes the tech companies responsible for these platforms will act on.

“There’s pretty widespread agreement that something needs to be done around social media,” Nesi said. “These are the types of standards that we need to be thinking about in order to actually make change.”

Nesi said that the report “may slightly overstate” some of the evidence against social media, and may be suggesting that social media use causes adverse effects such as poor mental health, when the findings only document a correlation.

“We can’t say social media is predicting a negative mental health outcome from those studies,” Nesi said. “The vast majority of the studies that are out there are really correlational.”

Part of the reason researchers can’t establish causality at times is because it’s hard to access the relevant data on these platforms, Nesi said.

“The only way to know more of its effects is to get that data and to be able to study it,” Nesi said. “Right now, we as researchers rely on a lot of self-report measures.”

The advisory attempts to address this issue with a section dedicated to critical questions that remain unanswered and separate requests for technology companies to provide access to researchers.

“I want to see our technology companies step up and do more to protect our kids,” Murthy told The Washington Post in an interview. “Share their data transparently and openly.”

Advice for parents

“Parents are really struggling,” Murthy said. “This is an impossible task that we’ve put on the shoulders of parents.”

Murthy and other experts offered this advice to parents and teens on moderating screen time and social media use.

- Consider establishing “tech-free” zones. Draw boundaries around where or when the family can use smartphones to protect sleep, face-to-face interactions and physical activity. “It’s an invitation for us to think about moments when tech is going to be part of the equation and moments when we want to remove tech from the equation,” said Emily Weinstein, a researcher and principal investigator at the Harvard Graduate School of Education and the co-author of “Behind Their Screens.” “When our phones are within reach, it’s very hard not to look at the screen or check the notification.”

- Model the behavior you want to see. “Kids and teens are very sensitive to hypocrisy,” Weinstein said. Parents need to have the relationship with their smartphone that they want their kids to have, she said.

- Delay the age your children first get on these platforms. “That’s easy to say,” Murthy said. “It’s hard to do.” This rule may be easier to institute with like-minded parents who are doing the same for their children, he said.

- Ask them to turn off the smartphone before bed. Smartphones and tablets are keeping children awake at night, cutting into vital time for shut-eye, experts say. “Too many young people are robbed of their sleep,” Murthy said. “One in 3 adolescents are up past midnight on weekdays in front of screens.”

Finding solutions through regulations and research to address the affect social media use is having on children “is really, really important,” Murthy said. “I’m just worried that we’ll look back on this time a year, five, 10 years from now and realize that this technology profoundly affected the mental health and well-being of young people.”