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Office of the Surgeon General (OSG). Social Media and Youth Mental Health: The U.S. Surgeon General’s Advisory [Internet]. Washington (DC): US Department of Health and Human Services; 2023.
Social Media and Youth Mental Health: The U.S. Surgeon General’s Advisory [Internet].
Show detailsOur children and adolescents don’t have the luxury of waiting years until we know the full extent of social media’s impact. Their childhoods and development are happening now. While social media use can have positive impacts for some children, the evidence noted throughout this Surgeon General’s Advisory necessitates significant concern with the way it is currently designed, deployed, and utilized. Child and adolescent use of platforms designed for adults places them at high risk of “unsupervised, developmentally inappropriate, and potentially harmful” use according to the National Scientific Council on Adolescence.87 At a moment when we are experiencing a national youth mental health crisis, now is the time to act swiftly and decisively to protect children and adolescents from risk of harm.
To date, the burden of protecting youth has fallen predominantly on children, adolescents, and their families. Parents face significant challenges in managing children and adolescents’ use of social media applications, and youth are using social media at increasingly earlier ages.4, 88 Nearly 70% of parents say parenting is now more difficult than it was 20 years ago, with technology and social media as the top two cited reasons.89 While nearly all parents believe they have a responsibility to protect their children from inappropriate content online,89 the entire burden of mitigating the risk of harm of social media cannot be placed on the shoulders of children and parents. Nearly 80% of parents believe technology companies have a responsibility to protect children from inappropriate content as well.89
We must provide children and their families with the information and tools to navigate the changing digital environment, but this burden to support our children must be further shared. There are actions technology companies can take to make their platforms safer for children and adolescents. There are actions researchers can take to develop the necessary research base to support further safeguards. And there is a role for local, state, and federal policy to implement protections for our children and adolescents.
The U.S. has a strong history of taking action in such circumstances. In the case of toys, transportation, and medications—among other sectors that have widespread adoption and impact on children—the U.S. has often adopted a safety-first approach to mitigate the risk of harm to consumers. According to this principle, a basic threshold for safety must be met, and until safety is demonstrated with rigorous evidence and independent evaluation, protections are put in place to minimize the risk of harm from products, services, or goods. For example, the Consumer Product Safety Commission requires toy manufacturers to undergo third-party testing and be certified through a Children’s Product Certificate as compliant with the federal toy safety standard for toys intended for use by children.90 To reduce the risk of injury from motor vehicle accidents, the National Highway Traffic Safety Administration requires manufacturers to fit new motor vehicles with standard airbags and seat belts, among other safety features, and conduct crash tests to be compliant with the Federal Motor Vehicle Safety Standards.91 Medications must demonstrate safety to the Food and Drug Administration before being made available and marketed for use.92 Given the mounting evidence for the risk of harm to some children and adolescents from social media use, a safety-first approach should be applied in the context of social media products.
To better safeguard the mental health and well-being of children and adolescents, policymakers, technology companies, researchers, families, and young people must all engage in a proactive and multifaceted approach. Through the recommendations below, we can provide more resources and tools to children and families, we can gain a better understanding of the full impact of social media, and we can maximize the benefits and minimize the harms of social media platforms to create safer, healthier online environments for children.
We can maximize the benefits and minimize the harms of social media platforms to create safer, healthier online environments for children.
What Policymakers Can Do
Policymakers play an important role in addressing the complex and multifaceted issues related to social media use and in protecting youth from harm.
- Strengthen protections to ensure greater safety for children interacting with all social media platforms, in collaboration with governments, academic organizations, public health experts, and technology companies.
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Develop age-appropriate health and safety standards for technology platforms. Such standards may include designing technology that is appropriate and safe for a child’s developmental stage; protecting children and adolescents from accessing harmful content (e.g., content that encourages eating disorders, violence, substance abuse, sexual exploitation, and suicide or discusses suicide means); limiting the use of features that attempt to maximize time, attention, and engagement; developing tools that protect activities that are essential for healthy development like sleep; and regularly assessing and mitigating risks to children and adolescents.
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Require a higher standard of data privacy for children to protect them from potential harms like exploitation and abuse. Six-in-ten adolescents say they think they have little or no control over the personal information that social media companies collect about them.32
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Pursue policies that further limit access—in ways that minimize the risk of harm—to social media for all children, including strengthening and enforcing age minimums.
- Ensure technology companies share data relevant to the health impact of their platforms with independent researchers and the public in a manner that is timely, sufficiently detailed, and protects privacy.
- Support the development, implementation, and evaluation of digital and media literacy curricula in schools and within academic standards. Digital and media literacy provides children and educators with digital skills to strengthen digital resilience, or the ability to recognize, manage, and recover from online risks (e.g., cyberbullying and other forms of online harassment and abuse, as well as excessive social media use).
- Support increased funding for future research on both the benefits and harms of social media use and other technology and digital media use for children, adolescents, and families.
- Engage with international partners working to protect children and adolescents against online harm to their health and safety.
What Technology Companies Can Do
Technology companies play a central role and have a fundamental responsibility in designing safe online environments and in preventing, minimizing, and addressing the risks associated with social media.
- Conduct and facilitate transparent and independent assessments of the impact of social media products and services on children and adolescents. Assume responsibility for the impact of products on different subgroups and ages of children and adolescents, regardless of the intent behind them.
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Be transparent and share assessment findings and underlying data with independent researchers and the public in a privacy protecting manner.
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Assess the potential risks of online interactions and take active steps to prevent potential misuse, reducing exposure to harms. When proactive responses fail, take immediate action to mitigate unintended negative effects.
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Establish scientific advisory committees to inform approaches and policies aimed at creating safe online environments for children. Scientific advisory committees should be comprised of independent experts and members of user subgroups, including youth.
- Prioritize user health and safety in the design and development of social media products and services.93, 94, 95, 96 Prioritize and leverage expertise in developmental psychology and user mental health and well-being in product teams to minimize risks of harm to children and adolescents.
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Ensure default settings for children are set to highest safety and privacy standards. Provide easy-to-read and highly visible information about policies regarding use by children.
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Adhere to and enforce age minimums in ways that respect the privacy of youth users.
- Design, develop, and evaluate platforms, products, and tools that foster safe and healthy online environments for youth, keeping in mind the needs of girls, racial, ethnic, and sexual and gender minorities. The platform design and algorithms should prioritize health and safety as the first principle, seek to maximize the potential benefits, and avoid design features that attempt to maximize time, attention, and engagement.
- Share data relevant to the health impact of platforms and strategies employed to ensure safety and well-being with independent researchers and the public in a manner that is timely and protects privacy.
- Create effective and timely systems and processes to adjudicate requests and complaints from young people, families, educators, and others to address online abuse, harmful content and interactions, and other threats to children’s health and safety. Social media platforms should take these complaints seriously, thoroughly investigate and consider them, and respond in a timely and transparent manner.
What Parents and Caregivers Can Do
The onus of mitigating the potential harms of social media should not be placed solely on the shoulders of parents and caregivers, but there are steps they can take to help protect and support children and adolescents against the risk of harm.
- Create a family media plan.97 Agreed-upon expectations can help establish healthy technology boundaries at home – including social media use. A family media plan can promote open family discussion and rules about media use and include topics such as balancing screen/online time, content boundaries, and not disclosing personal information. For information on creating a family media plan, visit www.healthychildren.org/MediaUsePlan.
- Create tech-free zones and encourage children to foster in-person friendships.98 Since electronics can be a potential distraction after bedtime and can interfere with sleep, consider restricting the use of phones, tablets, and computers for at least 1 hour before bedtime and through the night. Consider keeping family mealtimes and in-person gatherings device-free to build social bonds and engage in a two-way conversation. Help your child develop social skills and nurture his or her in-person relationships by encouraging unstructured and offline connections with others and making unplugged interactions a daily priority. See the American Academy of Pediatrics (AAP) guidelines for media use.
- Model responsible social media behavior. As children often learn behaviors and habits from what they see around them, try to model the behavior you want to see.97, 99 Parents can set a good example of what responsible and healthy social media use looks like by limiting their own use, being mindful of social media habits (including when and how parents share information or content about their child), and modeling positive behavior on your social media accounts.
- Teach kids about technology and empower them to be responsible online participants at the appropriate age.100 Discuss with children the benefits and risks of social media as well as the importance of respecting privacy and protecting personal information in age-appropriate ways. Have conversations with children about who they are connecting with, their privacy settings, their online experiences, and how they are spending their time online. Empower and encourage them to seek help should they need it. Learn more about the benefits and risks of social media use and get guidance from experts at AAP’s Center of Excellence on Social Media and Youth Mental Health and from the American Psychological Association‘s Health Advisory on Social Media Use in Adolescence.
- Report cyberbullying and online abuse and exploitation. Talk to your child about their reporting options, and provide support, without judgment, if he or she tells or shows you that they (a) are being harassed through email, text message, online games, or social media or (b) have been contacted by an adult seeking private images or asking them to perform intimate or sexual acts. You or your child can report cyberbullying to the school and/or the online platform, or your local law enforcement.101 Visit CyberTipline, Take it Down, or contact your local law enforcement to report any instances of online exploitation.
- Work with other parents to help establish shared norms and practices and to support programs and policies around healthy social media use. Such norms and practices among parents facilitate collective action and can make it easier to set and implement boundaries on social media use for children.
What Children and Adolescents Can Do
The burden of mitigating the potential harms of social media does not rest solely on the shoulders of children and adolescents, but there are measures they can take to navigate social media in a safe and healthy way.
- Reach out for help. If you or someone you know is being negatively affected by social media, reach out to a trusted friend or adult for help. For information from experts, visit AAP’s Center of Excellence on Social Media and Youth Mental Health. If you or someone you know is experiencing a mental health crisis, contact the 988 Suicide and Crisis Lifeline by calling or texting 988 for immediate help.
- Create boundaries to help balance online and offline activities. Limit the use of phones, tablets, and computers for at least 1 hour before bedtime and through the night to enable sufficient and quality sleep. Keep mealtimes and in-person gatherings device-free to help build social bonds and engage in two-way conversations with others. Nurture your in-person relationships by connecting with others and making unplugged interactions a daily priority.
- Develop protective strategies and healthy practices such as tracking the amount of time you spend online, blocking unwanted contacts and content, learning about and using available privacy and safety settings, learning and utilizing digital media literacy skills to help tell the difference between fact and opinion, and ensuring you are connecting with peers in-person. See this Tip Sheet on Social Media Use and Mental Health for healthy social media use created for and by young people.
- Be cautious about what you share. Personal information about you has value. Be selective with what you post and share online and with whom, as it is often public and can be stored permanently. If you aren’t sure if you should post something, it’s usually best if you don’t. Talk to a family member or trusted adult to see if you should.
- Protect yourself and others. Harassment that happens in email, text messaging, direct messaging, online games, or on social media is harmful and can be cyberbullying. It might involve trolling, rumors, or photos passed around for others to see – and it can leave people feeling angry, sad, ashamed, or hurt. If you or someone you know is the victim of cyberbullying or other forms of online harassment and abuse:
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Don’t keep online harassment or abuse a secret. Reach out to at least one person you trust, such as a close friend, family member, counselor, or teacher, who can give you the help and support you deserve. Visit stopbullying
.gov for helpful tips on how to report cyberbullying. If you have experienced online harassment and abuse by a dating partner, contact an expert at Love is Respect for support or if your private images have been taken and shared online without your permission, visit Take it Down to help get them removed. - »
Don’t take part in online harassment or abuse. Avoid forwarding or sharing messages or images and tell others to stop. Another way is to report offensive content to the site or network where you saw it.
What Researchers Can Do
Researchers play a critical role in helping to gain a better understanding of the full impact of social media on mental health and well-being and informing policy, best practices, and effective interventions.
- Establish the impact of social media on youth mental health as a research priority and develop a shared research agenda.102 Research should include but not be limited to:
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Rigorous evaluation of social media’s impact on youth mental health and well-being, including longitudinal and experimental studies. This could also include research on specific outcomes and clinical diagnoses (e.g., sleep duration and quality, attention, depression, anxiety, and body image), among specific populations (e.g., racial, ethnic, and sexual and gender minorities), and based on specific aspects of social media (e.g., designs, features, and algorithms).
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Role of age, developmental stage, cohort processes, and the in-person environment in influencing the onset and progression of poor mental health outcomes among social media users.
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Benefits and risks associated with specific social media designs, features, and content.
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Long-term effects on adults of social media use during childhood and adolescence.
- Develop and establish standardized definitions and measures for social media and mental health outcomes that are regularly evaluated and can be applied across basic research, population surveillance, intervention evaluation, and other contexts.
- Enhance research coordination and collaboration. Example opportunities include developing an accessible evidence database and forming a consortium of researchers focused on examining the positive and negative effects of social media on mental health and well-being. Researchers should work with community partners to make research findings publicly accessible and digestible.
- We Must Take Action: A Way Forward - Social Media and Youth Mental HealthWe Must Take Action: A Way Forward - Social Media and Youth Mental Health
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