1. Mental Health Champions Network Meetings June 19th 2018 June 21st 2018
Social Media and Children and Young People’s Mental Health Going beyond “screen time” panics to evaluate the evidence on children and young people’s online opportunities and risks
Set context of input:
The above image went viral of apparently bored school kids in front of Rembrandt’s most famous painting (‘The night watch’) and has been described as a ‘metaphor for our age’.
…it reportedly turned out that the children were actually attentive to the art works, using their phones to carry-out research (including using the museum’s smartphone app) as part of a project in conjunction with the museum tour.
Equally, what are our thoughts when we see a group of children sharing, and interacting, in a screen together vs. sharing in a book together???
…children and young people are growing up in a very different, and digital, world today to the world that we grew up in.
It’s important that we try to detach ourselves from “screen time” panics and our own nostalgia in order to develop our understanding of the evolving digital world that children & YP are growing up in.
Whilst it’s not to say that there aren’t associated risks, today is about evaluating the evidence on both the risks and benefits of social media to children and YP and exploring how we can support them in the digital world.
Mental Health Champions Network Meetings
June 19th 2018
June 21st 2018

2. Social media
“forms of electronic communication (such as websites for social networking and microblogging) through which users create online communities to share information, ideas, personal messages, and other content (such as videos)”
Facebook, twitter, instagram, WhatsApp, Facebook Messenger and Snapchat
As technology has developed, the lines have blurred between different types of digital media. The division between ‘internet use’ and ‘social media use’ is not always distinctive (e.g. services such as YouTube are merging TV content with interactive elements. Similarly many video gaming sites are now based on the internet and involve social networking, such as options to make new friendships and have conversations whilst gaming).
As such much of the research explores overall time spent online and studies on video gaming as these are also considered relevant to an exploration of social media.

3. What do we know?
We need to be rigorous in our exploration of the research:
Deterministic
Studies are small scale
Little longitudinal evidence
Context specific
Out of date quickly (given the ever-changing digital world and popularity of platforms)
Self-report methods are commonly used
Often contradictory
Going to be looking at lots of research today exploring the usage, risks and benefits of social media but before we do so it’s important to bear in mind that we need to be rigorous in doing so (for the above reasons)

4. The digital lives of children and young people
More younger children are going online (53% of 3-4 year olds, 79% of 5-7 year olds, 94% of 8-11 year olds and 99% of year olds) (Ofcom, 2017). The UK has the fifth highest percentage of those going online aged six or younger of all OECD* countries (OECD, 2016)
¼ of 8-11 year olds and ¾ of year olds have a profile on a social media or messaging site (Ofcom, 2017)
32% of year olds say snapchat is their main profile (Ofcom, 2017)
Over a third (37.3%) of 15 year olds in the UK are ‘extreme internet users’**. This is substantially higher than the EU average. (The only OCD country with higher levels of extreme internet use than the UK was Chile.)
Even on weekdays, nearly a quarter of YP in the UK (24.1%) spent over 6 hours online outside of school.
94.8% of 15 year olds in the UK use social media before or after school (slightly higher than the OECD average of 92.8%) (PISA, 2015).
Online activity is increasingly private, with children and YP using the internet in their bedrooms or on a smart phone.
The changing pace of technology, such as the recent development of livestreaming, means that the way young people interact with social media is continuing to change.
*Organisation for Economic Co-operation and Development
**student who uses the internet for more than six hours outside of school on a typical weekend day
Increase in private use is likely to hinder attempts to prevent children and YP from encountering online risks such as by restricting their access to inappropriate websites and supervising their online activities. Similarly, the growth in instant messaging means that parents or teachers are often not aware of activity online, such as a conversation in a whatsapp group as opposed to on a facebook profile.
Livestreaming has implications for YP’s wellbeing, such as the potential for their actions to be recorded and posted online without their consent.

5. Positive impacts of social media
Connecting with friends and family, especially over long distances, such as by sharing pictures and videos, and therefore addressing social isolation and loneliness;
Children and YP tend to view social media as a positive influence in their lives, in particular valuing the social benefits it can provide; 90.5% of 15 year old boys and 92.3% of 15 year old girls in the UK agreed or strongly agreed with the statement “It is very useful to have social networks on the internet”. (PISA, 2015)
Online socialising reinforces and broadens real-life relationships (Reich et al. 2012)
Making new friends, particularly with people with shared interests;
Use of social media has been associated with improved social skills amongst teenagers (such as helping shy YP become more socially active) (Rosen, 2011)
Community involvement, such as charitable or political activism;
Sharing new creative projects such as online videos, blogs and podcasts (Lilley et al. 2014);
Developing an individual identity during adolescence (Lilley et al. 2014);
Whilst much media attention has focused on the risk of harmed caused by social media, studies have also shown a positive impact. These include (see above)

6. Positive impacts of social media
Collaborating on projects through online communities (e.g. a homework whatsapp group)
Accessing health information online and finding supportive networks of people with similar conditions.
78% of young people contacting Childline now do so online (via or online chat)
59% of counselling from the service takes place online. (Childline, 2013)
Evidence indicates that online suicide prevention may be effective and that social media provides an opportunity to identify and support those at risk (Christensen et al. 2014)
The internet, and social media, can also be a valuable source of information and support for YP with mental health problems.
*there are also risks associated with the internet as a support for children and YP at risk of suicide (discussed further later in regard to self harm)

7. Online risks and the potential for harm to mental health and wellbeing
Excessive time spent online
The estimated weekly volume of time spent online at home or elsewhere increases with the age of the child:
7 hours 54 minutes for 3-4 year olds;
9 hours 6 minutes for 5-7 year olds;
13 hours 24 minutes for 8-11 year olds;
20 hours 48 minutes for year olds.
These estimates of time spent online at home or elsewhere are unchanged since 2016 for 3-4s, 5-7s, 8-11s and 12-15s, although they have increased markedly over the last decade. (Ofcom, 2017)
Excessive use also increases with age:
23% of year olds report excessive use, raising to 36% of year olds and 59% of year olds. (Ofcom, 2016)

8. Online risks and the potential for harm to mental health and wellbeing
The impact of excessive time spent online
The Office for National Statistics found that there is a “clear association” between time spent on social media and mental health problems (ONS, 2015):
12% of children who spend no time on social networking sites have symptoms of mental ill health
10% of children who spend up to 3 hours a day have symptoms of mental ill health
27% for those who are on the sites for 3 hour or more a day have symptoms of mental ill health.

9. Online risks and the potential for harm to mental health and wellbeing
The impact of excessive time spent online
Research has linked excessive internet use and/or social media use with:
Depression (ONS, 2015)
Poor sleep quality (Punamaki et al. 2007)
Other social and emotional problems , e.g. anxieties and the need for ‘likes’; 25% of year olds said that they feel nervous and/or anxious when they are offline (a phenomenon sometimes described as FOMO or ‘fear of missing out’) (Ofcom, 2016)
Sense of belonging and loneliness at school (PISA, 2015)
Bullying (PISA, 2015)
Life satisfaction (PISA, 2015)
The evidence suggests a “dose-response” relationship, where each hour of use increases the likelihood of negative effects.

10. Online risks and the potential for harm to mental health and wellbeing
The impact of excessive time spent online
In examining the impact of excessive time spent online we need to bear in mind that these are indicators of association and do not necessarily prove causation…
Could it be that someone already experiencing a mental health problem is more likely to use social media?
Are children and YP using the internet as a coping mechanism when they experience difficulties ‘offline’ at school?
Could it be the case that excessive internet use is preventing these YP from developing stronger social relationships offline?

11. Online risks and the potential for harm to mental health and wellbeing
Sharing too much?
‘online disinhibition effect’: more likely to share personal information or display more intense behaviour than they would do offline, including anti-social behaviour such as rude language and harsh criticisms.
45% of 12-15s who go online say that in the past 12 months they have seen ‘something hateful on the internet directed at a particular group of people, based on, for instance, their gender, religion, disability, sexuality or gender identity’ (Ofcom, 2017)
Seventeen per cent of 8-11s and 29% of 12-15s who go online say they have ever seen something online that they found worrying or nasty (Ofcom, 2017)
Increasing use of smartphones has increased the opportunity for YP to access social media at times when they are vulnerable (e.g. when drinking or in an emotional state).
Regulatory frameworks on issues such as data protection and privacy have not kept pace with technological change, and this can hinder YP’s ability to control their online presence.
Increase opportunity to access SM when vulnerable has in turn increased the opportunities for YP to share personal info, photos and video content on social networks, or to livestream their activities. This has increased the risks of YP ‘sharing too much’.
Whilst the issue of image sharing is not widespread, having had a personal image of this sort shared without their consent can have damaging consequences for a YP’s wellbeing.

12. Online risks and the potential for harm to mental health and wellbeing
Sharing too much?
Concerns have been raised about the sending of nude images or inappropriate information online, although the evidence suggests that this is not a widespread problem:
2.9% of children aged years had taken a fully naked picture of themselves, 55% of whom had shared the image (Martellozzo et al. 2016)
2% of year olds reported ‘feeling under pressure to send photos or other information about themselves to someone’ (Ofcom, 2017)
5% of year olds reported having ‘sent a photo or video of yourself to a friend that you now regret sending’ (Ofcom, 2017)
5% of year olds reported having ‘sent a photo or video of yourself to a person that you’ve only had contact with online’ (Ofcom,2017)
4% of year olds reported having ‘sent personal information such as your full name, address or phone number to a person you’ve only had contact with online’ (Ofcom, 2017)

13. Online risks and the potential for harm to mental health and wellbeing
Cyberbullying
Sending or posting abusive or threatening messages
Creating and sharing embarrassing photos or videos
Sharing secrets about someone online without their consent
Intentionally leaving someone out of an online activity or friendship group
Voting on someone in an abusive poll
Creating a website with mocking or critical content about someone
Hijacking online identities or creating a fake profile to damage another’s reputation
Sending explicit messages or encouraging a YP to send a text, then sharing that more widely
Cyberstalking: continuously harassing and denigration including threats of physical harm.

14. Online risks and the potential for harm to mental health and wellbeing
Cyberbullying continued…
In contrast to offline bullying, with cyberbullying:
It is not limited by school timetables or physical presence within the school building. There may not, therefore, be respite from bullying at school at evenings and weekends.
A single incident can be shared and forwarded multiple times.
The use of technology provides anonymity and allows for more frequent sexual or violent content and greater cruelty compared with face-to-face bullying.

15. Online risks and the potential for harm to mental health and wellbeing
Cyberbullying continued…
A fifth of 12-15s say they have ever been bullied; this is equally likely to have been face to face or on social media (both 12%), followed by bullying via messaging apps or text (5%). A smaller proportion of 8-11s (12%) say they have been bullied, with this more likely to have been face to face than on social media. (Ofcom, 2017)
Studies indicate that there is a link between offline and cyber-bullying, with children and YP using both internet and face-to-face communication to bully others.
This indicates that, while cyberbullying may be different in some respects to offline bullying, it is part of the same problem and cannot be addressed in isolation.
Studies suggest the majority of online bullying victims know the person bullying them. This implies that while the method of bullying may have changed, the relationship between the perpetrator and victim has not
Research has suggested that cyberbullying, like offline bullying, has a negative impact on children and YP’s wellbeing such as reduced confidence or self-esteem (Spears et al. 2015; Douglas et al. 2012)

16. Online risks and the potential for harm to mental health and wellbeing
Body image and social status
With the advent of smartphone cameras, and the development of online filters and image-manipulation techniques, there has been a rise in the popularity of ‘selfies’.
This has led to concerns about the abundance of idealised images of beauty on social networks and the impact this has on children and YP’s view of their own appearance.
The rise in social media means that children and YP are now not only exposed to photoshopped images of models and celebrities but also manipulated images posted by their own personal contacts.
The hypothesis is that this more personal comparison has a stronger effect on a YP’s self-esteem. There is some evidence of this negative impact:
Time spend by teenage girls on social media linked with body image concerns, particularly “higher levels of internalisation of the thin ideal, body surveillance and dieting, and lower body esteem” (Tiggerman&Slater, 2015)
There is also an increasing emphasis on social status:
Over one in ten 12-15s with a social media profile (13%) agree that getting likes or followers is more important to them than keeping their posts, comments or photos private. The same proportion feel there is pressure to look popular on social media ‘all the time’. (Ofcom, 2017)
*association does not prove causation

17. Online risks and the potential for harm to mental health and wellbeing
Harmful information and advice online
Children and YP can access harmful information on the internet or make online connections with people who encourage unhealthy behaviours, such as anorexia or self-harm:
1 in year olds say they have seen something of a sexual nature online or on their mobile phone that made them feel uncomfortable (Ofcom, 2017). Younger children were more likely to feel upset by viewing sexual content (Hasebrink et al. 2011)
25% of year olds say they have ever been contacted online by someone they don’t know (Ofcom, 2017)
13% of year olds and 16% of year olds have seen websites that promote eating disorders (Mascheroni&Olafsson, 2014)
Only 15% of UK 9-16 year olds who use the internet have been bothered by something they experienced online (Livingstone et al. 2014). (It should be noted that cyberbullying is an exception with 85% of those who had been a victim reporting that they had been upset by it; Hasebrink et al. 2011)
A systematic review of research on the internet and self-harm found that YP most often use the internet to find help, but there is the risk that the internet can normalise self-harm and discourage YP from talking about their problems and seeking professional help (Daine et al. 2013)

18. What does the research tell us?
There are undoubtedly risks to using social media, but also opportunities and benefits.
Are the risks as extreme as portrayed in the media or in our own fears though?? Research suggests that most children and young people are actually alright!!
For victimised/ vulnerable children and YP the internet/social media tends to make things worse…these children and YP are typically victimised/vulnerable both off and online though.
Increased use of social media appears to be related to increased risks (e.g. cyberbullying, social isolation and mental health problems). Association does not necessarily prove causation though:
Are children already experiencing a mental health problem or offline bullying more likely to use social media?
Are ‘extreme users’ using the internet/social media as a coping mechanism when they experience difficulties ‘offline’ at school?
Is excessive internet/social media use preventing these children and YP from developing stronger social relationships offline?

19. What does the research tell us?
Despite children and YP’s increasing use of social media the research suggests that the associated risks are not increasing
See Ofcom research: reports from 8-15 year olds as to ‘in the last year, have you seen anything online that you found worrying or nasty?’ have remained relatively stable in annual surveys between 2011 and 2016; reports from Childline of cyber bullying, sexting and CSE online have only seen slight changes between 2012 and 2017)
Does this suggest that the risks are constant/stable (and perhaps for particular groups, i.e. the vulnerable)?
Or that children and YP are become more desensitised over time to harmful content etc. on social media?
Or that children and YP are become more cautious over time in their use of the internet/social media?

20. Responses to online risk
Children and YP already use a range of coping mechanisms to deal with online risk (Ofcom, 2017):
Nearly all internet users aged 8-15 recall being told about how to use the internet safely, with this advice most likely to have come from a parent or teacher.
A majority also know how to take technical measures to keep themselves safe: almost seven in ten 12-15s who go online say they know how to block messages on social media from someone they don’t want to hear from, and around half have done this; almost half say they know how to change the settings so fewer people can view their social media profile, with a third having done this.
Whilst there is a necessity for advice, rules and regulations regarding safe internet/social media use, the speed of technological development indicates that a strategy based on eliminating all online risk is likely to be unsuccessful:
Restricting a child/YP’s has been shown to reduce the chances of them experiencing online risks, but not to reduce harm caused to those who do go on to experience risks .
Restricting children/YP’s access to the internet could inhibit the development of the skills needed to handle online risk
Friends Like Me (media project that features kids and teens who openly share their private thoughts and personal experiences of online screen life): see vimeos

21. Responses to online risk
Children and YP are living in an ever-changing digital world and we need to try and understand it as it’s a permanent part of modern childhood:
We need to listen to children and YP to find out about their lived experiences, and enquire about possible risks (both off and online) in a non-judgemental way
We need to connect with them through their medium
Our focus should be on how to develop digital resilience in children and YP to potential risks associated with social media use.
We should also focus on developing digital wisdom, i.e. doing the right thing, at the right time, in the right amount (when nobody is watching)
Given the inefficacy of attempts to protect children and YP for all online risk, the focus should be on how to develop digital resilience and wisdom in YP to potential risks associated with social media use

22. Responses to online risk – Digital Resilience and Wisdom
Growing up digital: made a number of recommendations aimed at improving children’s experience of the digital world and which focused on ‘digital resilience’ rather than ‘online safety’
The DCMS ‘Internet Safety Strategy’ Green Paper, published last year, made a commitment to improving children’s digital education, including consulting on a school curricula that would meet some of the challenges the internet and social media brings.
The DfE relationships and sex education consultation makes clear that any resulting guidance to schools will incorporate the digital elements of children’s friendships and relationships, including their interactions on social media
…in line with these recent publications and consultations the Government is reportedly looking at developing online content and materials on digital citizenship and resources to support children’s digital resilience. 
The ‘Digital 5 a Day’ guide sets out five ways in which parents and their children can make sure time spent online is productive (it is referenced as good practice in the DCMS Green Paper and the Government’s recent Green Paper on Mental Health)
The BBC launched ‘Own It’ in December 2017 , a new website full of fun and empowering tips, insight, stories and advice to help 9-12 year olds get the most out of their time online and which aims to help children develop the confidence and resilience to tackle the everyday challenges they face online