Surgeon general’s social media warning resonates with mental health leaders

Clinicians say there are a host of factors contributing to a mental health crisis among America’s children and teens, and yes, they go beyond the dangers of social media.

Still, Surgeon General Vivek Murthy has called for warning labels on social media platforms to alert parents to the risks of harm to young people, and his plea has galvanized discussions nationwide. He had earlier issued an advisory about the impact of social media on mental health.

“The mental health crisis among young people is an emergency — and social media has emerged as an important contributor,” Murthy wrote in an op-ed for The New York Times last week to make the case for warning labels.

Some researchers say there’s more work that needs to be done to understand how much social media use is affecting the mental health of teens.

But with social media exposing kids to bullying, bigotry, body shaming and other ills, it’s not hard to see why some clinicians are applauding the surgeon general’s pitch for warning labels.

Dr. Willough Jenkins, MD, a psychiatrist with Rady Children’s Hospital in San Diego, praises Murthy for bringing more attention to the dangers of social media for kids.

“As a child psychiatrist, I'm working with children who are coming to me already in situations where they're struggling with mental illness,” Jenkins tells Chief Healthcare Executive®. “And so for that specific population of children, I certainly see a lot of negative effects from social media. They have a great deal of difficulty regulating the amount of time that they're spending on social media.”

(See part of our conversation with Dr. Jenkins in this video. The story continues below.)

Dr. Dustin Nowaskie, MD, president and chief medical officer of OutCare Health, a nonprofit organization working for health equity for LGBTQ+ patients, welcomed the surgeon general’s push for warning labels. A queer, nonbinary psychiatrist, Nowaskie notes that LGBTQ+ individuals “engage with social media platforms at higher rates compared to their cisgender heterosexual counterparts.”

Social media platforms can help LGBTQ+ teens find individuals like themselves and build connections, but Nowaskie says social media can expose young people to abuse.

“It also is a double-edged sword, where it also invites a lot of opportunity for the discrimination and the stigma that we see socially, politically and in healthcare,” Nowaskie tells Chief Healthcare Executive®. “And so I do think, yes, there should be warnings, there should be safeguards in place, especially for youth, adolescents and young adults that are exploring something that is quite complex for human existence.”

Mitch Prinstein, PhD, chief science officer of the American Psychological Association, applauded Murthy’s effort to raise awareness of the risks of social media for young people. Last year, the association issued its first set of recommendations for parents regarding the use of social media by adolescents, urging parents to monitor how kids use social media and limiting exposure to harmful content.

“Research has shown that young people are especially vulnerable to specific content and functions on social platforms that interact with neural and psychological vulnerabilities in adolescence,” Prinstein said in a statement. “We concur with the surgeon general's reliance on psychological science to offer warnings to protect kids from harm on these platforms.”

A need for more research

Many healthcare leaders see a mental health crisis in America’s adolescents.

Hospitals have seen more kids coming into hospitals and emergencies with mental health emergencies. Researchers say more girls, in particular, are continuing to visit emergency departments for mental health emergencies. In addition, most children’s hospitals say they are seeing more patients in need of mental health services.

Jenkins says that social media isn’t the only factor contributing to the mental health challenges of kids, but she says it shouldn’t be dismissed.

“I think that social media is absolutely a part of the children's mental health crisis,” Jenkins says. “But I don't think at this point, we'd be able to say that it is the whole reason.

“There are so many things that are happening in our society at this time that are impacting our youth: pressures at school, climate change, political issues, changes to families and family structure … we just went through a pandemic,” she adds. “So it's a multifactorial issue. But I do agree with taking more scrutiny to social media and seeing what role this plays.”

When it comes to the question of how much of a role social media is contributing to the mental health of kids, Jenkins says, “there is a lot of research that's absolutely still needed.”

Some researchers say the surgeon general’s call for warnings on social media may be a step too far.

Nicholas B. Allen, the director of the Center for Digital Mental Health at the University of Oregon, told The New York Times that such warnings are typically reserved for cigarettes and other items where there is no safe level of usage.

“This is not an accurate description of social media. The scientific evidence simply does not support a view that social media is dangerous per se,” Allen told The Times.

Several hours a day

Some parents may be astonished at how much time their kids are spending on social media. Teens and kids who spend more than three hours a day on social media face twice the risk of anxiety or symptoms of depression, Murthy noted in his op-ed for The New York Times, citing a 2019 study by JAMA Psychiatry.

When asked if kids routinely spend several hours a day on social media platforms, Jenkins says, “It's not only common, it is the norm. The average is five hours a day on social media. And that's not including online time, when you think about watching a Netflix movie, playing some video games and all the other things that we know that children do. It is just an extraordinary amount of time.”

Children who are already struggling with mental health issues are especially vulnerable, Jenkins says. She says her practice screens kids and asks how long they spend on social media on a daily basis.

“Some children with conditions like ADHD really struggle with self control,” Jenkins says. “And so they really have a hard time with the algorithm and the urge to scroll. And they can get into more difficulty also with engaging with content that might not be productive as well.”

She also sees patients with eating disorders who struggle with the content they see on social media.

“For my patients who have eating disorders, of course, we know very well based on research that some of the content that they consume related to body image … is absolutely detrimental. So it is a big topic of conversation,” Jenkins says.

Most American teens (77%) say they visit YouTube every day, and at least half of all teens report daily use of TikTok (58%), Snapchat (51%), and Instagram (50%), according to a 2023 Pew Research Center survey.

Legislative efforts

The American Psychological Association and other healthcare advocates also joined the surgeon general in urging lawmakers and policymakers to take additional steps to protect kids on social media. Prinstein noted that families need help “with products that are designed to keep their kids engaged for as long as possible with few safeguards for their developmental vulnerabilities.”

A bipartisan group of lawmakers have pushed legislation, the Kids Online Safety Act, which calls for steps to make social media platforms safer for kids. The bill does not include warning labels, but it would require social media platforms to deploy tougher privacy settings for kids by default and reduce exposure to harmful content.

U.S. Sens. Richard Blumenthal, D-Conn., and Marsha Blackburn, R-Tenn., the leading sponsors of the legislation, welcomed the surgeon general’s call for warning labels, and hoped it would buoy their bill.

“We are pleased that the Surgeon General - America’s top doctor - continues to bring attention to the harmful impact that social media has on our children,” the senators said in a joint statement. “The time to hold a vote and pass the filibuster proof bipartisan Kids Online Safety Act is now.”

New York Gov. Kathy Hochul signed legislation last week that would put new limits on social media feeds for users under 18 years of age, and would block platforms from sending notifications on posts to kids between midnight and 6 a.m. Under the new law, state officials still must develop rules to verify parental consent and the age of users, and then social media companies will have 180 days to comply.

“By reining in addictive feeds and shielding kids’ personal data, we’ll provide a safer digital environment, give parents more peace of mind, and create a brighter future for young people across New York,” Hochul said last week.