Written evidence submitted by the Royal Society for Public Health (SMH0127)
- Our response to this inquiry is largely based on the findings from our #StatusofMind report, published in June 2017, which examined the positive and negative effects of social media on the mental health and wellbeing of young people aged 16-24, who have the highest incidence of social media use. This report was based on a UK-wide survey which asked respondents about five of the most popular social media platforms: Facebook, Instagram, Snapchat, Twitter and YouTube.
- Social media can have a number of positive effects. These include: providing access to other people’s health experiences and expert health information; emotional support and community building; a platform for self-expression and self-identity, and as a place to make, maintain and build upon relationships.
- Our response also details a number of potential negative effects of social media. These include: causing anxiety and depression; a lack of sleep; negative body image; cyberbullying, and creating feelings of ‘FoMO’ (Fear of Missing Out).
- The effects of social media on mental health and wellbeing varies from platform to platform, as revealed by our survey which asked young people, from their personal experience, to what extent each of the social media platforms they use made certain health-related factors better or worse. Respondents ranked Instagram as worst, whilst YouTube was ranked as best with the only net positive score.
- RSPH is calling for action from government, social media companies and policy makers to help promote the positive aspects of social media for young people, whilst mitigating the potential negatives. Our recommendations include: the introduction of a pop-up heavy usage warning; social media platforms to identify users who could be suffering from mental health problems by their posts and discretely signpost to support; and platforms to highlight when photos of people have been digitally manipulated.
The Royal Society for Public Health (RSPH) is an independent health education charity, dedicated to protecting and promoting the public’s health and wellbeing. We are the world’s longest-established public health body with more than 6,000 members drawn from the public health community both in the UK and internationally. Our operations include a qualification recognised awarding organisation, a training and development arm, health and wellbeing accreditation, and a certification service. We also produce a wide variety of public health conferences; our publishing division includes the internationally renowned journal Public Health; and our External Affairs department – established in 2014 – undertakes research, develops policy and campaigns to raise awareness of health and wellbeing issues.
Social media has become a space in which we form and build relationships, shape self-identity, express ourselves, and learn about the world around us; it is intrinsically linked to mental health. We believe social media can and should be utilised as a tool for good. Our challenge is to harness the positives of social media, ensure social media platforms are a safe place to be, and that young people have the relevant skills to navigate these and know where to seek help should they need it.
Social media isn’t going away soon, nor should it, and we must be ready to nurture the innovation that the future holds.
On the basis of our extensive research with young people on their experiences, positive and negative, of using social media, we are well placed to respond to this consultation.
(ii) The areas that should be the focus of any further research needed, and why
In early 2017, RSPH conducted a UK-wide survey of 1,479 16-24 year olds, asking them about five of the most popular social media platforms: Facebook, Instagram, Snapchat, Twitter and YouTube. The aim of the survey was to find out how young people felt each of these platforms impacted their health and wellbeing (both positively and negatively) and to make comparisons between these platforms- as well as asking them their views on a number of policy recommendations.
Our #StatusofMind report, published on the basis of this survey, highlights that social media has a number of potential positive effects on young people’s mental health and wellbeing including: providing access to other people’s health experiences and expert health information, emotional support and community building, providing a space for self-expression and self-identity and making, maintaining and building upon relationships.
However, with these positives came a range of potential negative effects of social media on mental health, with respondents to our survey reporting that social media was responsible for creating feelings of anxiety and depression, negative body image, cyber-bullying, poor sleep and a fear of missing out (FOMO).
Whilst emerging evidence available to us suggests that there may be some significant risks posed by social media use to young people’s mental health and emotional wellbeing, research is thus far limited. Due to social media being a relatively new introduction to the lives of young people, far more long-term research will be necessary before we are able to fully understand its effects. We would like to see academic institutions, independent researchers and social media companies, as well as government, actively funding and undertaking the much needed in-depth research into the subject.
RSPH plans to conduct further research throughout 2018 into the impact of social media on young people’s mental health. The proposed topic for this research will be to test the ‘balanced use hypothesis’, by considering the extent to which actively engaging in social media interactions is beneficial or detrimental to mental health, as opposed to passive viewing.
(iii) The well-being benefits from social media usage, including for example any apps that provide mental-health benefits to users;
In terms of well-being benefits, as outlined in our #StatusofMind report, social media has a number of potential positive effects on mental health. These include providing access to other people’s health experiences and expert health information, emotional support and community building, providing a space for self-expression and self-identity and making, maintaining and building upon relationships.
Sharing problems or issues with friends, peers and broader social networks can be met with positive reaction. Nearly seven in 10 teens reported receiving support on social media during tough or challenging times. Further research shows that Facebook users are more likely to report having higher levels of emotional support than general internet users – suggesting social media may be a catalyst for increased levels of this support. One respondent to our survey commented: “When I was feeling alone at university with no real friends I saw every day, having access to the support network provided by friends from home over Facebook was more valuable than I can possibly express.”
Respondents to our survey ranked YouTube as the only platform of the five they commented on to have a net positive impact on their mental health and wellbeing. YouTube was rated positively in terms of providing access to health information, awareness of other people’s health and wellbeing issues, providing emotional support, a space for self-expression, and self-identity and community building. For example, watching vlogs on the personal health issues of others their own age may improve young people’s health literacy, prompt individuals to access relevant health services and enable individuals to better explain their own health circumstances or make better health choices. Health campaigns can gain credibility through community promotion on social media platforms, and the very personal nature of someone sharing their experiences, especially on platforms as interactive as YouTube, can provide others with practical strategies and coping mechanisms.
With its almost universal reach and unprecedented ability to connect people from all walks of life, we understand that social media holds huge potential to act as a positive catalyst for good mental health.
(iv) The physical/mental harms from social media use and screen-use, including: safety online risks, the extent of any addictive behaviour, and aspects of social media/apps which magnify such addictive behaviour;
Along with positives, a range of potential negative effects of social media on mental health were revealed by our report.
Addiction to social media was hinted at in our report findings, with one in five respondents to our survey stating that they wake up during the night to check messages on social media. This has a negative impact on young people’s health and well-being as this lack of sleep leaves young people three times more likely to feel constantly tired at school than their classmates who don’t use social media during the night. Using social media on phones, laptops and tablets at night before bed is also linked with poor quality sleep, even more so than regular daytime use of social media. It is thought that the use of LED lights before sleep can interfere with and block natural processes in the brain that trigger feelings of sleepiness, as well as the release of the sleep hormone, melatonin. This means it takes longer to fall asleep and individuals end up getting fewer hours of sleep every night.
In terms of mental harms, research suggests that young people who are heavy users of social media – that is those spending more than two hours per day on social networking sites such as Facebook, Twitter or Instagram - are more likely to report poor mental health, including psychological distress (symptoms of anxiety and depression). Seeing friends constantly on holiday or enjoying nights out can make young people feel like they are missing out while others enjoy life. These feelings can promote a ‘compare and despair’ attitude in young people. Individuals may view heavily photo-shopped, edited or staged photographs and videos and compare them to their seemingly mundane lives.
The unrealistic expectations set by social media may leave young people with feelings of self-consciousness, low self-esteem and the pursuit of perfectionism which can manifest as anxiety disorders. Use of social media, particularly operating more than one social media account simultaneously, has also been shown to be linked with symptoms of social anxiety.
Bullying during childhood is a major risk factor for a number of issues including mental health, education and social relationships, with long-lasting effects often carried right through to adulthood. The rise of social media has meant that children and young people are in almost constant contact with each other. The rise in popularity of instant messaging apps such as Snapchat and WhatsApp can also become a problem as they act as rapid vehicles for circulating bullying messages and spreading images.
Our report revealed seven in 10 young people have experienced cyberbullying, with 37% of young people saying they experience cyberbullying on a high-frequency basis. Young people are twice as likely to be bullied on Facebook than on any other social network. These statistics are extremely worrying for the overall health and wellbeing of our young people. Victims of bullying are more likely to experience low academic performance, depression, anxiety, self-harm, feelings of loneliness and changes in sleeping and eating patterns – all of which could alter the course of a young person’s life as they undertake important exams at school or university, and develop personally and socially.
(v) Any measures being used, or needed, to mitigate any potential harmful effects of excessive screen-use — what solutions are being used;
(vi) The extent of awareness of any risks, and how awareness could be increased for particular groups — children, schools, social media companies, Government, etc.
On the basis of #StatusofMind, we have made a number of calls to action to social media companies to identify users who could be suffering from mental health problems by their posts, and discreetly signpost to support; to introduce pop-up heavy usage warning on social media, and for social media platforms to highlight when photos of people have been digitally manipulated. We have called upon NHS England to apply the Information Standard Principles to health information published via social media. Furthermore, we see an important step to be incorporating safe social media use in PSHE education in schools and for youth-workers and other professionals who engage with young people to have a digital (including social) media component in their training. As previously mentioned, it is essential that more research is carried out into the effects of social media on young people’s mental health.
(vii) What monitoring is needed, and by whom;
(viii) What measures, controls or regulation are needed;
A well rounded and joined-up approach to monitoring will be needed in order to ensure that social media is a safe space for young people.
Throughout 2018, RSPH plans to run an inquiry via the newly established All Party Parliamentary Group (APPG) on social media on young people’s mental health and wellbeing. The outcome of this inquiry will be the establishment a code of practice for social media developers and industry to encourage the development of platforms which are conducive to positive mental health and wellbeing. This code will include practical guidance for social media developers on how platforms can support positive mental health and wellbeing, and mitigate their potential negative impact. The APPG inquiry will engage with a range of key stakeholders and individuals both directly and indirectly affected by social media, including industry representatives, academics and young people themselves.
We hope that this code of practice will encourage industry and developers to voluntarily ensure their platforms are conducive to positive mental health and wellbeing. Indeed, it may be the case that the establishment of this code paves the way for more formal policy and regulation via government action.
As part of our ongoing public engagement on the issue, RSPH will also be running a campaign to encourage social media users to take part in a ‘digital detox’ for the month of September. This campaign will be titled #ScrollFreeSeptember, with the aim of this to be a wider understanding and to encourage conversation on the impact of social media on mental health and wellbeing.
(ix) Where responsibility and accountability should lie for such measures;
Responsibility and accountability for protecting young social media users must be spread across a variety of stakeholders, including: social media platforms and app developers; government and policy makers; educational institutions; those working closely with children and young people and social media users.
We propose that initially, industry should be given the chance to regulate themselves in line with a voluntary code of practice, as mentioned above. However, adherence to this code should be closely monitored by relevant government departments, such as DCMS, and regulation enacted if and when necessary.
April 2018