Written evidence submitted by Barnardo’s (SMH0134)

About Barnardo’s

Barnardo’s is the UK largest children’s charity supporting more than 272,000 children, young people, parents and carers through over 1,000 services across the UK.

Mental Health and Wellbeing is one of the strategic priorities set out in our Corporate Strategy. In 2016-2017, we provided specialist mental health and emotional well-being support to 21,100 children young people, parents and carers. This includes over 14,500 in our school-based programmes aimed at improving emotional health and resilience known as ‘Paths’ (Promoting Alternative Thinking Strategies), ‘All Stars’ and ‘LifeSkills’.

This submission addresses the questions on which we have the most evidence from our practice base and research.

What evidence is there on the effects of social media and screen-use on young people’s physical and mental well-being — for better and for worse — and any gaps in the evidence

1. Key facts

• 1 in 10 children have a diagnosable mental health disorder – that’s roughly 3 children in every classroom. Almost 1 in 4 children show some evidence of mental ill health (including anxiety and depression)[1].

• 79% of 12 to 15 year olds and 32% of 8 to 11 year olds own a mobile phone. Young people are also extensive users of social media sites, such as Facebook, Instagram and Snapchat. Approximately 86% of 9 to 16 year olds belong to a social networking site[2].

• Children aged 5 to 15 are now spending an average of 5 hours and 24 minutes per day engaged in social media activity, despite being at school for seven hours (five days per week), and spending approximately 10 and 16 minutes hours asleep2.

2. A child’s mental health and wellbeing is determined predominately by their peers and parents/guardians lifestyle, behaviour, values and wider socio-economic conditions. The early years shape healthy physical and mental development, and health and social behaviours. Giving every child the best start in life is crucial to reducing health inequalities and maintaining positive wellbeing throughout the life course. If we are to tackle the health and social inequalities that shape the course of people’s lives, then they should be addressed early so that every child has a fair chance of starting and developing well. Childhood and adolescence are crucial stages in the lives of young people, as poor mental health during this time can have profound effects later in life.

3. Use of social media and digital technology by young people has been increasing over the past decade. Evidence of a substantial rise in mental health problems in young people has increased interest in the links between social media and mental health.

4. Use of social media has many positive influences on young people’s lives such as increasing social connections, reducing social isolation and loneliness, accessing information and peer support networks, developing knowledge and learning through wider access to information and enabling young people to develop an identity and express themselves freely and creatively.

5. However research has also identified a number of potential risks and harms associated with social media use including:

• Excessive Use
• Cyberbullying
• Harmful content
• Exploitation
• Impact on physical and other social activities

6. Excessive Use

Increased stress, anxiety, poor self-esteem, depression, behaviour disorders, self-harm, sleep deprivation, eating disorders, poor social relationships and poor progress at school have also been linked to excessive use of social media[3],[4]. Research shows a ‘clear association’ between time spent on social media and mental health problems[5]. Whilst 12% of children who spend no time on social networking websites have symptoms of mental ill health, the figure rises to 27% for those who are on the sites for three or more hours a day. Excessive internet use has been linked to depression, poor sleep and other social and emotional problems[6].

The figure below shows internet use of 15 year olds in the UK on a typical weekday. The PISA Wellbeing study[7] found that nearly a quarter of young people (24.1%) spent over 6 hours online outside of school, described as ‘extreme internet use’.

The study also found that in the UK, young people who were extreme internet users had a life satisfaction score of 6.59 out of 10 compared to 7.40 for moderate internet users. Each additional hour spent online was associated with a negative impact on life satisfaction.

7. Cyberbullying

Cyberbullying can be used to describe any type of bullying that occurs online, for example abusive or threatening messages, sharing embarrassing photos, explicit messages and cyberstalking. 

In a US study, 68% of girls nationally reported having a negative experience on a social networking site[8]. Some teens have reported that Facebook can incite fights, especially with the creation of “burn” pages created for the explicit purpose of taunting or teasing others[9]. The PISA Wellbeing study found that ‘extreme internet users’ were more likely to report bullying than moderate internet users (17.8% compared to 6.7% respectively).

Research suggests that cyberbullying has similar impacts on wellbeing as offline bullying, including reduced confidence and self-esteem[10]. Children who are bullied are more likely to experience symptoms of mental health disorders, such as depression and anxiety, changes in sleep and eating habits, increased feelings of loneliness, and loss of interest in activities they used to enjoy. Cyberbullying victims also report self-injurious behavior, suicidal ideation, and exhibit suicidal behaviors[11].

Source: Royal Society for Public Health Vision, Voice and Practice[12]             

8. Harmful content

Young people are at risk of accessing harmful information via the internet and social media. For example, some websites imply that unhealthy behaviours, such as self-harm, are normal lifestyle choices [13] and pro-suicide information such as methods, is easy to access[14]. Some research suggests that clinical assessments for mental health should include questions about the online content they have viewed.

‘Social media glamorises mental illness, it makes it cool and trendy.’ (Barnardo’s young person – reference 16)

9. Online abuse and exploitation

Barnardo’s estimates an increase from 20% to 75% of the cases their Project Workers are involved with, had an initial referral liked to internet abuse. They highlight that victims of online abuse and exploitation accessing their services ‘do not necessarily have a stereotypical history of sexual abuse and/or exploitation. Increasingly, referrals are for children who come from stable, safe and supportive family environments’, there is no ‘typical victim’[15].

“The online exploitation of children is happening on an almost industrial scale.”(David Cameron, #WeProtectChildren Online Global Summit December 2014)

Source: Barnardo’s[16]

10. What do young people think?

In relation to use of social media, young people said that they:

‘Don’t think of consequences of sharing information or images across social media’

‘’Become obsessive about phones and block out reality and family. This leads to a reduction in social skills as they often sit alone in bedroom communicating via social media’

‘Are friends with people who they have never met face to face and often seek advice from cyber friends’

They felt that more education about social media and online safety is needed, particularly for parents as young people feel they are out of touch with how they communicate and therefore can’t relate to their problems. Young people also felt that cyberbullying is a big problem. And that young people need to be engaged more in other leisure activities.  Insight from parents shows that they do not trust their child to use the internet safely with concerns relating to:

• Companies collecting information about what their child is doing online (34%)
• Their child giving out personal details online to inappropriate people (32%)
• The amount of advertising in games, and their child feeling pressured to make in-game purchases (24%).

Teachers also report significant amounts of their time being used to deal with issues relating to inappropriate social media use – even when these occur outside of school hours[17].

“It does have an impact on children’s mental health and we do have to put it out there that 13 is the responsible age to have social media my parents are very strict about it I am not 13 yet so I can’t have it.”

"Once something is on there its always on there.”

“It does have an impact on mental health people get too addicted, they get hooked it does affect them.”

“A thing recently where a couple of year 8s shared a page from snapchat and it was called dirt disher for their school, things like such and such wants to shag such and such such and such is gay and on and on it was awful.”

“I had to delete snapchat as I was getting bullied on it, people at my school were sending me death threats.  If you open something on snapchat you have to take a screenshot of it because otherwise it will just go and then if you take it to the school they will be like can I have a look and you will be like well I don’t have it.”[18]

11. Impact on physical and other social activities

An on-line poll conducted for Barnardo’s[19]showed that:

• The number of young teenagers who play outside, read books or get enough sleep has dropped sharply in comparison to teenagers from previous decades,
• The study found barely half (54%) of those aged 13-15 read books. By contrast, 79% of adults aged over 18 said they did so when they were young teenagers.
• And just half (50%) of today’s young teenagers believe they get sufficient sleep against two-thirds (66%) of adults who said they did so when they were aged 13-15.
• However, the poll also showed that access to the internet helps three-quarters (75%) of today’s young teenagers to do their schoolwork, compared with 44% of 25-34 year olds when they were the same age.

It can also be a useful way for young people to find out about activities[20]:             

“It can be a good way for young people to link in with specific hobbies and stuff and get more information on things that they would not necessarily know where to go to so for example I link through gymnastics through it.”

“It’s good to keep in touch with friends who maybe move from one gymnastics club to the other so can help friendships.”

The areas that should be the focus of any further research needed, and why

12. Barnardo’s is of the view that further research is required with priority being given to:

• Gaining a better understanding of the digital lives of children and young people, including how they interact with social media and technology
• Recognition and understanding of the integrated nature of the online and the offline world to inform an integrated approach to digital literacy, which involves parents as well as schools and other professionals. This is vital to ensuring children benefit from online opportunities and are able to safeguard themselves from the risk of harm. This needs to be age appropriate as children’s digital literacy develops in nature and degree as they grow older but is marked by significant gaps in understanding of the digital environment[21].
• Information and training for professionals who routinely engage with young people with higher levels of risk-taking behaviour, to better understand the impact the digital world has on mental health and wellbeing and how they can best support young people
• Peer education aimed at preventing mental health crisis and promoting digital resilience
• Guidance on screen usage and research on the impact of digital devices on early brain development, including attachment and relationships.
• Gaining a better understanding of the impact of the use of social media on time spent on physical or other social activities and the impact on children’s health
• Targeted outreach for parents with low digital literacy and resilience
• Education for young people in relation to digital resilience, appropriate to age and learning style, including:

• Creating positive content
• How to stay safe and protect yourself and others online
• Building empathy and responsibility online
• Identifying, understanding and dealing with challenging content and experiences

Barnardo’s also recommends an increased focus on prevention, including education, information and advice:

• training for professionals to improve identification of possible harm online
• interventions to incorporate an assessment of possible online harm

The well-being benefits from social media usage, including for example any apps that provide mental-health benefits to users

13. As the PISA research shows little or moderate use of social media has a negative impact on a child’s well-being. For many young people the ability to get information on line from sites such as Xenzone[22] is invaluable in enabling them to take control of when and how they access support.

14. However, Government working with the technology companies and providers of such apps need to work together to:
• Agree appropriate content related to the child’s age
• How a child or young person can access further support – for example is there on line counselling or signposting to a counsellor, if for example, a child is feeling suicidal?
• Agree how the use of apps can be monitored and evaluated so that future development is evidence based

• Any measures being used, or needed, to mitigate any potential harmful effects of excessive screen-use — what solutions are being used?

15. The evidence base on what works to help keep young people safe on line is still being developed. A comprehensive study of online use and risk in European children recommended the following to help minimise risk:

• Strengthen regulatory frameworks: “Children can only be supported in managing the online environment if this is substantially regulated – by law enforcement, interface and website design, search processes, content and service providers, online safety resources, etc – just as they can only be taught to cross a road on which drivers and driving are carefully regulated”.
• Awareness raising should concentrate on those most at risk, for example the youngest online content consumers, those who are most vulnerable/less resilient to harmful content.
• Recognise that children can be both perpetrators and victims of harmful behaviour online.
• Reduce reliance on parents and parenting strategies as a way of protecting young people online – this does not operate in isolation nor should we place the burden solely on parents. We must recognise the ecological framework of actors involved in online safety.

• Evaluate the effectiveness of all initiatives but particularly ‘educational’ initiatives such as those that aim to increase media literacy. This way we can continue to put resource behind the initiatives that have demonstrably positive effects and reduce the risk of promulgating interventions that, at best, have no effect and at worst, deepen the problem.

The extent of awareness of any risks, and how awareness could be increased for particular groups — children, schools, social media companies, Government, etc;

16. Barnardo’s works with the UK’s most vulnerable children and young people and there is emerging evidence of the experiences of social media for these groups. Children with disabilities, young carers, minority ethnic groups, lesbian, gay, bi-sexual, transgender and questioning (LGBTQ+) young people, children in care and those with poor mental health are often identified as being most vulnerable to negative impacts of social media use.

17. Research shows[23] that children belonging to identified vulnerable groups are likely to be less resilient to online and offline risks and that those who encounter risks offline are likely to encounter them online and those who encounter one risk are also likely to encounter other risks. Groomers are also likely to target young people who are perceived to be vulnerable.

18. A report from the Children’s Commissioner[24] highlights specific issues for children in care for including limited access to the internet in children’s residential care homes and foster placements; lack of support from foster carers and other professionals and a lack of appropriate safeguarding as a direct result of the responsible adults’ lack of digital skills; and a lack of understanding about the pervasiveness of social media in a young person’s life, how safeguarding practices apply to digital activity, and of how digital tracking can lead to significant problems for looked after children.

19. Children in care are four times more likely to have a mental health difficulty than their peers[25]. This would strongly suggest more research into the impact of social media on vulnerable groups of children and young people, including those experiencing on-line abuse; those in and leaving care. This would require collaboration between the young people themselves; their carers; the Government and social media companies.

20. Girls are also more likely to suffer with friendship/relationship issues and pressures to change their appearance, whilst boys are more vulnerable to violence or aggressive content, and unwanted sexual messages. This suggests that research and practice development needs to take gender differences into account.

What monitoring is needed, and by whom; what measures, controls or regulation are needed; and Where responsibility and accountability should lie for such measures;

21. Barnardo’s is calling for children and childhood to be put at the centre of technological development.[26] We can do this most effectively working in partnership with organisations that are experts in the fields of emergent technologies and incubating trends – the social media giants, internet service providers, new media start-ups and the academics and thinkers surrounding the technology sector.

22. Barnardo’s wants to bring its expertise in the safety and welfare of the most vulnerable children and young people to a new and energetic dialogue. This means we need to:

• Ensure technology is designed, legislated for and used responsibly; including ensuring Britain takes a global lead on regulation.
• ensure children know their rights, and adults their responsibilities, online, especially within social and personal networks
• Empower and enable children by giving them tools to take control of their lives, free at the point of access, developed by and with the companies who have a vested interest in the internet continuing to be seen as a force for good.
• Recognise the integrated nature of the online/offline world[27] especially in safeguarding the most vulnerable children and enable professionals to do so by equipping them with the right skills and tools.

23. The UK Council for Child Internet Safety (UKCCIS), established by the Government nearly ten years ago, has done great work bringing together the right expertise to improve our response to online child protection issues and helping to bring to justice some of the worst perpetrators of child abuse. Yet the challenges ahead go beyond the issue of online safety – we need to think more broadly about the welfare of and chances for our children too especially the impact on their mental health and well-being. We need to stop reacting and start anticipating – and shaping – change for the benefit of our children. UKCCIS recently published their education framework.[28]

24. This requires the recognition that children and young people do not see their internet presence as separate from their physical world. As Barnardo’s report highlights[29] the advance of technology and the changes it has driven have been revolutionary and it has transformed childhood.  Young people have quickly and comprehensively integrated digital/social media onto all aspects of their lives from friendships, to relationships, to information finding, to education, to recreation – it means that it is here to stay. Therefore, a successful approach to supporting young people navigate across physical and digital relationships and the impact on their health would need a whole systems approach identifying the benefits and challenges that social media brings to all aspects of a child’s life and working with children in an integrated way to help them find healthy usage, rather than a pure focus on time spent on social media or types of use.

April 2018