Children and young people’s mental health has been centre stage in the media this week, in the light of a recent survey published by NHS Digital. The report shows a rise in mental health difficulties, coupled with increased waits for contact with mental health specialists. A perfect storm of rising demand and reduced capacity in the system.
The report precipitated a flurry of reports in the media calling for the Government to put more resources into young people’s mental health services. A Guardian article identified social media, along with other factors, as potential sources of pressure on young people’s mental health. Another focused on the role of mobile apps such as Calm Harm, and the online counselling service Kooth, in helping young people cope with distress. So what is the role of digital technology in young people’s mental health? Should we be increasing the availability of online services? And are social media good or bad for children?
In a recent post I summarised findings from a representative survey of teens age 13-17 entitled Social Media, Social Life: Teens Reveal their Experiences (Common Sense Media 2018) which found that despite adult assumptions, most teens report social media have a positive effect in their lives, such as making them feel less lonely. And whilst vulnerable teens are more likely to report negative effects of social media (such as bullying) they are nevertheless more likely to report positive benefits, such as feeling less lonely and depressed. Whilst this is an American study, it has parallels to findings from the UK. Social media appear to have a heightened effect (both good and bad) in the lives of vulnerable teens.
With this mixed and nuanced picture – by simply restricting, banning or blaming young people for their use of social media and digital technologies – adults run the risk of removing valuable coping mechanisms. A more rounded approach, in which adults consider indicators of a balanced young person (such as sleep, physical health, social connection, engagement with school, hobbies and interests) is preferable to setting blanket time limits for technology. This post from LSE’s Parenting for a Digital Future gives parents helpful pointers for supporting your child online.
Back to the role of digital technologies in the NHS. The health minister has a big focus on this topic, as illustrated by his recent policy paper which sets out a vision for digital, data and technology in the NHS. Whilst this is welcome, what if an emphasis on technology has an unintended consequence of actually compounding the inverse care law – meaning that those who most need help are least likely to get it?
During a recent NHS England event with other 40 young people affected by mental health difficulties, we asked what might be a barrier to using digital technology. As can be seen from the photo, young people cited poverty and literacy as barriers to access. An estimated 300,000 15-24 year olds lack basic digital skills (Nominet, 2017). As this 2018 Digital Nation infographic from the Good Things Foundation illustrates, social determinants such as education and income are as much a factor in digital take-up as age. These barriers are further compounded by disruptions of care and the criminal justice system, family breakups and addiction or violence in the household (Nominet, 2017). eHealth literacy, defined by the World Health Organisation as the cognitive and social skills to access, understand and user information in ways which promote and maintain good health, is similarly negatively affected by inequality.
So when considering the role of digital technology in the lives of young people with mental health difficulties, the evidence indicates we should take an holistic approach to helping them navigate their use of social media, which recognises the upsides and the downsides. We should be attuned to differential use of technology as influenced by inequality and the impact of digital exclusion. It is imperative that we ensure mental health technology benefits young people who are most excluded as well as those more likely to benefit. It is in this way we will develop digital services which satisfy core NHS principles and values of equity and fairness and meet the needs of all young people.