Latest / Healthier Together: Larimer County's Public Health Podcast / Social Media & Youth Mental Health

Transcript

Social Media & Youth Mental Health · Healthier Together: Larimer County's Public Health Podcast

0:02
Welcome to Healthier Together, Larimer County's
0:04
public health podcast, where we come together
0:06
for healthier lives, connected communities, and
0:08
real conversations. From your local public health
0:10
team, I'm your host, Tom. And I'm Joanna. This
0:13
is your weekly Minnesota where we'll provide
0:15
a brief update on local public health news. Today,
0:18
we have Jonathan Judge, Director of Community
0:20
Engagement and Campaigns at Rise Above Colorado,
0:24
here to talk about social media and youth mental
0:26
health. Jonathan, thank you so much for joining
0:28
us. My pleasure. Thanks for asking us to join.
0:31
To start, can you tell us a bit more about Rise
0:34
Above Colorado and the work that you do? Absolutely.
0:36
We are a statewide nonprofit, and we focus on
0:40
upstream prevention for youth. And that largely
0:43
revolves around substance misuse, mental health,
0:46
the overlap between the two. But because it's
0:48
upstream, it really is skill building. It's equipping
0:52
teens with the... necessary resources they need,
0:55
the skills to just connect with others, to improve
0:59
their lives, their communities, and I'm really
1:01
proud to be a part of that work. So how does
1:03
social media fit into Rise Above's work? That's
1:07
a big question, and it's one that we are constantly
1:10
revisiting. But the short answer is that teens
1:14
are there. We know that we can reach teens in
1:16
that space. We can be a beacon of good in what
1:20
can sometimes be a confusing, negative environment.
1:23
And with their messaging, we're able to scale
1:26
that to an extent that just 10 years ago would
1:32
have been unfathomable. And it's shocking and
1:34
amazing all at once. But not too long ago, we
1:37
were able to reach 90 plus percent of Colorado
1:40
youth through Instagram and Snapchat alone. And
1:44
that's just virtually impossible to do elsewhere.
1:45
So we can provide those resources I referenced
1:49
in that space. We can provide. opportunities
1:52
for them to connect with things that are bigger
1:54
than themselves, hopefully provide some of those
1:56
necessary resources around prevention and kind
2:00
of push back against that negativity that exists
2:02
there. What sort of outreach does Rise Above
2:05
do through social media? We've launched campaigns
2:08
and we typically do that twice a year. So our
2:10
current campaign we call Fill Your World With
2:13
Good. And it is really demonstrating to teens
2:17
by reflecting back all the positive, healthy
2:19
things that they're doing to them. had opportunities
2:22
to capture some of that through large -scale
2:24
community art projects, through just content
2:26
that they themselves submitted, through some
2:29
of those resources I referenced that are youth
2:31
-developed. Our teen website is youth -created,
2:34
youth -informed. So sharing that out with them
2:36
and through that, giving them a sense of what's
2:42
possible with their lives, their sense of connection
2:44
to one another, what they can contribute to their
2:46
communities. while simultaneously kind of navigating
2:49
just those ups and downs that come with the teen
2:53
years. So we spend a lot of time developing those
2:56
campaigns, working with our youth council to
2:58
make sure that we're meeting the mark, using
3:01
metadata to make sure that teens are, it's resonating
3:04
with teens, and then learning from that on a
3:06
cyclical basis. So we've been in this space for
3:09
a number of years. I don't know if you remember
3:11
MySpace way back in the day, but we stepped into
3:14
that and have ridden out all the ups and downs
3:16
ever since. And we can do quite a bit by scaling
3:21
up, and we can also try as much as possible to
3:25
get them to occasionally log off and to experience
3:29
life beyond the screen. So every two years, Rise
3:32
Above Colorado does a statewide youth survey
3:35
that includes some questions both about mental
3:37
health and social media. Can you tell us a bit
3:41
about what that survey looks like, the data collection
3:44
process, who participates, that sort of thing?
3:47
Absolutely. It's likewise a statewide survey.
3:50
And we contract out to an organization, a company
3:53
called Healthcare Research. And typically we
3:56
survey upwards of 800, 900 youth and do oversampling
4:02
in some communities where we have partnerships,
4:05
contracts. They try to put their finger on the
4:07
pulse of what's happening with youth. through
4:10
that outreach. And it's anywhere from a 20 to
4:13
30 minute survey, largely focused on mental health,
4:16
substance misuse. We added questions about sleep
4:19
this last time to better understand the relationship
4:22
between those three. And then we also just internally
4:25
have measurements for our campaign work. So whether
4:29
or not youth have heard of Rise Above Colorado,
4:32
to what extent, tracking usage, perception of
4:35
risk, all those things so that we can better
4:37
equip. our staff, our partners, better inform
4:42
our work to make sure that we're effective, that
4:44
we're meeting the needs of young adults, and
4:48
that we're as much as possible staying ahead
4:50
of some of the trends and being effective. So
4:53
how often do you do this survey? Every two years.
4:57
And we're currently in the field right now. So
4:59
later this year, we'll have the freshest data
5:01
available. We will happily come back and share
5:05
that. We make that available through our website
5:08
as well so that people that are interested, they
5:10
can pour over that data. We really want this
5:13
out there. We feel it's incredibly valuable.
5:15
And we try as best as possible to make sure that
5:18
when we do break it down, we pay health care
5:20
research extra to tease out all these correlations,
5:23
the causation in some cases. We have the margin
5:27
of error built in there so we can say this is
5:30
something worth. absolutely certain exists or
5:34
this is something, you know, that's maybe on
5:35
the margins, but let's keep our eye on it. And
5:37
then we've been doing this ever since we launched
5:39
approximately 17 years ago. So we've had that
5:42
ability to track this over time, to measure it
5:46
against Healthy Kids Colorado survey data, others
5:49
to just see what's going on. And it's been amazingly
5:52
consistent with these other efforts to gather,
5:54
collect data so that we're pretty confident in
5:56
what we find and how we can present this out
5:59
and how we can react to that information. What
6:02
did you learn in the 2024 survey about youth
6:05
mental health in Colorado? A lot. We went deeper
6:10
this past survey to better understand the correlations
6:14
that do exist. There are some strong causations,
6:17
but it's mostly at this point correlation. For
6:20
me, the biggest takeaway right out of the gate
6:22
was how much more younger kids are behaving like
6:29
older teens. Going to 12-, 13 -year -olds, their
6:33
behavior, especially around social media and
6:35
even their perception of risk around substance
6:37
misuse, their mental health, more and more are
6:41
behaving like 15-, 16-, 17 -year -olds. So that
6:45
was something that really popped out from the
6:47
data that we are going to absolutely be looking
6:50
at to see if that trend is continuing. But as
6:54
it relates to social media, for example, their
6:55
online behavior in terms of usage. is almost
6:59
identical to 15, 16 -year -olds. And by law,
7:03
you're not even supposed to be able to have a
7:04
social media account at age 12, but they are
7:06
very much in that space to the extent that they're
7:09
spending, I think it was close to two hours a
7:12
day on social media alone. That doesn't even
7:14
account for other screen time. So that is something
7:17
that really jumped out from the data and that
7:21
we are going to be watching for. Apart from that,
7:24
some of the... Things that we have tracked over
7:27
time still persist to this day where we're seeing
7:31
correlations between poor mental health days,
7:35
increased usage of various substances, lower
7:39
perception of risk. We added questions about
7:42
sleep, saw a strong correlation between social
7:44
media usage there and again, perception of risk
7:46
being lower, things like access to drugs being
7:49
higher. So there's just things that you could
7:51
tease out. And that, again, is helpful if we
7:54
want to If we want to structure prevention to
7:58
try to reach youth and knowing that these 12,
8:00
13 -year -olds are beginning to behave like their
8:03
older peers, creating opportunities for that
8:06
prevention to arrive at an earlier stage and
8:08
working through that. Having said all that, I
8:11
want to also emphasize that there's a lot of
8:13
great news. We still know that most teens are
8:16
not using substances by strong majority. So we've
8:21
got to balance that. open concern, those opportunities,
8:25
those challenges out there, and realize that
8:29
there are tremendous things happening with you.
8:31
There's, without question, struggles. There's,
8:33
without question, a need for prevention work,
8:37
for the good work that you and your department
8:39
does, that parents do on a day -to -day basis.
8:42
All that is very much necessary, but big picture,
8:46
the sky is not necessarily falling in, although
8:48
we can pull some headlines from here in that
8:49
doom and gloom. could be extracted in that sense.
8:53
We have to balance that out and give youth these
8:56
options, these opportunities to latch onto that
8:59
good, to grow that good, and to develop the skills
9:02
needed to help themselves and their peers out.
9:04
One of the data points that jumped out to me
9:07
from the 2024 survey was about belonging. Some
9:11
of the questions had to do with belonging and
9:14
asked things like, do you feel accepted by students
9:17
and adults in your school? And I noticed that
9:20
that had declined over time. And some of the
9:23
biggest shifts were along the front range. Those
9:26
areas had maybe declined the most recently. Could
9:29
you talk about that a little bit more? This is
9:32
pure conjecture on my part, but I do think that
9:35
there is this pretty strong connection with that
9:37
sense of belonging and the rise of social digital
9:40
media. I think the information we're seeing within
9:44
the survey and just looking at research more
9:47
broadly. We're seeing a case that is becoming
9:51
more and more concrete over time. And it's not
9:54
the sole cause, but I do think that there is
9:56
something that we need to hone in on there and
10:00
be prepared to act on, whether it's through policy,
10:05
decisions we make as individuals, what we can
10:06
do collectively as a community. But there's something
10:09
there. And you're right, that did decline. And,
10:12
you know, how they see support coming from friends.
10:16
The ways in which that they can show for others
10:18
and that sense of connection to school, that
10:21
sense of meaning through the work that they pursue
10:23
there, their future, those all dropped significantly.
10:27
So we're looking at that as well. But I think
10:30
that that's actionable. That's something that
10:32
can be changed and is a big opportunity for us
10:37
in this space and what we can contribute through
10:39
opportunities to converse like this and to reach
10:42
out to others, whether it's the schools or them.
10:44
support networks that exist in communities, but
10:46
we'll take a look at that again. Did the 2024
10:50
survey find any correlation between social media
10:53
use and poor mental health? Yes, I'm glad to
10:56
use correlation because there are some out there
10:59
that are pretty adamant with causation, and we
11:02
haven't reached that point yet. What I've come
11:06
to understand is that social media tends to be,
11:09
in a sense, a volume knob where depending on
11:13
what you bring to that activity, it can really
11:15
heighten your sense of anxiety, it can heighten
11:17
that sense of doom, and it can also accentuate
11:20
the positives out there. It's still an emerging
11:23
technology. I think that there are some good
11:26
things that come with it, and youth overwhelmingly
11:28
will tell you that they see social media as a
11:31
net positive in their lives. There's study after
11:34
study that confirms that. All that said, though,
11:37
those correlations are very stark. And we see
11:40
everything from declines in sleep to issues with
11:44
mental health to those perceived risks dropping
11:49
when social media use increases. Now, whether
11:52
or not it's mental health that's driving that
11:55
usage or the usage that is souring mental health,
12:00
that's where it gets messy. But there's no doubt
12:03
that there is a strong connection between the
12:04
two. Do we know more broadly how social media
12:08
impacts youth mental health? And are there specific
12:12
groups of youth that are more impacted by increased
12:15
social media use? Another good question that
12:18
we're learning a lot. I would argue that, I'll
12:23
put it this way, one of the biggest concerns
12:24
I have isn't necessarily social media as it exists,
12:27
but more what it's replacing. As screen time
12:30
goes up, that is less opportunity to... be outside,
12:34
to engage in the real world, to have those meaningful
12:36
connections. And in particular, it's a decrease
12:41
in sleep. We're seeing tremendous impacts there
12:45
where people are streaming, they're on social
12:47
media to the unhealthy extent, really impact
12:51
who they are as an individual, how they interact
12:53
with one another, the world at large. I think
12:55
the average adult, and this is screen time, not
12:57
necessarily social media, is consuming about
13:00
seven hours a day. And when you do the math on
13:04
that, that's almost a third of your life, not
13:07
even accounting for sleep, which is devastating
13:10
in some ways. There's amazing things to be had
13:12
there. There is that sense of connection. There's
13:15
digital art, all these beautiful things that
13:16
can occur, but that is a lot of time. And when
13:19
you do step back and account for what that looks
13:22
like, big picture in the aggregate, it's breathtaking.
13:27
Children are watching. They're observing this.
13:29
They're getting screens at increasingly younger
13:31
ages. And that has an impact. So there is a healthy
13:37
concern to be had there. And it's pretty equal
13:39
in terms of who it impacts. It really doesn't
13:43
discriminate. We do see, though, that this is
13:46
where it gets tricky, causation and correlation.
13:49
But people that do struggle with their mental
13:51
health, their screen time, without question,
13:53
is higher. And what causes that? What's reinforcing
13:57
that? I mean, it's difficult to untangle, but
14:00
when you see somebody struggling with their mental
14:02
health, chances are pretty good that they're
14:03
going to be likewise spending a lot of time online.
14:07
Rise Above also provides educational resources
14:09
for people who work with youth, which empower
14:12
teens with knowledge and skills to prevent substance
14:15
misuse. I saw that one of those resources is
14:19
Beyond the Screen, which deals with media and
14:22
critical thinking in a digital age. Can you tell
14:25
us a bit more about Beyond the Screen? This is
14:28
our most recent resource, and we're really excited
14:30
to get it out, to see it adopted, to have youth
14:34
engage with it, because I think it's just timely.
14:37
But I'm also just proud of the content, and I'm
14:40
glad you referenced the critical thinking, because
14:42
I think with the rapid change we experienced
14:44
going back to MySpace, to where we are now with
14:46
TikTok, to virtual reality, AI, these things
14:49
are rapidly changing, and that's only going to
14:51
increase with time. But critical thinking is
14:53
universal. And if we can apply it and apply it
14:56
at an early age and give youth the ability to
14:59
use some of these tools, use them wisely, use
15:02
them effectively, and not be dependent upon them,
15:06
not use them to the expense of all these really
15:08
other life -affirming things, that's critically
15:10
important. And I think adults struggle with this
15:13
too. And we need mom and dad to understand this
15:16
and better adopt some of these strategies and
15:20
apply that critical thinking. So that is available.
15:23
It's free on our website. We are in the process
15:25
of doing some revisions with the teacher manual,
15:29
but the core lesson itself is ready to be used
15:32
at any point. And we would love to get it out
15:34
there. So if an educator or someone who works
15:37
in the community with youth wanted to access
15:40
that curriculum. how could they do so? If they
15:42
go directly to our website, we have a resources
15:44
tab and we have a whole host of educational resources
15:48
that can be used at any point, all free of charge.
15:51
Everything from not prescribed to closing the
15:55
gap, which talks about these misperceptions we
15:57
have that's related to that critical thinking
15:59
skills within the Beyond the Screen. Then within
16:02
Beyond the Screen itself, just so much information,
16:04
resources that can be immediately adopted. The
16:08
Beyond the Screen presentation, talks a lot about
16:12
how media impacts mental health. And it mentions
16:15
that youth mental health is deeply impacted by
16:17
sleep, exercise, and in -person connection, all
16:21
of which fall as screen time goes up. Can you
16:26
talk about that correlation a little bit? Absolutely.
16:28
And that's my number one concern. I think just
16:32
out of interest, I went back and researched what
16:35
general reaction was to the invention of the
16:39
radio. the invention of television, and the sky
16:43
was absolutely falling in both cases. The alarm,
16:46
the concerns were stark. And I think to an extent
16:52
we've been through this before, and I think some
16:54
of that carries over into this conversation about
16:56
social media where we are reacting to a great
17:00
extent, but where I know for a certainty that
17:03
we aren't overreacting is what it's replacing.
17:07
And whether it is keeping youth awake at night
17:10
as they're scrolling through social media, whether
17:13
it is the manosphere and just the easy access
17:16
to just horrible information or just streaming,
17:20
you know, the latest series that just dropped
17:23
and missing out on X, Y, and Z. We're missing
17:26
out. And as that takes hold more and more. I
17:31
think that's going to have a negative impact
17:34
on just the social fabric. Personally, professionally,
17:37
people are going to struggle a bit more. Without
17:39
question, that sense of connection, that sense
17:41
of purpose that we get through human interaction
17:43
or the beauty of nature and what we can do in
17:48
terms of our just physical mental health by being
17:50
outside, those things take hits. So to the extent
17:54
that we can educate youth on that and encourage
17:57
them to... Monitor the screen time. You don't
18:00
have to unplug 100%, but just be more aware of
18:03
it. Understand how it impacts your sleep. Get
18:07
that sleep. Reach out to your friends. Have those
18:10
real -world interactions. Spend time outside.
18:13
Take that walk. All those things are going to
18:16
have a net impact for the positive on you, your
18:19
relationships, your future well -being. The Beyond
18:23
the Screen presentation wraps up with some skill
18:26
building for youth. What skills does it teach
18:29
for how to interact with media? It really helps,
18:33
hopefully, youth ask questions. And in particular,
18:36
as it relates to social media and the information
18:39
we're consuming and media just in general. I
18:42
mean, we are sponges constantly being bombarded
18:44
with information, stepping back and asking questions.
18:48
Who's the intended audience? Who constructed
18:50
this message? Why did they do it? What's the
18:53
technique they're using? Are they trying to inform
18:55
me, persuade me, entertain me? So we list all
18:58
these things out. We practice that a couple times
19:00
within the lesson. But I think by having that
19:02
context and understanding that you can pause,
19:06
you can think through a messaging. Is this complete
19:10
information? What are they leaving out? Scrolling
19:12
through Instagram or you're reacting to something
19:15
on TikTok, we can better consume this media.
19:18
We can better understand the world in which we
19:20
live, make better decisions, and hopefully just
19:23
improve life for everybody by doing those basic
19:26
things. Easier said than done, but I think if
19:28
we all just kind of paused, caught our breath,
19:31
asked them some basic questions, we wouldn't
19:34
see some of the problems, the issues that we
19:36
were experiencing today. Are there other skills
19:39
or interventions that you've seen be effective,
19:41
either reducing social media use or limiting
19:45
its impact on mental health? I think one of the
19:47
biggest aha moments for young adults is to understand
19:51
the relationship to these companies, these big
19:53
tech companies. Pause and ask, you know, who,
19:58
what is the customer within this world of social
20:02
media? And 99 % of them will respond, you know,
20:06
I'm the customer. I sign up to Facebook. Mark
20:08
Zuckerberg gets my information. I get to use
20:10
the service. You know, they're doing that when
20:12
it's the exact opposite. Users are the product.
20:16
And when I think teens have a better understanding
20:18
of they're what's being sold, that these platforms
20:21
are created for revenue. They are designed for
20:24
companies. to access them, their data. That is
20:29
a kind of a paradigm shift that I think empowers
20:32
them and better suits them to navigate this space.
20:36
And I think you can make some observations in
20:38
a broader setting with that. But that, I see
20:42
the lights flash on in that moment during the
20:45
presentation. And then the skill building, just
20:48
having that critical thinking, being able to
20:50
apply that not only social media, but to... all
20:52
their interactions. Just carrying that forward
20:55
as a young adult into adulthood, that's really
20:58
important, something that I think can help all
21:00
of us. And then beyond the individual level,
21:03
are there policies that you'd like to see to
21:07
help protect youth mental health and help limit
21:09
that social media use? I would love to see phone
21:14
-free spaces. This is personally, I think, a
21:17
policy proposal, but without question, schools.
21:21
I think there's a role where young adults need
21:25
to have access to a telephone that doesn't have
21:28
to be in the middle of a class, though. So I
21:29
think there are things that we can do to minimize
21:32
that. I think, you know, in social settings,
21:35
when you're with people, this is more just a
21:37
personal thing, but keeping the phones in the
21:39
pocket, away, having that interaction, I think
21:42
that would be a beautiful thing. I would love
21:45
to see more. a sharper focus on these social
21:49
media companies. And I think it would be really
21:53
beneficial to understand and respond to the profit
21:58
incentive there, the ways in which they manipulate
22:01
their algorithms. Extending this to AI, I think,
22:04
you know, that's a wholly separate subject, but
22:07
we absolutely need some regulations there because
22:10
that has the potential to radically impact everything
22:13
we're talking about to a degree that I think
22:15
we... We're slow to understand. And then there's
22:20
some experimental things happening out there
22:21
with schools, countries around with their, you
22:24
know, I think Australia recently raised the age
22:26
from 13 to 18. I mean, I'm really curious to
22:29
monitor that. Like, I don't know that a 13, 14,
22:32
15 -year -old needs to be spending so much time
22:35
on TikTok. I don't think that's a healthy thing.
22:38
So, you know, I'd like to watch that, see what
22:40
those ripple effects might be. But, you know,
22:43
it's... It's something that we need to better
22:46
understand. We need to put our time and resources
22:48
into. We need to have conversations about. And,
22:51
you know, we need to include youth in this, but
22:53
things aren't where they need to be in this social
22:57
media realm. Is there anything that you wish
23:00
more youth knew about social media? I'd like
23:04
to extend that conversation about the customer,
23:06
the product to do youth at large. I think that
23:08
would be a really helpful conversation piece
23:11
to have. For everybody, youth included. Along
23:15
with that, I mean, youth overwhelmingly see social
23:18
media as a net positive in their lives. Survey
23:21
after survey has shown that. And I'd like to
23:23
have them better understand the downfall as well,
23:27
just the pros and the cons. And when they are
23:31
simultaneously asking about FOMO, fear of missing
23:33
out, or their sleep, they intuitively get that.
23:36
They realize that, but I don't think they...
23:39
really fully understand how that impacts them.
23:42
So when we're talking about mental health, when
23:44
we're talking about these real -world effects,
23:46
by spending so much time on social media or screens
23:49
more broadly, I think teens would potentially
23:53
make different choices if they had the breadth
23:56
of information available to understand what this
23:59
does to them and where those impacts are and
24:02
what even modest changes can do to improve how
24:06
they feel and how they engage with the world.
24:08
If people would like to learn more about Rise
24:11
Above Colorado or support your work, where can
24:14
they go for more information? Online. I hate
24:18
to say that, but yeah, we're all over social
24:20
media. So we do try to be that force of good
24:23
out there, have these conversations in real terms
24:26
that everybody can easily understand. And we
24:29
have a website that's very interactive where
24:32
you can find these resources we've referenced
24:33
where you can find. information on substances
24:36
and help. So, you know, if you're struggling
24:39
with your mental health, if you're struggling
24:41
with substance misuse, if you have friends that
24:43
are struggling, these resources are all there.
24:45
And that's iriseaboveco .org. And then in addition
24:49
to Rise Above, if there are youth listening who
24:51
are struggling with their mental health, what
24:53
resources are available for them or for their
24:56
parents? Glad you mentioned parents, because
24:58
I think parents are probably the number one.
25:01
The best thing that can happen with intervention
25:03
prevention, just having those conversations,
25:05
having parents equip themselves with knowledge,
25:07
and being open to have these tough conversations
25:10
with their youth in this way that builds trust.
25:13
But other trusted adults, counselors, there's
25:15
iMatter, which is a great resource that's available
25:18
out there, 988. Local health departments, they
25:21
have fantastic resources. So there's a lot within
25:24
the community that teens, parents can reach out
25:28
to. embrace for support for help for inspiration
25:31
and i think just you know not to preach but just
25:34
getting out there and trying to spend time outside
25:37
take that walk you know get that extra hour of
25:40
sleep and and see how that goes and then pursue
25:42
that if it improves your life which i dare say
25:45
it will awesome well thank you so much for joining
25:48
us today my pleasure thanks for having me Next
25:54
up, we're joined by Dr. Sarah Taylor Cavalier,
25:56
who works as a child and adolescent psychologist
25:58
at the Pediatric Mental Health Institute at Children's
26:02
Hospital Colorado. Dr. Taylor Cavalier, thank
26:04
you so much for joining us. Thanks so much for
26:07
having me. To start, can you tell us a little
26:09
bit about yourself and the work that you do at
26:11
Children's Hospital? Yeah, absolutely. I'm a
26:13
clinical child psychologist, which means that
26:17
I focus on working with kids and adolescents
26:20
who have a variety of different concerns ranging
26:23
from anxiety and depression to things like suicidality
26:26
or OCD. I work especially in our higher levels
26:30
of care, so things like our inpatient unit and
26:33
our partial hospitalization day program. So I'm
26:36
often working with the teens and families who
26:38
are either presenting for a crisis or generally
26:41
struggling to manage symptoms in outpatient care.
26:44
What services does the Pediatric Mental Health
26:47
Institute provide then? So we provide a lot of
26:50
services. We have our outpatient clinic and outpatient
26:54
basically just means that you're kind of doing
26:56
that once a week therapy or maybe a little bit
26:58
more, but you're not staying overnight. And that
27:01
we have clinics for eating disorders, OCD, mood,
27:05
anxiety. And then we also have our higher levels
27:08
of care. So we have our neuropsychiatric special
27:11
care unit, which is focused on treating kids
27:14
who have neurodevelopmental disabilities, things
27:16
like autism. They have a whole spectrum of care.
27:19
And then we have our more general programs that
27:22
I work in. So like our partial hospitalization
27:24
program is day programming where kids get to
27:27
go home and sleep at night. And then our inpatient
27:31
psychiatric unit, which is a unit that serves
27:34
kids five and up who may need to have round -the
27:38
-clock care at that time. And then, of course,
27:41
emergency services are always available. Gotcha.
27:45
Well, thank you so much for telling us a little
27:47
bit more about that. The focus of our conversation
27:49
today was going to be around social media's impact
27:52
on youth mental health. It's been in the news
27:54
a lot lately. Can you tell us a little bit about
27:56
the current landscape of social media use, screen
28:00
usage among teens, and how that shows up in some
28:02
of your work? Yeah, definitely. I would say that
28:05
when I first started doing a lot of this work,
28:07
I was aware generally of the social media. impacts
28:12
and technology impacts but then when I started
28:14
working with parents more intensely and more
28:16
frequently I realized that this was a topic that
28:18
came up every week of how do I like this is this
28:23
is a huge issue in our households and it's it's
28:26
absolutely impacting my kids mental health and
28:28
I need help navigating it and I think that's
28:29
what got me interested in all of these issues
28:32
because A lot of times our science is like decades
28:35
behind our actual practice. And in this case,
28:38
we don't have decades because technology is evolving
28:40
so quickly. Right. This is relatively new stuff.
28:43
But it's very new. Yeah. I'm curious how exactly
28:45
does social media usage impact youth mental health?
28:48
Yeah. So I was also curious about that. And I
28:52
felt like every time I tried to find a source,
28:55
it felt very convoluted and like. Everyone seemed
28:58
to be saying a different thing. And that's kind
29:00
of what we get with some of the research. But
29:02
what we know is that at a group level, the number
29:07
of hours on social media is not going to make
29:09
a huge difference overall. However, we also know
29:13
that there's a subset of kids that have different
29:16
patterns of use. And we might call this like
29:17
more of an addictive pattern of use where it's
29:20
very hard for them to get off the phone or the
29:21
screen. They're spending significantly more time
29:24
on the screen. For this group, it can act almost
29:28
like an amplifier for the concerns that they
29:31
might already be vulnerable to. So, for example,
29:34
if you have a kid who is using their device in
29:38
order to regulate their emotions in some way,
29:40
we typically see that that in the long run actually
29:43
just makes it more difficult for them to regulate
29:45
their emotions. Interesting. So it doesn't sound
29:48
like there's a huge correlation between time
29:50
spent on social media and mental health, but
29:52
it's a part of like a segment of the population
29:54
that tends to... experience those kind of adverse
29:56
impacts at a higher percentage. It also depends
30:00
on like when you were like where you were in
30:02
development and your gender and that kind of
30:04
thing so we know for example that social media
30:06
use in girls particularly pre -adolescent girls
30:09
seems to have be significantly predictive of
30:12
more internal like more depression and anxiety
30:14
as they head into adolescence and we also know
30:18
that there's certain kinds of social media use
30:20
that are In the current research, predicting
30:23
worse outcomes later. So those are things like
30:27
passive video watching where we're just kind
30:31
of like doom scrolling. Those predicted worse
30:34
outcomes in both like our depression, anxiety
30:37
realm, but also in our like big behaviors realm
30:40
where we're struggling with rule breaking and
30:42
that kind of thing. And in general, there's been
30:45
this trend of like the more passive the activity
30:50
is. the more likely it is to lead to worse mental
30:54
health outcomes, whereas something like FaceTiming
30:56
a friend was helpful. Oh, interesting. That kind
30:59
of leads into my next question here, just regarding
31:02
the design of social media platforms. I think
31:04
in the news there was, hey, the endless feed
31:07
was one of those things that really just triggered
31:09
people to continue to engage in the product.
31:11
Are there other things like that that maybe social
31:13
media companies are using to kind of engineer
31:16
this kind of behavior? Yeah, absolutely. So when
31:20
I talk to families about their adolescent and
31:22
they will usually come to me saying something
31:24
like, I cannot get them off of it. Like I can't
31:26
do it. And I've, I've tried everything and it's
31:28
not working. And I usually try to explain two
31:31
different pieces of social media. The first is
31:33
that these apps are designed in order to keep
31:36
you engaged because engagement is what pays them.
31:38
And so for a kid who's already struggling with
31:41
something like maybe dopamine regulation, maybe
31:43
they have ADHD or something like that. These
31:46
apps are providing a lot of dopamine. And so
31:48
in many ways, they're just doing the smartest
31:51
thing that they can in the moment, which is trying
31:54
to regulate their brain levels of dopamine by
31:56
getting it really quickly. I think the other
31:58
piece to think about is adolescence is a developmental
32:02
stage where we are trying to do a couple of really
32:05
important tasks. We're trying to figure out what
32:08
our identity is and how it's different from our
32:10
family. And we're also trying to... form really
32:13
strong interpersonal networks. Your social life
32:17
becomes super important when you're an adolescent,
32:19
if you remember. And that's why those are really
32:21
healthy and good. We want that. It's part of
32:24
becoming an adult. And social media tends to
32:27
give instant access to both of those. developmental
32:30
needs really quickly. So I can try on different
32:33
identities every day on social media. I can feel
32:36
like I have a huge social network by just logging
32:39
onto Instagram. And I think that this is a huge
32:41
reason why so many teens struggle to get off
32:44
of these platforms when their parents are desperate
32:46
for them to. Interesting. And this kind of correlates
32:50
to another thing that's come up that we've noticed,
32:52
where the percentage of youth who report that
32:54
they're feeling a sense of connectedness or belonging.
32:57
It's declined in recent years. And then you're
32:59
saying, hey, you know, they're able to interact
33:01
with their peers. And that does provide that
33:04
sense of connection. How do you see social media
33:07
influencing feelings of loneliness and isolation
33:09
for youth then? Yeah. So I think it can kind
33:13
of be like a chicken and egg issue where we know
33:16
that kids who are already lonely are more likely
33:20
to feel lonely when they use social media, especially
33:23
passively. If they're using that to cope, it's
33:26
likely to increase that feeling of loneliness
33:27
because we're seeing all of our friends doing
33:30
all these seemingly very fun things while we're,
33:33
you know, I don't know, sitting at home living
33:35
our regular life. We also know that kids who
33:37
are already doing well socially feel like social
33:40
media kind of adds into that overall social well
33:44
-being. They're also more likely to be using
33:46
it actively. So DMing or talking back and forth,
33:50
interacting with other people. Yeah, not that
33:52
passive behavior that you were just talking about.
33:54
Yeah, exactly. Exactly. Yeah. So it can be both
33:58
a tool for connection, but also a real source
34:02
of disconnection and feeling alone. Gotcha. Can
34:05
you think of any groups that are negatively impacted
34:08
by the effects of social media? You know, you'd
34:11
mentioned that there are some folks who might
34:13
have like a pre -existing mental health condition.
34:16
Can you think of any other maybe segments of
34:18
the population that might be more adversely impacted?
34:21
Yeah. So really the populations that we see as
34:26
being most vulnerable offline are also the same
34:28
ones that are the most vulnerable online. So
34:31
I mentioned. pre -adolescent girls, particularly
34:35
girls who already are developing maybe some body
34:37
image concerns, those are going to be a group
34:40
that's going to be more negatively impacted in
34:42
the research. We also know that LGBTQ plus kids
34:46
or gender minority kids are more likely to spend
34:49
time on social media or on their screens in general.
34:52
And this is likely because they're looking for
34:55
community and affiliation and the internet is
34:57
actually a really great place to find that. But
35:00
we also know that They are some of the more vulnerable
35:02
populations. Any kid who already has anxiety
35:05
or depression, I like to say that social media
35:08
or screen use is like a magnifying glass which
35:10
is going to amplify what's already there. And
35:13
we also know that income plays a role in screen
35:16
time. So lower income kids are more likely to
35:19
be using their screens more because there might
35:22
be less bandwidth for supervision and that kind
35:24
of thing. And they're also more likely to report
35:26
that they... their online world is impacting
35:29
their offline world in a not so great way. This
35:32
leads to our next question is, you know, what
35:35
interventions can be effective at reducing social
35:37
media usage or limiting screen time and, you
35:40
know, maybe helping increase somebody's mental
35:43
health? There's a couple of things to think about.
35:46
I find that parents often want to know exactly
35:49
how many hours their kids should be on the phone
35:51
and how can they take it away after those hours
35:53
have passed. And I very much understand that
35:56
impulse. What we've seen in the research in general,
35:59
though, is that kind of this over control, restrictive
36:02
parental monitoring of technology does not seem
36:06
to have our best outcomes. What has best outcomes
36:09
is when we're able to have a relationship where
36:12
we talk about media openly and we're not afraid
36:14
to come to our parent and say, hey, I saw this
36:17
thing online that freaked me out. I typically
36:19
teach families to think. Instead of exact minutes,
36:23
think about what are the developmental tasks
36:25
that my kid needs for successful development
36:30
at this age. These are usually things like enough
36:32
sleep, eating food, doing their schoolwork, seeing
36:35
friends in person, moving their body. And if
36:38
those developmental tasks are being met, then
36:41
have screen time fit in around them, as opposed
36:44
to thinking about like you get 26 minutes of
36:46
Instagram, which I think can be stressful for
36:48
everybody. But more focusing on like, how can
36:51
I make sure that those developmental tasks are
36:53
being met? I often tell parents that it's not
36:55
the screen necessarily specifically that might
37:00
be causing the problem. It's what the screen
37:01
is replacing. So we know that kids who use more
37:04
screens are more physically inactive. And all
37:06
of, you know, if you're not active, you're not
37:08
seeing your friends, you're not eating well,
37:09
you're not sleeping well. I mean, that is a recipe
37:11
for your mood not doing super hot afterward.
37:15
So those are some options, I would say. The American
37:19
Academy of Pediatrics has a wonderful family
37:22
media plan. If you just pop into Google AAP family
37:27
media plan, it's the first tab, and you can work
37:31
on it as a family. and decide what your values
37:34
are for technology and how you're going to engage
37:36
with it. And this includes all members of the
37:38
family, not just the kid. I usually say to do
37:41
this at a time when everyone's feeling pretty
37:43
neutral as opposed to when we're in the heat
37:45
of an argument about technology. Like maybe there's
37:48
a croissant involved. We're all feeling really
37:50
collaborative in that moment because it can be
37:54
a tough thing to talk about. We know that the
37:57
more we're able to co -view content with our
37:59
kid, the better the outcome. Kids just like one
38:03
-on -one staring at their device is very different
38:04
from kid and parent looking at their device together
38:07
and interacting about it. Same with like a family
38:09
movie night or joining your kid in their video
38:12
game playing. These do a couple of things. A,
38:15
it gives you time to connect with your kid and
38:17
it's not just them and their device. But I think
38:20
most importantly, it brings you into their online
38:23
world, which is really what we want is for them
38:27
to feel safe. for you to be a part of their online
38:31
world. Maybe you follow them on Instagram. We
38:34
just know from the research that parents who
38:36
are involved in this way, those kids have the
38:38
best outcomes. So I typically recommend co -viewing
38:41
as much as we can. And when you're co -viewing,
38:43
being the chillest version of yourself. So you're
38:48
going to want to just like jump in and be like,
38:50
oh my God, that's awful. Like, what are you watching?
38:53
And my recommendation is to, for the moment.
38:56
tuck that away and instead get really curious
38:59
about what you're seeing on the screen so how
39:02
do we feel after scrolling for this long or what
39:06
do you think about that chat that's going on
39:08
in your video game as opposed to jumping in and
39:11
and criticizing because that can make kids less
39:14
likely to come to us right if they feel like
39:17
they're being judged that's not a great way to
39:19
start that conversation yeah and it's hard because
39:22
you're going to see things where you're like
39:23
what in the world but uh sticking with it and
39:27
just getting very curious. Gotcha. So beyond
39:30
the individual level, I mean, that's a lot of
39:31
stuff that, you know, a parent could do with
39:33
their child. But can you think of anything that,
39:35
you know, maybe at a systemic level or like a
39:37
policy level that you would want to see kind
39:40
of addressing these social media concerns? I
39:43
think at a policy level, there's lots of different
39:46
angles to this, right? So we know that Australia
39:49
rolled out that policy of, you know, no social
39:52
media under 16. Some people were really happy
39:57
about that and wished it could be implemented
39:58
here. Other people felt like it wasn't going
40:01
to do anything because you can just lie about
40:02
your age. Right, and then kids will find a way
40:05
around it. Yeah, exactly. I think in general,
40:07
we need to have pauses on the way that we're
40:11
able to engage with media. So I don't think that
40:13
getting connection through social media is a
40:15
problem. But I do think that things like endless
40:17
scrolling make it difficult, especially for kids
40:20
with pre -existing mental health issues, to get
40:22
off of the screen, off of social media. And so
40:25
if I were to create a policy, it would not be
40:27
eliminating the social media, but instead making
40:30
it so that it's not constantly feeding you new
40:34
information and instead has a pause point where
40:38
there's no more information to be gleaned. So
40:40
I would be remiss if I did not ask you on a personal
40:44
level here, what would you do to limit your own
40:48
social media usage? talking about this more about
40:51
myself because i have definitely struggled with
40:54
you know hey there's reddit and it's an endless
40:57
feed and it will just give you all the content
40:59
that you want and trying to limit that myself
41:01
has been a struggle so i've i've done things
41:03
like you know changed my phone so that it's a
41:05
grayscale so it's less appealing are there other
41:07
things that you know somebody else might want
41:09
to do if they're trying to you know break their
41:10
own social media stranglehold. Totally. I think
41:15
that brings up a good point that we also know
41:16
that the modeling we do impacts how much our
41:19
kids use their screen. So if we're modeling that
41:22
we're on our device at dinner, we can't super
41:26
expect our kid not to be doing the same thing.
41:28
So having a moment of self -reflection is helpful.
41:32
I think similarly to you, I find myself doom
41:35
scrolling all the time. That's kind of how they
41:38
were designed. I would recommend for parents,
41:41
if you find yourself in one of those moments,
41:43
modeling, checking in with your emotions afterwards.
41:45
So like, whoa, I just got like really sucked
41:48
into a rabbit hole there. My body feels kind
41:50
of like achy and like I think I need to go take
41:52
a step outside. So just modeling, like understanding
41:55
how it felt to engage with different media. I
41:59
think the other piece is for yourself. I can't
42:02
remember the exact study, but I do remember seeing
42:03
a study that said that those time limits on apps
42:06
actually increase a lot of time. That has been
42:09
my experience. I can't remember why, but yeah,
42:11
that was something that I saw. And that has also
42:14
been my experience. What's been helpful for me
42:16
on a personal level is to, instead of like having
42:20
time limits, having certain spaces or time periods
42:23
where small screens are not an option. So some
42:29
families love things like Ope. Phone goes to
42:32
take a nap when you enter the dining room or
42:34
phone does not go upstairs. And this is our screen
42:38
free zone. I think I you can choose like, OK,
42:43
I am I'm going to do offline activities from
42:46
this time to this time. So it's hopefully feeling
42:49
a little bit more additive as opposed to like
42:50
something you're restricting yourself from and
42:53
just checking in with yourself when you have.
42:55
those screen free times like do you feel better
42:57
how was your sleep like did that help at all
43:00
what did you find yourself engaging in instead
43:01
of your screen what did that kind of necessary
43:04
boredom bring out in you and is it something
43:06
that you liked because often it is that's fantastic
43:09
advice I guess the main thing I'd want to add
43:12
is that our goal is not to never have our kids
43:16
see a screen again because that's just not realistic
43:18
in our current world, but rather to have them
43:23
be able to engage with social media or engage
43:25
online in a way that allows them to become a
43:28
healthy digital citizen as adults. And so our
43:31
goal is not actually to figure out exactly the
43:36
number of minutes that they need to have, but
43:38
rather to figure out how can I engage with Instagram
43:41
in a way that makes me and my body and my emotions
43:43
feel good, as opposed to feel more lonely or
43:47
more depressed. I'll also say if you have a kid
43:50
who's already struggling with mental health issues
43:51
or is maybe one of those groups that I mentioned
43:53
earlier, it can be important that if we're removing
43:58
a screen, we're adding something else in in order
44:00
to help regulate. So if I am just taking away
44:03
screens and that's the only way my kid has ever
44:05
known how to regulate, that's going to be a lot
44:08
more difficult than if I'm taking away screens
44:10
and my kid has a couple of tools in his toolbox
44:12
to still regulate his emotions. As we're taking
44:18
away, we also need to add back. That's been my
44:20
own personal experience as well. One of the things
44:22
I noticed when I cut down on my social media
44:24
usage was like, I have this time. Like, what
44:27
am I supposed to be doing with this time? Into
44:30
the habit of reading stuff and actually engaging
44:32
with a novel and things like that. That's been
44:34
helpful. Dr. Sarah Taylor Cavalier, thank you
44:37
so much for joining us. We really appreciate
44:38
you taking the time. Of course. Thanks so much.
44:41
Appreciate it. Do you have a question about public
44:46
health in Larimer County or a topic you'd like
44:49
us to discuss? Let us know. Email us at healthiertogetheratlarimer
44:54
.org. Thanks for listening, Larimer County. Until
44:57
next week, stay well, stay connected, and remember,
44:59
we really are healthier together.