For this week’s blog, I have invited Cecelia Hollands, the Director of Clinical Programming for Barber Behavioral Health, to discuss the role of technology in mental health, especially as it relates to children and youth. This is an especially timely topic considering May in Mental Health Awareness Month. Although technology does present challenges, it also, under the right circumstance, has the potential to connect people.

Cecelia is a licensed professional counselor who has worked in mental health in the Erie area for ten years in various roles, including as a psychiatric rehabilitation specialist, mobile therapist, and outpatient therapist.  In addition to her work at the Barber National Institute, Cecelia also serves on the Board of the White Pine Center for Healing. 

I want to thank Cecelia for offering her perspectives and wealth of expertise on this topic.

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Several weeks ago, I presented at a mental health fair to a group of parents on the topic of the role of technology as it pertains to mental health in children and youth.  As I was preparing for the presentation, I began thinking about my own experiences parenting my two-and-a-half-year-old.  I was reminded of an incident that occurred about a month ago, when I had momentarily left my daughter in the living room so that I could retrieve something to drink for her.  As I was filling her sippy cup, I became aware that the theme song from Blippi was playing somewhere in the background.  When I returned to the living room, my daughter was relaxing comfortably on the couch, remote in hand, watching her program.  In the minute or two it had taken me to get her a drink, she had picked up the remote, turned the television on, and selected Blippi from the Netflix menu.  I was stunned!  Though I was amused more than anything else, I was also mildly concerned that, at just two-and-a-half, she had the wherewithal to use the TV independently.  In that moment, I was reminded of just how ubiquitous technology is and how my daughter will never know a time when tablets and smartphones are not part of everyday life.  Research is clear that the question is not whether technology impacts the development of children and adolescents, but how.

            The most current research suggests that children and adolescents who spend more than one hour per day on a mobile device are at increased risk for developing depression and anxiety.  According to the Pew Research Center, 95% of U.S. teens use a smartphone and 45% of those users report that they are online “almost constantly.”  In fact, a study by Common Sense Media found that the average American teenager spends an average of nine hours per day using technology; the average for eight to 12-year-olds was six hours.  Essentially, “the vast majority of American children and adolescents are spending six to nine times more time with technology than is required to begin experiencing negative mental health symptoms” (Common Sense Media).

            In addition to putting children and youth at greater risk of developing depression and anxiety, excessive technology use can also contribute to distractibility, poor emotion regulation, difficulty completing tasks, and difficulty making friends.  Technology use affects us on a neurological level as well and is associated with both transient changes in arousal and mood and long-term changes in behavior and brain function.

            It’s difficult to discuss technology use amongst children and teens without addressing the impact of social media.  Research by the Child Mind Institute supports the hypothesis that social media use can be detrimental to self-esteem.  Excess time spent on social media can lead children and youth to judge their value based on “likes” and increases the likelihood of weight dissatisfaction and self-objectification.  A 2015 poll found that the average 16 to 25-year-old woman will spend over five hours per week taking “selfies.”  Disturbingly, a 2018 poll from the American Academy of Facial Plastic and Reconstructive found that 42% of surgeons were asked by their patients to perform procedures that would improve one’s appearance in selfies.  In fact, there is now a term for children and youth who fixate on their appearance due to social media:  selfie dysmorphia (sometimes called Snapchat dysmorphia).  Fixation on one’s appearance can lead to more serious issues, such as body dysmorphic disorder, anxiety, and depression.

            Social media has also created another pathway for children and teens to bully one another.  Cyberbullying is linked to an increased risk of depression, and frequently, victims suffer in silence, so parents and caregivers may be completely unaware that it is even occurring.  Some studies have shown that the effects of bullying can be as bad as or worse than childhood abuse.  According to research by the Pew Research Center, 46% of youth report having been bullied online.  A similar poll from the Cyberbullying Research Center found that 13% of youth reported having bene perpetrators of cyberbullying.  Interestingly, “bully-victims,” or those who both are targeted and target others, are most at risk for developing depressive symptoms.

            All this is not to say that technology is without merit.  Throughout the pandemic, it was the ability to provide telehealth sessions that enabled clients to continue their mental health treatment without risk of exposure to COVID-19, not to mention the innumerable apps that have been developed to give users instant access to mindfulness exercises, meditation exercises, and psychoeducation on their diagnosis.  Social media can be used as a tool to connect to others via online support groups and for therapists to connect to each other to help clients obtain care with providers who specialize in treating certain diagnoses.  The key is for parents and caregivers to teach children and adolescents how to use technology safely and responsibly.  To establish safe guidelines for technology use:

• Don’t overreact.  Technology isn’t going anywhere, so we need to teach healthy habits early.
• Teach children about responsible online activity, especially in the areas of safety/privacy.  Make sure they know that they can speak to an adult if someone online is engaging them in scary or hurtful information.
• Use your judgment.  Establish tech-free zones and determine what counts as screen time (for example, does doing homework count?  Video chatting with a friend?)
• Protect bedtime.  Limit technology use for 30 minutes before your child or children go to sleep.
• Pay attention.  Discuss with your child what types of sites are off-limits and don’t allow them to have their phone or tablet in their room.
• Teach (and model) good online behavior.  Discuss cyberbullying, what to do if they witness cyberbullying, and over-sharing online.
• Foster real-life friendships.  Help your child develop social skills and “real-life” relationships.

For better or worse, technology is here to stay.  To protect children and youth from technology’s potential deleterious effects on their mental health, parents and caregivers must not only help children learn about safe, balanced, and healthy habits, but also to model those habits on a daily basis.

Cecelia Hollands, MA, LPC