Big story: down with social media?

06 December 2019

The evidence around the ill effects of social media and long periods of screen time is not straightforward, writes journalist Juliette Astrup. She looks at the latest research on how young people can make the most of online positives and blot out the dark side of the internet.

Stay off screens for at least an hour before bed, recommends the Royal College of Paediatrics and Child Health (RCPCH), following new research that links three or more hours of daily social media use to poor sleep patterns (Scott et al, 2019).

Young people’s brains need a chance to ‘wind down’ and ‘the content they are viewing plus the light emitted from screens can increase brain stimulation and make it difficult to fall asleep’, explains Dr Max Davie, RCPCH officer for health improvement.

As advice goes, this is pretty clear cut. But for many parents, knowing how to manage their children’s usage more generally feels far from straightforward. Here, Max is less prescriptive, maintaining that ‘there is no firm evidence suggesting we should stipulate a specific limit on the amount of time young people spend on screens’. He insists: ‘Screen use isn’t in itself harmful, as long as it doesn’t dictate family life and prevent young people spending time on other fulfilling activities such as socialising with family and friends, exercising or enjoying hobbies.’

Similarly, guidance issued by the UK’s four chief medical officers (CMOs) earlier this year stopped short of usage limits, but recommended keeping mobile devices away from the dinner table and at bedtime, and children taking a break from sedentary screen use every two hours (Davies et al, 2019).

Responding to a review of current evidence (Dickson et al, 2018), the CMOs concluded: ‘This research does not present evidence of a causal relationship between screen-based activities and mental health problems.’ Rather, akin to the RCPCH, they suggest that any detrimental effects of screen time may be caused indirectly as ‘screen time can displace health-promoting activities’ such as exercise and sleep.

Not what, but how

There appears to be a growing consensus around the use of social media, and screen time more generally, that harms arise through the way in which the internet is used.

The recently published State of the nation report looking at the wellbeing of children and young people in England finds that social media use is not directly harming children’s mental health, but highlights the associated risks such as online bullying and lack of sleep (Department for Education (DfE), 2019a).

The report states: ‘Experiences of being bullied, including online bullying, had an association with psychological health about eight times larger than social media use.’

In turn, this chimes with another recent study published in The Lancet that followed nearly 10,000 teenagers, and found that very frequent use of social media affected teenage mental health or wellbeing indirectly, especially in girls, by increasing their exposure to bullying and reducing sleep and physical exercise (Viner et al, 2019).

Responding to the research, Dr Louise Theodosiou, from the Royal College of Psychiatrists’ Child and Adolescent Faculty, called for more studies ‘to understand how we can prevent the more negative impacts of social media, particularly on vulnerable children and young people, and the negative impacts of digital technology generally’.

Taking action to address online harms means walking a tightrope between protecting users and freedom of expression

The dark side of social media

As much as it can be a force for good in our society as a means of social contact and access to advice, education and support, social media also has a dark side – with online abuse, grooming, cyber bullying and trolling barely beneath the surface.

September 2019 saw the release of the shocking documentary Jesy Nelson: Odd one out, detailing the devastation wrought on the Little Mix singer’s mental health by online abuse. More recently, a number of female MPs such as Nicky Morgan and Heidi Allen cited such abuse as among the reasons for their quitting parliament.

Children are particularly vulnerable. The NSPCC (2017) found that one in three children and young people had recently seen violent or hateful behaviour online, one in five had seen sexual content, and one in five had been exposed to bullying.

The potential for social media to expose young people to harmful material was also brought sharply into focus by the tragic suicide of 14-year-old Molly Russell in 2017. Following the discovery of material about self-harm, depression and suicide on her Instagram account, the company banned graphic images of self-harm and built new technology to find it, deleting or reducing the visibility of 834,000 pieces of content in the first three months (Heathman, 2019).

Action and reaction

Instagram has updated its approach since then, announcing at the end of October that it would go further, also removing ‘fictional depictions of self-harm’ including drawings, cartoons and memes about suicide, in addition to any other method ‘promoting’ self-harm (Mosseri, 2019).

However, in taking such steps, the company has faced criticism after blurring out images of healed self-harm scars – prompting a global discussion of what is appropriate and what isn’t under the hashtag #youcantcensormyskin.

Taking action to address such online harms – even seeking to define them – means walking a tightrope, balancing appropriate action to protect users, with the rights of freedom of expression on the other, as Adam Mosseri, head of Instagram, reflects. ‘Two things are true about online communities, and they are in conflict with one another,’ he says. ‘First, the tragic reality is that some young people are influenced in a negative way by what they see online, and as a result they might hurt themselves. This is a real risk.

‘But at the same time, there are many young people who are coming online to get support with the struggles they’re having — like those sharing healed scars or talking about their recovery from an eating disorder. Often these online support networks are the only way to find other people who have shared their experiences.’

There is also the argument that, as driven by user-generated content as it is, social media is merely a mirror or amplifier of society and the communities and individuals within it. As such, is it even fair to lay the blame on the platforms? And, vast and global as they are, how far is it even possible to police them?

‘Parents also need to be aware of what their children are accessing, rather than leaving them to it. we need to be sharing what we know with parents’

Laying down the law

The pace at which the internet has changed our lives has far outstripped not only our ability as a society to resolve the issues it throws up, but also the legislation needed to address them. The government, like the social media companies, is under pressure to fill the gaps.

In April 2019, the Online harms white paper set out the government’s intention to introduce a new mandatory ‘duty of care’, which will require relevant companies to take reasonable steps to keep their users safe and tackle illegal and harmful activity on their services (HM Government, 2019).

And in the summer of 2019, the government consulted on proposals to give Ofcom the power to fine social media firms which host videos, following a new EU directive extending the regulation of TV and video to include online video-sharing platforms for the first time.

The intention to develop proposals to improve internet safety was reiterated in the 2019 Queen’s Speech, although the background briefing indicates that this is likely to be done by placing the onus on tech companies to ‘have the right processes and systems in place to fulfil their obligations rather than penalising them for individual instances of unacceptable content’ (Prime Minister’s Office (PMO), 2019).

The government also refers to ‘additional measures, including a media literacy strategy, to empower users to stay safe online’ (PMO, 2019).

Staying safe

Whether any or all of this will come to pass remains to be seen. In the meantime, tech companies themselves continue to take steps. Instagram for example has been making ‘likes’ on posts private – invisible to the poster’s followers, in several countries this year, and announced in November it would be extending the trial to parts of the US. Facebook too, which owns Instagram, is trialling making ‘likes’ private in Australia, to address concerns that they can lead to anxiety caused by social comparison (Australian Associated Press, 2019).

They are also seeking to educate users: Facebook offers a ‘parents’ portal’ containing advice, and Twitter, in partnership with Unesco, has just published a new learning guide, containing sections on online safety, cyber bullying and controlling your digital footprint (Unesco, 2019).

Until we see the ‘wild west’ of the online world tamed, if that is even possible, learning to navigate it safely must be a priority. And if the government has been slow to progress its Online harms legislation, it has at least moved forward with proposals to educate young people about the dangers.  

As of September 2020, pupils at both primary and secondary schools in England will learn about staying safe online, including keeping personal information private, navigating the virtual world, challenging harmful content and balancing online and offline worlds, as part of the new compulsory relationships and health curriculum (DfE, 2019b).

You have a part to play

Community practitioners too have a role to play helping parents and young people make informed choices to stay safe online, says health visitor Moira Dawson, CPHVA regional rep for the East Midlands: ‘It’s very difficult for parents, and HVs and school nurses – who are often parents themselves – to direct them towards help, such as making use of parental controls on devices to restrict access to certain sites or put in place time limits, or opting for devices aimed specifically at children. Parents also need to be aware of what their children are accessing, rather than leaving them to it.

‘Parents will also quite often hear conflicting messages. For example, when school-age children are set homework online, for many working parents that might mean sitting down to do it after 6pm, not long before bedtime, when the advice is to stay off screens.

‘We need to be sharing what we know with parents, and helping them navigate the advice they are being given.’ Ultimately, parents must judge for themselves how social media and screen time is impacting on their children, and make their own choices around how they incorporate it into family life. But as education, research, guidelines, public discourse and legislature all play catch-up, perhaps the soundest advice remains that of the CMOs earlier this year (Davies et al, 2019): ‘Take a precautionary approach.’  



Australian Associated Press. (2019) Facebook to hide number of likes in trial aimed at improving users' wellbeing. The Guardian. See: (accessed 13 November 2019).

Davies SC, Atherton F, Calderwood C, McBride M. (2019) United Kingdom chief medical officers’ commentary on ‘Screen-based activities and children and young people’s mental health and psychosocial wellbeing: a systematic map of reviews’. See: (accessed 13 November 2019).

Department for Education. (2019a) State of the nation 2019: children and young people’s wellbeing research report. See: (accessed 13 November 2019).

Department for Education. (2019b) Relationships education, relationships and sex education (RSE) and health education. See: (accessed 13 November 2019).

Dickson K, Richardson M, Kwan I, MacDowall W, Burchett H, Stansfield C, Brunton G, Sutcliffe K, Thomas J. (2018) Screen-based activities and children and young people’s mental health: a systematic map of reviews. See: (accessed 13 November 2019).

Heathman A. (2019) Instagram bans self-harm and suicide drawings as platform head pledges to do more. See: (accessed 13 November 2019).

HM Government. (2019) Online harms: white paper. See: (accessed 13 November 2019).

Mosseri A. (2019) Taking more steps to keep the people who use Instagram safe. See: (accessed 13 November 2019).

NSPCC. (2017) Net Aware report 2017: ‘freedom to express myself safely’: exploring how young people navigare opportunities and risks in their online lives. See: (accessed 13 November 2019).

Prime Minister’s Office. (2019) The Queen’s Speech and associated background briefing, on the occasion of the opening of parliament on Monday 14 October. See: (accessed 13 November 2019).

Scott H, Biello SM, Woods HC. (2019) Social media use and adolescent sleep patterns: cross-sectional findings from the UK millennium cohort study. BMJ Open 9(9): e031161. See: (accessed 13 November 2019).

Unesco. (2019) Unesco and Twitter team up for media and information literacy. See: (accessed 13 November 2019).

Viner RM, Gireesh A, Stiglic N, Hudson LD, Goddings A-L, Ward J, Nicholls D. (2019) Roles of cyberbullying, sleep, and physical activity in mediating the effects of social media use on mental health and wellbeing among young people in England: a secondary analysis of longitudinal data.  See: (accessed 13 November 2019).