The rise in social media popularity between 2010 and 2020 is closely linked to the nationwide crash in youth mental health that characterized the 2010s. Lawmakers have increasingly put pressure on the U.S. government to take social media regulation more seriously, with cases involving platforms such as Facebook, Instagram and X (formerly Twitter) Rise to the Supreme Court level.
Yet despite the ubiquity of social media, researchers at Northwestern Medicine and the Ann & Robert H. Lurie Children’s Hospital of Chicago found that in Illinois, emergency department visits and hospitalizations among adolescents for depression and anxiety declined after the COVID-19 lockdown and have leveled off at lower pre-2016 levels.
“We wanted to see if COVID was exacerbating the problem or changing it in any way,” said Joe Feinglass of Northwestern, lead author the study, published August 5 in the American Journal of Emergency Medicine“And the answer was — somewhat to our surprise —that COVID actually reduced emergency room visits, which was expected during the shutdown but continued into 2023.”
The process
The study analyzed all emergency department visits and admissions of Illinois adolescents with a coded primary diagnosis of depression or anxiety disorder between January 2016 and June 2023. Data were collected from 232 hospitals across the state.
The study also assessed patients by zip code and collected local data on the percentage of residents living in poverty. The data show that the decline in visits was smaller for girls than boys, but larger in lower-income areas and for visits to smaller community hospitals.
A potential Factor: Social Media
The authors speculated about what caused the increase and then sustained decline in emergency department visits by young people—but not inpatient psychiatric hospital stays—during the study period.
Feinglass said he was initially unsure what factors correlated with his results, but over time he became convinced that social media use was by far the “most credible” reason for the 2010s.‘ Increase in emergency room visits and hospitalizations for depression and anxiety. Feinglass is a research professor of medicine at Northwestern University’s Feinberg School of Medicine.
“Social media affects the lives of teens and young people day by day, hour by hour,” Feinglass said. “In 2012, about 5% of teens owned a smartphone. By the end of that period, 85% own a smartphone. The number of hours of sleep decreases, interactions with other people decrease. To the extent that you use these screens, your screen time destroys your ability to actually have social interactions.”
The decline in emergency department visits since the pandemic-related closures may indicate that youth social media use has reached its limits, leading to a plateau in emergency department visits and admission rates, he said, adding that the use of smartphones through video chat technology may have created new forms of face-to-face social contact that would not otherwise have been possible.
Other Impact of the pandemic
Although there were strong concerns that school closures could worsen mental health, adolescents’ experiences of time spent at home with families and subsequent anecdotal reports from teachers suggest that school may have become easier, thereby reducing the stressor identified by adolescents as the biggest stressor.
Additionally, The pandemic has helped expand virtual mental health services. “COVID may have led to improvements and innovations in mental health services,” Feinglass said. “With telemedicine, the number of consultations available online and by phone has increased tremendously. Mental health hotlines are also more accessible.”
RELATED: Have young adults recovered mentally from COVID-19?
An ongoing epidemic
Outpatient emergency department visits for depression and anxiety, where patients are sent home rather than hospitalized, fell the most, while inpatient admissions remained constant throughout the study period. The authors say this may be due to the fixed number of psychiatric hospital beds available to young people with mental illness.
However, the number of inpatient hospital admissions shows that the mental health epidemic among adolescents continues, said Feinglass, but the currently stable rate of outpatient Visits may simply reflect a saturation point in social media use by young people.
Further measures: intervene before the crisis comes
The authors say it’s not enough to simply increase the number of psychiatric beds or therapists. Instead, social and cultural conditions must be changed beforehand to change the course of the epidemic. Lead author and chief medical officer at Lurie Children’s Audrey Brewer added that updated pediatric primary care, including mental health screenings, can ensure children receive treatment for mental health problems before they reach a critical point.
“We need to better understand how to shift adolescent mental health care from emergency hospital settings to more effective home and work settings,” Brewer said. “There is also an ongoing debate about how best to limit addictive cell phone and social media use by children and adolescents.”
