Dr Bernadka Dubicka, Consultant Child and Adolescent Psychiatrist, Pennine Care NHS Foundation Trust and Chair, Child and Adolescent Faculty, Royal College of Psychiatrists discusses the impact of screen media on children and young people.

In 2018, the Royal College of Psychiatrists held a debate for young people about social media, a subject of their own choosing. The young people spoke eloquently but had differing views. One young person held up his smartphone and stated ‘this is my heroin – it’s the heroin of our generation’. In contrast, another young person argued ‘I don’t agree – this is my life line, I am a looked after child, living on my own, and it’s the only way I have of keeping in touch with my family and friends’.

Therein lies the conundrum. In the United Kingdom, this debate is played out regularly in our media, often with similarly polarised positions. Much of the debate has centred around the impact of screen time; however, this overly simplifies the relationship that young people have with screens.

The benefits of screens and new technologies are multiple, from social connectivity to education, life opportunities, mental health support and entertainment, to name but a few. Technology has been harnessed for therapies such as virtual reality for anxiety and psychosis, self-help in depression and anxiety, online counselling and improving diagnosis, although much more research is required in children and adolescents.

However, multiple concerns exist around the widespread use of screen media and the effects on young people. With regard to screen time, the evidence of any harms at the general population level has been reported as minimal, although there is evidence that deactivation of Facebook in adults can result in subjective improvements in wellbeing.

Increasing concerns exist however about a range of potential harms in vulnerable young people. For example, there is evidence that young people who experience more adversity in their offline lives are more likely to experience harmful effects of screen media, including receiving more negative feedback and difficulties in regulating their Internet usage.

This can lead to a ‘digital divide’ between those who can healthily engage, and potentially benefit from, Internet usage, and those on the other end of the scale, who are particularly vulnerable to adverse effects, and particularly likely to experience negative online interactions. This divide may be partly mediated by parenting: in a European study, parents in wealthier homes were more likely to ‘actively mediate’ what their child did online; however, levels of parental digital literacy were also reported as being important in overcoming this digital divide.

Very young children’s development may be adversely affected by screen use, and the World Health Organization has published guidance advocating the precautionary principle for young children on the basis that the ‘potential benefits of reducing sedentary screen time & time spent restrained outweigh possible harms or costs and may increase health equity by improving health outcomes’.

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Dr Bernadka Dubicka discusses the impact of screen media on children and young people.

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