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Health and Medicine
Date November 13, 2024
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Q&A with Dr. Michael Silverstein: How social media can impact child health, and what to do about it

Before a conference on social media’s mental health impacts on children and families, the director of the Hassenfeld Child Health Innovation Institute spoke about the importance of grasping the true nature of social media’s grip.

PROVIDENCE, R.I. [Brown University] — No adult who has tried to compete with social media for a child’s attention will deny that the platforms hold powerful sway over today’s hyper-connected, always-online generation. Yet the precise nature of that influence, and what to do about it, is a matter of not just debate but vast confusion, said Dr. Michael Silverstein, director of the Hassenfeld Child Health Innovation Institute at Brown University. 

“There's been so much out there lately about the impact of social media use on kids’ mental health, and social media is largely assumed to not only be ‘bad’ but also to have a ‘causal’ relationship with mental health problems,” said Silverstein, who is also a professor of health services, policy and practice at Brown’s School of Public Health. “We just don’t know for sure that either of those things are true.”

To better understand the impacts of social media on children’s mental health, Hassenfeld Institute leaders are hosting a conference on Thursday, Nov. 14, in Washington, D.C., that will bring together researchers, medical professionals, scholars from across the country, advocates for parents and children, and policymakers to examine children’s social media use, including benefits, challenges and opportunities for change. 

“The goal is to foster collaboration across sectors and identify opportunities for shared action to improve children’s mental health in the digital age,” Silverstein said. “That includes innovative research strategies that focus on outcomes that matter to families and ultimately allow us to test the effectiveness of mental health promotion approaches.”

Silverstein, whose research focuses on preventing mental illness and who is a vice chair of the U.S. Preventive Services Task Force, spoke in advance of the event about social media and kids’ mental health.

Q: Can you help put the social media phenomenon in context? How does it compare to previous phenomena that were assumed to have negative effects on children’s mental health, such as violent television programs or video games? 

Unlike, say, the video games of yesteryear, social media follows you from school to soccer practice to your friend's house to your house; from the kitchen to the bedroom to the bathroom. This phenomenon can exist and persist in most physical spaces, as well as in a person’s mental space. Let’s say a classmate is being mean to a student at school. Well, the student can get away from that, at least temporarily, by coming home. But if a classmate is being mean to a student over text or social media, they can’t get away from it, even if they leave school. They will still be confronted or reminded by it whenever they turn on or even look at the computer, the phone or the watch they use to interact with others online. That makes it uniquely powerful in terms of potential mental health effects.  

The other difference, related but distinct, is that social media is often experienced through this particular device, a smart phone, that fits into a pocket and has been integrated into the way children are educated in school today. Giving up that device and that technology can have a negative effect on a student’s ability to learn. Many things, both beneficial and negative, co-mingle on these devices and on these social platforms, which makes understanding their effects, and addressing the negative effects, to be very, very complicated.

Q: What do you hope a conference like this will add to the conversation? 

We're hoping to expand our insights and question our assumptions around both what the problem is and what the solutions are. I think we, as people who genuinely want to help improve children’s mental health, are locked into a conversation loop, which goes from thinking that social media is bad and calling for limits on use, to saying that there’s both good and bad about social media and we don’t know enough yet about either to limit use. 

While there are many groups working to better understand and act upon the effects of social media on the developing brain and children’s mental health, they typically take a binary ‘either/or’ approach. That leads to either urging restrictions, or telling parents or teachers to take the phone away (without explaining why or how to do that) or it focuses on the technical aspects of social media platforms that warrant government or industry regulation. Our top goal for this conference is an expansion of perspective that merges and integrates these approaches with new ways of thinking.

Social media follows you from school to soccer practice to your friend's house to your house; from the kitchen to the bedroom to the bathroom. This phenomenon can exist and persist in most physical spaces, as well as in a person’s mental space. That makes it uniquely powerful in terms of potential mental health effects.

Dr. Michael Silverstein Director of Hassenfeld Child Health Innovation Institute; Professor of Health Services, Policy, and Practice
 
Michael Silverstein

Q: Who will be involved in this conversation?

We’ll be hearing from young people about how they experience social media and what they want from adults in terms of helping them use social media in a way that’s better for their mental health. We’ll hear from parent groups about raising children in the age of digital media, and educators and scholars about the impact of social media in the educational setting. In attendance will be leading researchers in this space, including Dr. Jennifer Radesky from the University of Michigan Medical School, who examines the use of mobile and interactive technology by parents and young children, parent-child relationships and child social-emotional development; Elizabeth Burke Bryant, who is working to close disparities in maternal and child health, starting with family mental health, through policy and systems change; and Jaqueline Nesi, a psychologist at Brown who studies the role of social media in adolescents' mental health and development. There will also be policymakers like U.S. Sen. Marsha Blackburn, Sen. Sheldon Whitehouse and Rep. Kim Schrier. We hope to pull together those perspectives and have a conversation about next directions: What else do we need to know, first, and then, where do we need to go? 

Q: How are you thinking about deliverables or next steps?

The meeting is a starting point. I hope that a year from now we will have started two or three programs or pilot studies to elucidate what the problem is as well as how to attack it.

Q: How does this focus fit into the mission of the Hassenfeld Child Health Innovation Institute at Brown?

The Hassenfeld Institute is committed to the elimination of disparities in health. Kids are such an integral part of the society that surrounds them. Largely speaking, they haven't reached the age where the kind of chronic illnesses of adulthood have settled in — most children start off physically healthy but accumulate experiences that impact their health positively and negatively, both in the short term and the long term, and can alter the trajectory of their health.

Earlier in my training, the way that children’s mental health was addressed was by focusing on diagnosable mental health problems, such as bipolar illness or depression. Now when health professionals think about child mental health, we think about it in terms of children's overall wellness: their ability to thrive in school, to have sleepovers with their friends, to maximize their potential as they as they proceed through life. And we think of that as inseparable from their surroundings. Instead of focusing only diagnosing and treating depression in a child, we are also thinking about the child who isn't experiencing depression but who lives in a community or in a household where there are risk factors for depression, and trying to find ways to prevent it. We want to know: How can we surround that child with the best array of activities and resources that give them the most resilience as they proceed through life? 

Q: How can a child’s mental health affect their physical health? 

We know that at the core of any physical ailment that a child may or may not develop later on, mental health is both a risk factor and an amplifier: suboptimal mental health early in a child’s life can predict suboptimal physical health later on in adulthood. And it's been shown time and time again that physical ailments get worse if mental health isn’t optimized. 

At the Hassenfeld Institute, we’re thinking about poor mental health in childhood as a social determinant of health, and we’re focusing on mental illness prevention now to help children live better both now and later. To bring it back to social media: it’s imperative to understand how social media affects children’s mental health so that we can clearly define the problems that exist and come up with effective solutions to those problems — without making things worse or causing new problems. 

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Q-and-A School of Public Health

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