research on the effects of social media on mental health

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Social Media Use and Its Connection to Mental Health: A Systematic Review

Fazida karim.

1 Psychology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA

2 Business & Management, University Sultan Zainal Abidin, Terengganu, MYS

Azeezat A Oyewande

3 Family Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA

4 Family Medicine, Lagos State Health Service Commission/Alimosho General Hospital, Lagos, NGA

Lamis F Abdalla

5 Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA

Reem Chaudhry Ehsanullah

Safeera khan.

Social media are responsible for aggravating mental health problems. This systematic study summarizes the effects of social network usage on mental health. Fifty papers were shortlisted from google scholar databases, and after the application of various inclusion and exclusion criteria, 16 papers were chosen and all papers were evaluated for quality. Eight papers were cross-sectional studies, three were longitudinal studies, two were qualitative studies, and others were systematic reviews. Findings were classified into two outcomes of mental health: anxiety and depression. Social media activity such as time spent to have a positive effect on the mental health domain. However, due to the cross-sectional design and methodological limitations of sampling, there are considerable differences. The structure of social media influences on mental health needs to be further analyzed through qualitative research and vertical cohort studies.

Introduction and background

Human beings are social creatures that require the companionship of others to make progress in life. Thus, being socially connected with other people can relieve stress, anxiety, and sadness, but lack of social connection can pose serious risks to mental health [ 1 ].

Social media

Social media has recently become part of people's daily activities; many of them spend hours each day on Messenger, Instagram, Facebook, and other popular social media. Thus, many researchers and scholars study the impact of social media and applications on various aspects of people’s lives [ 2 ]. Moreover, the number of social media users worldwide in 2019 is 3.484 billion, up 9% year-on-year [ 3 - 5 ]. A statistic in Figure  1  shows the gender distribution of social media audiences worldwide as of January 2020, sorted by platform. It was found that only 38% of Twitter users were male but 61% were using Snapchat. In contrast, females were more likely to use LinkedIn and Facebook. There is no denying that social media has now become an important part of many people's lives. Social media has many positive and enjoyable benefits, but it can also lead to mental health problems. Previous research found that age did not have an effect but gender did; females were much more likely to experience mental health than males [ 6 , 7 ].

Impact on mental health

Mental health is defined as a state of well-being in which people understand their abilities, solve everyday life problems, work well, and make a significant contribution to the lives of their communities [ 8 ]. There is debated presently going on regarding the benefits and negative impacts of social media on mental health [ 9 , 10 ]. Social networking is a crucial element in protecting our mental health. Both the quantity and quality of social relationships affect mental health, health behavior, physical health, and mortality risk [ 9 ]. The Displaced Behavior Theory may help explain why social media shows a connection with mental health. According to the theory, people who spend more time in sedentary behaviors such as social media use have less time for face-to-face social interaction, both of which have been proven to be protective against mental disorders [ 11 , 12 ]. On the other hand, social theories found how social media use affects mental health by influencing how people view, maintain, and interact with their social network [ 13 ]. A number of studies have been conducted on the impacts of social media, and it has been indicated that the prolonged use of social media platforms such as Facebook may be related to negative signs and symptoms of depression, anxiety, and stress [ 10 - 15 ]. Furthermore, social media can create a lot of pressure to create the stereotype that others want to see and also being as popular as others.

The need for a systematic review

Systematic studies can quantitatively and qualitatively identify, aggregate, and evaluate all accessible data to generate a warm and accurate response to the research questions involved [ 4 ]. In addition, many existing systematic studies related to mental health studies have been conducted worldwide. However, only a limited number of studies are integrated with social media and conducted in the context of social science because the available literature heavily focused on medical science [ 6 ]. Because social media is a relatively new phenomenon, the potential links between their use and mental health have not been widely investigated.

This paper attempt to systematically review all the relevant literature with the aim of filling the gap by examining social media impact on mental health, which is sedentary behavior, which, if in excess, raises the risk of health problems [ 7 , 9 , 12 ]. This study is important because it provides information on the extent of the focus of peer review literature, which can assist the researchers in delivering a prospect with the aim of understanding the future attention related to climate change strategies that require scholarly attention. This study is very useful because it provides information on the extent to which peer review literature can assist researchers in presenting prospects with a view to understanding future concerns related to mental health strategies that require scientific attention. The development of the current systematic review is based on the main research question: how does social media affect mental health?

Research strategy

The research was conducted to identify studies analyzing the role of social media on mental health. Google Scholar was used as our main database to find the relevant articles. Keywords that were used for the search were: (1) “social media”, (2) “mental health”, (3) “social media” AND “mental health”, (4) “social networking” AND “mental health”, and (5) “social networking” OR “social media” AND “mental health” (Table  1 ).

Out of the results in Table  1 , a total of 50 articles relevant to the research question were selected. After applying the inclusion and exclusion criteria, duplicate papers were removed, and, finally, a total of 28 articles were selected for review (Figure  2 ).

PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Inclusion and exclusion criteria

Peer-reviewed, full-text research papers from the past five years were included in the review. All selected articles were in English language and any non-peer-reviewed and duplicate papers were excluded from finally selected articles.

Of the 16 selected research papers, there were a research focus on adults, gender, and preadolescents [ 10 - 19 ]. In the design, there were qualitative and quantitative studies [ 15 , 16 ]. There were three systematic reviews and one thematic analysis that explored the better or worse of using social media among adolescents [ 20 - 23 ]. In addition, eight were cross-sectional studies and only three were longitudinal studies [ 24 - 29 ].The meta-analyses included studies published beyond the last five years in this population. Table  2  presents a selection of studies from the review.

IGU, internet gaming disorder; PSMU, problematic social media use

This study has attempted to systematically analyze the existing literature on the effect of social media use on mental health. Although the results of the study were not completely consistent, this review found a general association between social media use and mental health issues. Although there is positive evidence for a link between social media and mental health, the opposite has been reported.

For example, a previous study found no relationship between the amount of time spent on social media and depression or between social media-related activities, such as the number of online friends and the number of “selfies”, and depression [ 29 ]. Similarly, Neira and Barber found that while higher investment in social media (e.g. active social media use) predicted adolescents’ depressive symptoms, no relationship was found between the frequency of social media use and depressed mood [ 28 ].

In the 16 studies, anxiety and depression were the most commonly measured outcome. The prominent risk factors for anxiety and depression emerging from this study comprised time spent, activity, and addiction to social media. In today's world, anxiety is one of the basic mental health problems. People liked and commented on their uploaded photos and videos. In today's age, everyone is immune to the social media context. Some teens experience anxiety from social media related to fear of loss, which causes teens to try to respond and check all their friends' messages and messages on a regular basis.

On the contrary, depression is one of the unintended significances of unnecessary use of social media. In detail, depression is limited not only to Facebooks but also to other social networking sites, which causes psychological problems. A new study found that individuals who are involved in social media, games, texts, mobile phones, etc. are more likely to experience depression.

The previous study found a 70% increase in self-reported depressive symptoms among the group using social media. The other social media influence that causes depression is sexual fun [ 12 ]. The intimacy fun happens when social media promotes putting on a facade that highlights the fun and excitement but does not tell us much about where we are struggling in our daily lives at a deeper level [ 28 ]. Another study revealed that depression and time spent on Facebook by adolescents are positively correlated [ 22 ]. More importantly, symptoms of major depression have been found among the individuals who spent most of their time in online activities and performing image management on social networking sites [ 14 ].

Another study assessed gender differences in associations between social media use and mental health. Females were found to be more addicted to social media as compared with males [ 26 ]. Passive activity in social media use such as reading posts is more strongly associated with depression than doing active use like making posts [ 23 ]. Other important findings of this review suggest that other factors such as interpersonal trust and family functioning may have a greater influence on the symptoms of depression than the frequency of social media use [ 28 , 29 ].

Limitation and suggestion

The limitations and suggestions were identified by the evidence involved in the study and review process. Previously, 7 of the 16 studies were cross-sectional and slightly failed to determine the causal relationship between the variables of interest. Given the evidence from cross-sectional studies, it is not possible to conclude that the use of social networks causes mental health problems. Only three longitudinal studies examined the causal relationship between social media and mental health, which is hard to examine if the mental health problem appeared more pronounced in those who use social media more compared with those who use it less or do not use at all [ 19 , 20 , 24 ]. Next, despite the fact that the proposed relationship between social media and mental health is complex, a few studies investigated mediating factors that may contribute or exacerbate this relationship. Further investigations are required to clarify the underlying factors that help examine why social media has a negative impact on some peoples’ mental health, whereas it has no or positive effect on others’ mental health.

Conclusions

Social media is a new study that is rapidly growing and gaining popularity. Thus, there are many unexplored and unexpected constructive answers associated with it. Lately, studies have found that using social media platforms can have a detrimental effect on the psychological health of its users. However, the extent to which the use of social media impacts the public is yet to be determined. This systematic review has found that social media envy can affect the level of anxiety and depression in individuals. In addition, other potential causes of anxiety and depression have been identified, which require further exploration.

The importance of such findings is to facilitate further research on social media and mental health. In addition, the information obtained from this study can be helpful not only to medical professionals but also to social science research. The findings of this study suggest that potential causal factors from social media can be considered when cooperating with patients who have been diagnosed with anxiety or depression. Also, if the results from this study were used to explore more relationships with another construct, this could potentially enhance the findings to reduce anxiety and depression rates and prevent suicide rates from occurring.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.

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Science News

Social media harms teens’ mental health, mounting evidence shows. what now.

Understanding what is going on in teens’ minds is necessary for targeted policy suggestions

Most teens use social media, often for hours on end. Some social scientists are confident that such use is harming their mental health. Now they want to pinpoint what explains the link.

Carol Yepes/Getty Images

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By Sujata Gupta

February 20, 2024 at 7:30 am

In January, Mark Zuckerberg, CEO of Facebook’s parent company Meta, appeared at a congressional hearing to answer questions about how social media potentially harms children. Zuckerberg opened by saying: “The existing body of scientific work has not shown a causal link between using social media and young people having worse mental health.”

But many social scientists would disagree with that statement. In recent years, studies have started to show a causal link between teen social media use and reduced well-being or mood disorders, chiefly depression and anxiety.

Ironically, one of the most cited studies into this link focused on Facebook.

Researchers delved into whether the platform’s introduction across college campuses in the mid 2000s increased symptoms associated with depression and anxiety. The answer was a clear yes , says MIT economist Alexey Makarin, a coauthor of the study, which appeared in the November 2022 American Economic Review . “There is still a lot to be explored,” Makarin says, but “[to say] there is no causal evidence that social media causes mental health issues, to that I definitely object.”

The concern, and the studies, come from statistics showing that social media use in teens ages 13 to 17 is now almost ubiquitous. Two-thirds of teens report using TikTok, and some 60 percent of teens report using Instagram or Snapchat, a 2022 survey found. (Only 30 percent said they used Facebook.) Another survey showed that girls, on average, allot roughly 3.4 hours per day to TikTok, Instagram and Facebook, compared with roughly 2.1 hours among boys. At the same time, more teens are showing signs of depression than ever, especially girls ( SN: 6/30/23 ).

As more studies show a strong link between these phenomena, some researchers are starting to shift their attention to possible mechanisms. Why does social media use seem to trigger mental health problems? Why are those effects unevenly distributed among different groups, such as girls or young adults? And can the positives of social media be teased out from the negatives to provide more targeted guidance to teens, their caregivers and policymakers?

“You can’t design good public policy if you don’t know why things are happening,” says Scott Cunningham, an economist at Baylor University in Waco, Texas.

Increasing rigor

Concerns over the effects of social media use in children have been circulating for years, resulting in a massive body of scientific literature. But those mostly correlational studies could not show if teen social media use was harming mental health or if teens with mental health problems were using more social media.

Moreover, the findings from such studies were often inconclusive, or the effects on mental health so small as to be inconsequential. In one study that received considerable media attention, psychologists Amy Orben and Andrew Przybylski combined data from three surveys to see if they could find a link between technology use, including social media, and reduced well-being. The duo gauged the well-being of over 355,000 teenagers by focusing on questions around depression, suicidal thinking and self-esteem.

Digital technology use was associated with a slight decrease in adolescent well-being , Orben, now of the University of Cambridge, and Przybylski, of the University of Oxford, reported in 2019 in Nature Human Behaviour . But the duo downplayed that finding, noting that researchers have observed similar drops in adolescent well-being associated with drinking milk, going to the movies or eating potatoes.

Holes have begun to appear in that narrative thanks to newer, more rigorous studies.

In one longitudinal study, researchers — including Orben and Przybylski — used survey data on social media use and well-being from over 17,400 teens and young adults to look at how individuals’ responses to a question gauging life satisfaction changed between 2011 and 2018. And they dug into how the responses varied by gender, age and time spent on social media.

Social media use was associated with a drop in well-being among teens during certain developmental periods, chiefly puberty and young adulthood, the team reported in 2022 in Nature Communications . That translated to lower well-being scores around ages 11 to 13 for girls and ages 14 to 15 for boys. Both groups also reported a drop in well-being around age 19. Moreover, among the older teens, the team found evidence for the Goldilocks Hypothesis: the idea that both too much and too little time spent on social media can harm mental health.

“There’s hardly any effect if you look over everybody. But if you look at specific age groups, at particularly what [Orben] calls ‘windows of sensitivity’ … you see these clear effects,” says L.J. Shrum, a consumer psychologist at HEC Paris who was not involved with this research. His review of studies related to teen social media use and mental health is forthcoming in the Journal of the Association for Consumer Research.

Cause and effect

That longitudinal study hints at causation, researchers say. But one of the clearest ways to pin down cause and effect is through natural or quasi-experiments. For these in-the-wild experiments, researchers must identify situations where the rollout of a societal “treatment” is staggered across space and time. They can then compare outcomes among members of the group who received the treatment to those still in the queue — the control group.

That was the approach Makarin and his team used in their study of Facebook. The researchers homed in on the staggered rollout of Facebook across 775 college campuses from 2004 to 2006. They combined that rollout data with student responses to the National College Health Assessment, a widely used survey of college students’ mental and physical health.

The team then sought to understand if those survey questions captured diagnosable mental health problems. Specifically, they had roughly 500 undergraduate students respond to questions both in the National College Health Assessment and in validated screening tools for depression and anxiety. They found that mental health scores on the assessment predicted scores on the screenings. That suggested that a drop in well-being on the college survey was a good proxy for a corresponding increase in diagnosable mental health disorders. 

Compared with campuses that had not yet gained access to Facebook, college campuses with Facebook experienced a 2 percentage point increase in the number of students who met the diagnostic criteria for anxiety or depression, the team found.

When it comes to showing a causal link between social media use in teens and worse mental health, “that study really is the crown jewel right now,” says Cunningham, who was not involved in that research.

A need for nuance

The social media landscape today is vastly different than the landscape of 20 years ago. Facebook is now optimized for maximum addiction, Shrum says, and other newer platforms, such as Snapchat, Instagram and TikTok, have since copied and built on those features. Paired with the ubiquity of social media in general, the negative effects on mental health may well be larger now.

Moreover, social media research tends to focus on young adults — an easier cohort to study than minors. That needs to change, Cunningham says. “Most of us are worried about our high school kids and younger.” 

And so, researchers must pivot accordingly. Crucially, simple comparisons of social media users and nonusers no longer make sense. As Orben and Przybylski’s 2022 work suggested, a teen not on social media might well feel worse than one who briefly logs on. 

Researchers must also dig into why, and under what circumstances, social media use can harm mental health, Cunningham says. Explanations for this link abound. For instance, social media is thought to crowd out other activities or increase people’s likelihood of comparing themselves unfavorably with others. But big data studies, with their reliance on existing surveys and statistical analyses, cannot address those deeper questions. “These kinds of papers, there’s nothing you can really ask … to find these plausible mechanisms,” Cunningham says.

One ongoing effort to understand social media use from this more nuanced vantage point is the SMART Schools project out of the University of Birmingham in England. Pedagogical expert Victoria Goodyear and her team are comparing mental and physical health outcomes among children who attend schools that have restricted cell phone use to those attending schools without such a policy. The researchers described the protocol of that study of 30 schools and over 1,000 students in the July BMJ Open.

Goodyear and colleagues are also combining that natural experiment with qualitative research. They met with 36 five-person focus groups each consisting of all students, all parents or all educators at six of those schools. The team hopes to learn how students use their phones during the day, how usage practices make students feel, and what the various parties think of restrictions on cell phone use during the school day.

Talking to teens and those in their orbit is the best way to get at the mechanisms by which social media influences well-being — for better or worse, Goodyear says. Moving beyond big data to this more personal approach, however, takes considerable time and effort. “Social media has increased in pace and momentum very, very quickly,” she says. “And research takes a long time to catch up with that process.”

Until that catch-up occurs, though, researchers cannot dole out much advice. “What guidance could we provide to young people, parents and schools to help maintain the positives of social media use?” Goodyear asks. “There’s not concrete evidence yet.”

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• Open access
• Published: 06 July 2023

Pros & cons: impacts of social media on mental health

• Ágnes Zsila 1 , 2 &
• Marc Eric S. Reyes   ORCID: orcid.org/0000-0002-5280-1315 3  

BMC Psychology volume  11 , Article number:  201 ( 2023 ) Cite this article

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The use of social media significantly impacts mental health. It can enhance connection, increase self-esteem, and improve a sense of belonging. But it can also lead to tremendous stress, pressure to compare oneself to others, and increased sadness and isolation. Mindful use is essential to social media consumption.

Social media has become integral to our daily routines: we interact with family members and friends, accept invitations to public events, and join online communities to meet people who share similar preferences using these platforms. Social media has opened a new avenue for social experiences since the early 2000s, extending the possibilities for communication. According to recent research [ 1 ], people spend 2.3 h daily on social media. YouTube, TikTok, Instagram, and Snapchat have become increasingly popular among youth in 2022, and one-third think they spend too much time on these platforms [ 2 ]. The considerable time people spend on social media worldwide has directed researchers’ attention toward the potential benefits and risks. Research shows excessive use is mainly associated with lower psychological well-being [ 3 ]. However, findings also suggest that the quality rather than the quantity of social media use can determine whether the experience will enhance or deteriorate the user’s mental health [ 4 ]. In this collection, we will explore the impact of social media use on mental health by providing comprehensive research perspectives on positive and negative effects.

Social media can provide opportunities to enhance the mental health of users by facilitating social connections and peer support [ 5 ]. Indeed, online communities can provide a space for discussions regarding health conditions, adverse life events, or everyday challenges, which may decrease the sense of stigmatization and increase belongingness and perceived emotional support. Mutual friendships, rewarding social interactions, and humor on social media also reduced stress during the COVID-19 pandemic [ 4 ].

On the other hand, several studies have pointed out the potentially detrimental effects of social media use on mental health. Concerns have been raised that social media may lead to body image dissatisfaction [ 6 ], increase the risk of addiction and cyberbullying involvement [ 5 ], contribute to phubbing behaviors [ 7 ], and negatively affects mood [ 8 ]. Excessive use has increased loneliness, fear of missing out, and decreased subjective well-being and life satisfaction [ 8 ]. Users at risk of social media addiction often report depressive symptoms and lower self-esteem [ 9 ].

Overall, findings regarding the impact of social media on mental health pointed out some essential resources for psychological well-being through rewarding online social interactions. However, there is a need to raise awareness about the possible risks associated with excessive use, which can negatively affect mental health and everyday functioning [ 9 ]. There is neither a negative nor positive consensus regarding the effects of social media on people. However, by teaching people social media literacy, we can maximize their chances of having balanced, safe, and meaningful experiences on these platforms [ 10 ].

We encourage researchers to submit their research articles and contribute to a more differentiated overview of the impact of social media on mental health. BMC Psychology welcomes submissions to its new collection, which promises to present the latest findings in the emerging field of social media research. We seek research papers using qualitative and quantitative methods, focusing on social media users’ positive and negative aspects. We believe this collection will provide a more comprehensive picture of social media’s positive and negative effects on users’ mental health.

Data Availability

Not applicable.

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Acknowledgements

Ágnes Zsila was supported by the ÚNKP-22-4 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.

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Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice

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Introduction

Social media has become a prominent fixture in the lives of many individuals facing the challenges of mental illness. Social media refers broadly to web and mobile platforms that allow individuals to connect with others within a virtual network (such as Facebook, Twitter, Instagram, Snapchat, or LinkedIn), where they can share, co-create, or exchange various forms of digital content, including information, messages, photos, or videos (Ahmed et al. 2019 ). Studies have reported that individuals living with a range of mental disorders, including depression, psychotic disorders, or other severe mental illnesses, use social media platforms at comparable rates as the general population, with use ranging from about 70% among middle-age and older individuals to upwards of 97% among younger individuals (Aschbrenner et al. 2018b ; Birnbaum et al. 2017b ; Brunette et al. 2019 ; Naslund et al. 2016 ). Other exploratory studies have found that many of these individuals with mental illness appear to turn to social media to share their personal experiences, seek information about their mental health and treatment options, and give and receive support from others facing similar mental health challenges (Bucci et al. 2019 ; Naslund et al. 2016b ).

Across the USA and globally, very few people living with mental illness have access to adequate mental health services (Patel et al. 2018 ). The wide reach and near ubiquitous use of social media platforms may afford novel opportunities to address these shortfalls in existing mental health care, by enhancing the quality, availability, and reach of services. Recent studies have explored patterns of social media use, impact of social media use on mental health and wellbeing, and the potential to leverage the popularity and interactive features of social media to enhance the delivery of interventions. However, there remains uncertainty regarding the risks and potential harms of social media for mental health (Orben and Przybylski 2019 ) and how best to weigh these concerns against potential benefits.

In this commentary, we summarized current research on the use of social media among individuals with mental illness, with consideration of the impact of social media on mental wellbeing, as well as early efforts using social media for delivery of evidence-based programs for addressing mental health problems. We searched for recent peer reviewed publications in Medline and Google Scholar using the search terms “mental health” or “mental illness” and “social media,” and searched the reference lists of recent reviews and other relevant studies. We reviewed the risks, potential harms, and necessary safety precautions with using social media for mental health. Overall, our goal was to consider the role of social media as a potentially viable intervention platform for offering support to persons with mental disorders, promoting engagement and retention in care, and enhancing existing mental health services, while balancing the need for safety. Given this broad objective, we did not perform a systematic search of the literature and we did not apply specific inclusion criteria based on study design or type of mental disorder.

Social Media Use and Mental Health

In 2020, there are an estimated 3.8 billion social media users worldwide, representing half the global population (We Are Social 2020 ). Recent studies have shown that individuals with mental disorders are increasingly gaining access to and using mobile devices, such as smartphones (Firth et al. 2015 ; Glick et al. 2016 ; Torous et al. 2014a , b ). Similarly, there is mounting evidence showing high rates of social media use among individuals with mental disorders, including studies looking at engagement with these popular platforms across diverse settings and disorder types. Initial studies from 2015 found that nearly half of a sample of psychiatric patients were social media users, with greater use among younger individuals (Trefflich et al. 2015 ), while 47% of inpatients and outpatients with schizophrenia reported using social media, of which 79% reported at least once-a-week usage of social media websites (Miller et al. 2015 ). Rates of social media use among psychiatric populations have increased in recent years, as reflected in a study with data from 2017 showing comparable rates of social media use (approximately 70%) among individuals with serious mental illness in treatment as compared with low-income groups from the general population (Brunette et al. 2019 ).

Similarly, among individuals with serious mental illness receiving community-based mental health services, a recent study found equivalent rates of social media use as the general population, even exceeding 70% of participants (Naslund et al. 2016 ). Comparable findings were demonstrated among middle-age and older individuals with mental illness accessing services at peer support agencies, where 72% of respondents reported using social media (Aschbrenner et al. 2018b ). Similar results, with 68% of those with first episode psychosis using social media daily were reported in another study (Abdel-Baki et al. 2017 ).

Individuals who self-identified as having a schizophrenia spectrum disorder responded to a survey shared through the National Alliance of Mental Illness (NAMI) and reported that visiting social media sites was one of their most common activities when using digital devices, taking up roughly 2 h each day (Gay et al. 2016 ). For adolescents and young adults ages 12 to 21 with psychotic disorders and mood disorders, over 97% reported using social media, with average use exceeding 2.5 h per day (Birnbaum et al. 2017b ). Similarly, in a sample of adolescents ages 13–18 recruited from community mental health centers, 98% reported using social media, with YouTube as the most popular platform, followed by Instagram and Snapchat (Aschbrenner et al. 2019 ).

Research has also explored the motivations for using social media as well as the perceived benefits of interacting on these platforms among individuals with mental illness. In the sections that follow (see Table 1 for a summary), we consider three potentially unique features of interacting and connecting with others on social media that may offer benefits for individuals living with mental illness. These include: (1) Facilitate social interaction; (2) Access to a peer support network; and (3) Promote engagement and retention in services.

Facilitate Social Interaction

Social media platforms offer near continuous opportunities to connect and interact with others, regardless of time of day or geographic location. This on demand ease of communication may be especially important for facilitating social interaction among individuals with mental disorders experiencing difficulties interacting in face-to-face settings. For example, impaired social functioning is a common deficit in schizophrenia spectrum disorders, and social media may facilitate communication and interacting with others for these individuals (Torous and Keshavan 2016 ). This was suggested in one study where participants with schizophrenia indicated that social media helped them to interact and socialize more easily (Miller et al. 2015 ). Like other online communication, the ability to connect with others anonymously may be an important feature of social media, especially for individuals living with highly stigmatizing health conditions (Berger et al. 2005 ), such as serious mental disorders (Highton-Williamson et al. 2015 ).

Studies have found that individuals with serious mental disorders (Spinzy et al. 2012 ) as well as young adults with mental illness (Gowen et al. 2012 ) appear to form online relationships and connect with others on social media as often as social media users from the general population. This is an important observation because individuals living with serious mental disorders typically have few social contacts in the offline world and also experience high rates of loneliness (Badcock et al. 2015 ; Giacco et al. 2016 ). Among individuals receiving publicly funded mental health services who use social media, nearly half (47%) reported using these platforms at least weekly to feel less alone (Brusilovskiy et al. 2016 ). In another study of young adults with serious mental illness, most indicated that they used social media to help feel less isolated (Gowen et al. 2012 ). Interestingly, more frequent use of social media among a sample of individuals with serious mental illness was associated with greater community participation, measured as participation in shopping, work, religious activities, or visiting friends and family, as well as greater civic engagement, reflected as voting in local elections (Brusilovskiy et al. 2016 ).

Emerging research also shows that young people with moderate to severe depressive symptoms appear to prefer communicating on social media rather than in-person (Rideout and Fox 2018 ), while other studies have found that some individuals may prefer to seek help for mental health concerns online rather than through in-person encounters (Batterham and Calear 2017 ). In a qualitative study, participants with schizophrenia described greater anonymity, the ability to discover that other people have experienced similar health challenges and reducing fears through greater access to information as important motivations for using the Internet to seek mental health information (Schrank et al. 2010 ). Because social media does not require the immediate responses necessary in face-to-face communication, it may overcome deficits with social interaction due to psychotic symptoms that typically adversely affect face-to-face conversations (Docherty et al. 1996 ). Online social interactions may not require the use of non-verbal cues, particularly in the initial stages of interaction (Kiesler et al. 1984 ), with interactions being more fluid and within the control of users, thereby overcoming possible social anxieties linked to in-person interaction (Indian and Grieve 2014 ). Furthermore, many individuals with serious mental disorders can experience symptoms including passive social withdrawal, blunted affect, and attentional impairment, as well as active social avoidance due to hallucinations or other concerns (Hansen et al. 2009 ), thus potentially reinforcing the relative advantage, as perceived by users, of using social media over in person conversations.

Access to a Peer Support Network

There is growing recognition about the role that social media channels could play in enabling peer support (Bucci et al. 2019 ; Naslund et al. 2016b ), referred to as a system of mutual giving and receiving where individuals who have endured the difficulties of mental illness can offer hope, friendship, and support to others facing similar challenges (Davidson et al. 2006 ; Mead et al. 2001 ). Initial studies exploring use of online self-help forums among individuals with serious mental illnesses have found that individuals with schizophrenia appeared to use these forums for self-disclosure and sharing personal experiences, in addition to providing or requesting information, describing symptoms, or discussing medication (Haker et al. 2005 ), while users with bipolar disorder reported using these forums to ask for help from others about their illness (Vayreda and Antaki 2009 ). More recently, in a review of online social networking in people with psychosis, Highton-Williamson et al. ( 2015 ) highlight that an important purpose of such online connections was to establish new friendships, pursue romantic relationships, maintain existing relationships or reconnect with people, and seek online peer support from others with lived experience (Highton-Williamson et al. 2015 ).

Online peer support among individuals with mental illness has been further elaborated in various studies. In a content analysis of comments posted to YouTube by individuals who self-identified as having a serious mental illness, there appeared to be opportunities to feel less alone, provide hope, find support and learn through mutual reciprocity, and share coping strategies for day-to-day challenges of living with a mental illness (Naslund et al. 2014 ). In another study, Chang ( 2009 ) delineated various communication patterns in an online psychosis peer-support group (Chang 2009 ). Specifically, different forms of support emerged, including “informational support” about medication use or contacting mental health providers, “esteem support” involving positive comments for encouragement, “network support” for sharing similar experiences, and “emotional support” to express understanding of a peer’s situation and offer hope or confidence (Chang 2009 ). Bauer et al. ( 2013 ) reported that the main interest in online self-help forums for patients with bipolar disorder was to share emotions with others, allow exchange of information, and benefit by being part of an online social group (Bauer et al. 2013 ).

For individuals who openly discuss mental health problems on Twitter, a study by Berry et al. ( 2017 ) found that this served as an important opportunity to seek support and to hear about the experiences of others (Berry et al. 2017 ). In a survey of social media users with mental illness, respondents reported that sharing personal experiences about living with mental illness and opportunities to learn about strategies for coping with mental illness from others were important reasons for using social media (Naslund et al. 2017 ). A computational study of mental health awareness campaigns on Twitter provides further support with inspirational posts and tips being the most shared (Saha et al. 2019 ). Taken together, these studies offer insights about the potential for social media to facilitate access to an informal peer support network, though more research is necessary to examine how these online interactions may impact intentions to seek care, illness self-management, and clinically meaningful outcomes in offline contexts.

Promote Engagement and Retention in Services

Many individuals living with mental disorders have expressed interest in using social media platforms for seeking mental health information (Lal et al. 2018 ), connecting with mental health providers (Birnbaum et al. 2017b ), and accessing evidence-based mental health services delivered over social media specifically for coping with mental health symptoms or for promoting overall health and wellbeing (Naslund et al. 2017 ). With the widespread use of social media among individuals living with mental illness combined with the potential to facilitate social interaction and connect with supportive peers, as summarized above, it may be possible to leverage the popular features of social media to enhance existing mental health programs and services. A recent review by Biagianti et al. ( 2018 ) found that peer-to-peer support appeared to offer feasible and acceptable ways to augment digital mental health interventions for individuals with psychotic disorders by specifically improving engagement, compliance, and adherence to the interventions and may also improve perceived social support (Biagianti et al. 2018 ).

Among digital programs that have incorporated peer-to-peer social networking consistent with popular features on social media platforms, a pilot study of the HORYZONS online psychosocial intervention demonstrated significant reductions in depression among patients with first episode psychosis (Alvarez-Jimenez et al. 2013 ). Importantly, the majority of participants (95%) in this study engaged with the peer-to-peer networking feature of the program, with many reporting increases in perceived social connectedness and empowerment in their recovery process (Alvarez-Jimenez et al. 2013 ). This moderated online social therapy program is now being evaluated as part of a large randomized controlled trial for maintaining treatment effects from first episode psychosis services (Alvarez-Jimenez et al. 2019 ).

Other early efforts have demonstrated that use of digital environments with the interactive peer-to-peer features of social media can enhance social functioning and wellbeing in young people at high risk of psychosis (Alvarez-Jimenez et al. 2018 ). There has also been a recent emergence of several mobile apps to support symptom monitoring and relapse prevention in psychotic disorders. Among these apps, the development of PRIME (Personalized Real-time Intervention for Motivational Enhancement) has involved working closely with young people with schizophrenia to ensure that the design of the app has the look and feel of mainstream social media platforms, as opposed to existing clinical tools (Schlosser et al. 2016 ). This unique approach to the design of the app is aimed at promoting engagement and ensuring that the app can effectively improve motivation and functioning through goal setting and promoting better quality of life of users with schizophrenia (Schlosser et al. 2018 ).

Social media platforms could also be used to promote engagement and participation in in-person services delivered through community mental health settings. For example, the peer-based lifestyle intervention called PeerFIT targets weight loss and improved fitness among individuals living with serious mental illness through a combination of in-person lifestyle classes, exercise groups, and use of digital technologies (Aschbrenner et al. 2016b , c ). The intervention holds tremendous promise as lack of support is one of the largest barriers towards exercise in patients with serious mental illness (Firth et al. 2016 ), and it is now possible to use social media to counter such. Specifically, in PeerFIT, a private Facebook group is closely integrated into the program to offer a closed platform where participants can connect with the lifestyle coaches, access intervention content, and support or encourage each other as they work towards their lifestyle goals (Aschbrenner et al. 2016a ; Naslund et al. 2016a ). To date, this program has demonstrated preliminary effectiveness for meaningfully reducing cardiovascular risk factors that contribute to early mortality in this patient group (Aschbrenner, Naslund, Shevenell, Kinney, et al., 2016), while the Facebook component appears to have increased engagement in the program, while allowing participants who were unable to attend in-person sessions due to other health concerns or competing demands to remain connected with the program (Naslund et al. 2018 ). This lifestyle intervention is currently being evaluated in a randomized controlled trial enrolling young adults with serious mental illness from real world community mental health services settings (Aschbrenner et al. 2018a ).

These examples highlight the promise of incorporating the features of popular social media into existing programs, which may offer opportunities to safely promote engagement and program retention, while achieving improved clinical outcomes. This is an emerging area of research, as evidenced by several important effectiveness trials underway (Alvarez-Jimenez et al. 2019 ; Aschbrenner et al. 2018a ), including efforts to leverage online social networking to support family caregivers of individuals receiving first episode psychosis services (Gleeson et al. 2017 ).

Challenges with Social Media for Mental Health

The science on the role of social media for engaging persons with mental disorders needs a cautionary note on the effects of social media usage on mental health and wellbeing, particularly in adolescents and young adults. While the risks and harms of social media are frequently covered in the popular press and mainstream news reports, careful consideration of the research in this area is necessary. In a review of 43 studies in young people, many benefits of social media were cited, including increased self-esteem and opportunities for self-disclosure (Best et al. 2014 ). Yet, reported negative effects were an increased exposure to harm, social isolation, depressive symptoms, and bullying (Best et al. 2014 ). In the sections that follow (see Table 1 for a summary), we consider three major categories of risk related to use of social media and mental health. These include: (1) Impact on symptoms; (2) Facing hostile interactions; and (3) Consequences for daily life.

Impact on Symptoms

Studies consistently highlight that use of social media, especially heavy use and prolonged time spent on social media platforms, appears to contribute to increased risk for a variety of mental health symptoms and poor wellbeing, especially among young people (Andreassen et al. 2016 ; Kross et al. 2013 ; Woods and Scott 2016 ). This may partly be driven by the detrimental effects of screen time on mental health, including increased severity of anxiety and depressive symptoms, which have been well documented (Stiglic and Viner 2019 ). Recent studies have reported negative effects of social media use on mental health of young people, including social comparison pressure with others and greater feeling of social isolation after being rejected by others on social media (Rideout and Fox 2018 ). In a study of young adults, it was found that negative comparisons with others on Facebook contributed to risk of rumination and subsequent increases in depression symptoms (Feinstein et al. 2013 ). Still, the cross-sectional nature of many screen time and mental health studies makes it challenging to reach causal inferences (Orben and Przybylski 2019 ).

Quantity of social media use is also an important factor, as highlighted in a survey of young adults ages 19 to 32, where more frequent visits to social media platforms each week were correlated with greater depressive symptoms (Lin et al. 2016 ). More time spent using social media is also associated with greater symptoms of anxiety (Vannucci et al. 2017 ). The actual number of platforms accessed also appears to contribute to risk as reflected in another national survey of young adults where use of a large number of social media platforms was associated with negative impact on mental health (Primack et al. 2017 ). Among survey respondents using between 7 and 11 different social media platforms compared with respondents using only 2 or fewer platforms, there were 3 times greater odds of having high levels of depressive symptoms and a 3.2 times greater odds of having high levels of anxiety symptoms (Primack et al. 2017 ).

Many researchers have postulated that worsening mental health attributed to social media use may be because social media replaces face-to-face interactions for young people (Twenge and Campbell 2018 ) and may contribute to greater loneliness (Bucci et al. 2019 ) and negative effects on other aspects of health and wellbeing (Woods and Scott 2016 ). One nationally representative survey of US adolescents found that among respondents who reported more time accessing media such as social media platforms or smartphone devices, there were significantly greater depressive symptoms and increased risk of suicide when compared with adolescents who reported spending more time on non-screen activities, such as in-person social interaction or sports and recreation activities (Twenge et al. 2018 ). For individuals living with more severe mental illnesses, the effects of social media on psychiatric symptoms have received less attention. One study found that participation in chat rooms may contribute to worsening symptoms in young people with psychotic disorders (Mittal et al. 2007 ), while another study of patients with psychosis found that social media use appeared to predict low mood (Berry et al. 2018 ). These studies highlight a clear relationship between social media use and mental health that may not be present in general population studies (Orben and Przybylski 2019 ) and emphasize the need to explore how social media may contribute to symptom severity and whether protective factors may be identified to mitigate these risks.

Facing Hostile Interactions

Popular social media platforms can create potential situations where individuals may be victimized by negative comments or posts. Cyberbullying represents a form of online aggression directed towards specific individuals, such as peers or acquaintances, which is perceived to be most harmful when compared with random hostile comments posted online (Hamm et al. 2015 ). Importantly, cyberbullying on social media consistently shows harmful impact on mental health in the form of increased depressive symptoms as well as worsening of anxiety symptoms, as evidenced in a review of 36 studies among children and young people (Hamm et al. 2015 ). Furthermore, cyberbullying disproportionately impacts females as reflected in a national survey of adolescents in the USA, where females were twice as likely to be victims of cyberbullying compared with males (Alhajji et al. 2019 ). Most studies report cross-sectional associations between cyberbullying and symptoms of depression or anxiety (Hamm et al. 2015 ), though one longitudinal study in Switzerland found that cyberbullying contributed to significantly greater depression over time (Machmutow et al. 2012 ).

For youth ages 10 to 17 who reported major depressive symptomatology, there were over 3 times greater odds of facing online harassment in the last year compared with youth who reported mild or no depressive symptoms (Ybarra 2004 ). Similarly, in a 2018 national survey of young people, respondents ages 14 to 22 with moderate to severe depressive symptoms were more likely to have had negative experiences when using social media and, in particular, were more likely to report having faced hostile comments or being “trolled” from others when compared with respondents without depressive symptoms (31% vs. 14%) (Rideout and Fox 2018 ). As these studies depict risks for victimization on social media and the correlation with poor mental health, it is possible that individuals living with mental illness may also experience greater hostility online compared to individuals without mental illness. This would be consistent with research showing greater risk of hostility, including increased violence and discrimination, directed towards individuals living with mental illness in in-person contexts, especially targeted at those with severe mental illnesses (Goodman et al. 1999 ).

A computational study of mental health awareness campaigns on Twitter reported that while stigmatizing content was rare, it was actually the most spread (re-tweeted) demonstrating that harmful content can travel quickly on social media (Saha et al. 2019 ). Another study was able to map the spread of social media posts about the Blue Whale Challenge, an alleged game promoting suicide, over Twitter, YouTube, Reddit, Tumblr, and other forums across 127 countries (Sumner et al. 2019 ). These findings show that it is critical to monitor the actual content of social media posts, such as determining whether content is hostile or promotes harm to self or others. This is pertinent because existing research looking at duration of exposure cannot account for the impact of specific types of content on mental health and is insufficient to fully understand the effects of using these platforms on mental health.

Consequences for Daily Life

The ways in which individuals use social media can also impact their offline relationships and everyday activities. To date, reports have described risks of social media use pertaining to privacy, confidentiality, and unintended consequences of disclosing personal health information online (Torous and Keshavan 2016 ). Additionally, concerns have been raised about poor quality or misleading health information shared on social media and that social media users may not be aware of misleading information or conflicts of interest especially when the platforms promote popular content regardless of whether it is from a trustworthy source (Moorhead et al. 2013 ; Ventola 2014 ). For persons living with mental illness, there may be additional risks from using social media. A recent study that specifically explored the perspectives of social media users with serious mental illnesses, including participants with schizophrenia spectrum disorders, bipolar disorder, or major depression, found that over one third of participants expressed concerns about privacy when using social media (Naslund and Aschbrenner 2019 ). The reported risks of social media use were directly related to many aspects of everyday life, including concerns about threats to employment, fear of stigma and being judged, impact on personal relationships, and facing hostility or being hurt (Naslund and Aschbrenner 2019 ). While few studies have specifically explored the dangers of social media use from the perspectives of individuals living with mental illness, it is important to recognize that use of these platforms may contribute to risks that extend beyond worsening symptoms and that can affect different aspects of daily life.

In this commentary, we considered ways in which social media may yield benefits for individuals living with mental illness, while contrasting these with the possible harms. Studies reporting on the threats of social media for individuals with mental illness are mostly cross-sectional, making it difficult to draw conclusions about direction of causation. However, the risks are potentially serious. These risks should be carefully considered in discussions pertaining to use of social media and the broader use of digital mental health technologies, as avenues for mental health promotion or for supporting access to evidence-based programs or mental health services. At this point, it would be premature to view the benefits of social media as outweighing the possible harms, when it is clear from the studies summarized here that social media use can have negative effects on mental health symptoms, can potentially expose individuals to hurtful content and hostile interactions, and can result in serious consequences for daily life, including threats to employment and personal relationships. Despite these risks, it is also necessary to recognize that individuals with mental illness will continue to use social media given the ease of accessing these platforms and the immense popularity of online social networking. With this in mind, it may be ideal to raise awareness about these possible risks so that individuals can implement necessary safeguards, while highlighting that there could also be benefits. Being aware of the risks is an essential first step, before then recognizing that use of these popular platforms could contribute to some benefits like finding meaningful interactions with others, engaging with peer support networks, and accessing information and services.

To capitalize on the widespread use of social media and to achieve the promise that these platforms may hold for supporting the delivery of targeted mental health interventions, there is need for continued research to better understand how individuals living with mental illness use social media. Such efforts could inform safety measures and also encourage use of social media in ways that maximize potential benefits while minimizing risk of harm. It will be important to recognize how gender and race contribute to differences in use of social media for seeking mental health information or accessing interventions, as well as differences in how social media might impact mental wellbeing. For example, a national survey of 14- to 22-year olds in the USA found that female respondents were more likely to search online for information about depression or anxiety and to try to connect with other people online who share similar mental health concerns when compared with male respondents (Rideout and Fox 2018 ). In the same survey, there did not appear to be any differences between racial or ethnic groups in social media use for seeking mental health information (Rideout and Fox 2018 ). Social media use also appears to have a differential impact on mental health and emotional wellbeing between females and males (Booker et al. 2018 ), highlighting the need to explore unique experiences between gender groups to inform tailored programs and services. Research shows that lesbian, gay, bisexual, or transgender individuals frequently use social media for searching for health information and may be more likely compared with heterosexual individuals to share their own personal health experiences with others online (Rideout and Fox 2018 ). Less is known about use of social media for seeking support for mental health concerns among gender minorities, though this is an important area for further investigation as these individuals are more likely to experience mental health problems and online victimization when compared with heterosexual individuals (Mereish et al. 2019 ).

Similarly, efforts are needed to explore the relationship between social media use and mental health among ethnic and racial minorities. A recent study found that exposure to traumatic online content on social media showing violence or hateful posts directed at racial minorities contributed to increases in psychological distress, PTSD symptoms, and depression among African American and Latinx adolescents in the USA (Tynes et al. 2019 ). These concerns are contrasted by growing interest in the potential for new technologies including social media to expand the reach of services to underrepresented minority groups (Schueller et al. 2019 ). Therefore, greater attention is needed to understanding the perspectives of ethnic and racial minorities to inform effective and safe use of social media for mental health promotion efforts.

Research has found that individuals living with mental illness have expressed interest in accessing mental health services through social media platforms. A survey of social media users with mental illness found that most respondents were interested in accessing programs for mental health on social media targeting symptom management, health promotion, and support for communicating with health care providers and interacting with the health system (Naslund et al. 2017 ). Importantly, individuals with serious mental illness have also emphasized that any mental health intervention on social media would need to be moderated by someone with adequate training and credentials, would need to have ground rules and ways to promote safety and minimize risks, and importantly, would need to be free and easy to access.

An important strength with this commentary is that it combines a range of studies broadly covering the topic of social media and mental health. We have provided a summary of recent evidence in a rapidly advancing field with the goal of presenting unique ways that social media could offer benefits for individuals with mental illness, while also acknowledging the potentially serious risks and the need for further investigation. There are also several limitations with this commentary that warrant consideration. Importantly, as we aimed to address this broad objective, we did not conduct a systematic review of the literature. Therefore, the studies reported here are not exhaustive, and there may be additional relevant studies that were not included. Additionally, we only summarized published studies, and as a result, any reports from the private sector or websites from different organizations using social media or other apps containing social media–like features would have been omitted. Although, it is difficult to rigorously summarize work from the private sector, sometimes referred to as “gray literature,” because many of these projects are unpublished and are likely selective in their reporting of findings given the target audience may be shareholders or consumers.

Another notable limitation is that we did not assess risk of bias in the studies summarized in this commentary. We found many studies that highlighted risks associated with social media use for individuals living with mental illness; however, few studies of programs or interventions reported negative findings, suggesting the possibility that negative findings may go unpublished. This concern highlights the need for a future more rigorous review of the literature with careful consideration of bias and an accompanying quality assessment. Most of the studies that we described were from the USA, as well as from other higher income settings such as Australia or the UK. Despite the global reach of social media platforms, there is a dearth of research on the impact of these platforms on the mental health of individuals in diverse settings, as well as the ways in which social media could support mental health services in lower income countries where there is virtually no access to mental health providers. Future research is necessary to explore the opportunities and risks for social media to support mental health promotion in low-income and middle-income countries, especially as these countries face a disproportionate share of the global burden of mental disorders, yet account for the majority of social media users worldwide (Naslund et al. 2019 ).

Future Directions for Social Media and Mental Health

As we consider future research directions, the near ubiquitous social media use also yields new opportunities to study the onset and manifestation of mental health symptoms and illness severity earlier than traditional clinical assessments. There is an emerging field of research referred to as “digital phenotyping” aimed at capturing how individuals interact with their digital devices, including social media platforms, in order to study patterns of illness and identify optimal time points for intervention (Jain et al. 2015 ; Onnela and Rauch 2016 ). Given that most people access social media via mobile devices, digital phenotyping and social media are closely related (Torous et al. 2019 ). To date, the emergence of machine learning, a powerful computational method involving statistical and mathematical algorithms (Shatte et al. 2019 ), has made it possible to study large quantities of data captured from popular social media platforms such as Twitter or Instagram to illuminate various features of mental health (Manikonda and De Choudhury 2017 ; Reece et al. 2017 ). Specifically, conversations on Twitter have been analyzed to characterize the onset of depression (De Choudhury et al. 2013 ) as well as detecting users’ mood and affective states (De Choudhury et al. 2012 ), while photos posted to Instagram can yield insights for predicting depression (Reece and Danforth 2017 ). The intersection of social media and digital phenotyping will likely add new levels of context to social media use in the near future.

Several studies have also demonstrated that when compared with a control group, Twitter users with a self-disclosed diagnosis of schizophrenia show unique online communication patterns (Birnbaum et al. 2017a ), including more frequent discussion of tobacco use (Hswen et al. 2017 ), symptoms of depression and anxiety (Hswen et al. 2018b ), and suicide (Hswen et al. 2018a ). Another study found that online disclosures about mental illness appeared beneficial as reflected by fewer posts about symptoms following self-disclosure (Ernala et al. 2017 ). Each of these examples offers early insights into the potential to leverage widely available online data for better understanding the onset and course of mental illness. It is possible that social media data could be used to supplement additional digital data, such as continuous monitoring using smartphone apps or smart watches, to generate a more comprehensive “digital phenotype” to predict relapse and identify high-risk health behaviors among individuals living with mental illness (Torous et al. 2019 ).

With research increasingly showing the valuable insights that social media data can yield about mental health states, greater attention to the ethical concerns with using individual data in this way is necessary (Chancellor et al. 2019 ). For instance, data is typically captured from social media platforms without the consent or awareness of users (Bidargaddi et al. 2017 ), which is especially crucial when the data relates to a socially stigmatizing health condition such as mental illness (Guntuku et al. 2017 ). Precautions are needed to ensure that data is not made identifiable in ways that were not originally intended by the user who posted the content as this could place an individual at risk of harm or divulge sensitive health information (Webb et al. 2017 ; Williams et al. 2017 ). Promising approaches for minimizing these risks include supporting the participation of individuals with expertise in privacy, clinicians, and the target individuals with mental illness throughout the collection of data, development of predictive algorithms, and interpretation of findings (Chancellor et al. 2019 ).

In recognizing that many individuals living with mental illness use social media to search for information about their mental health, it is possible that they may also want to ask their clinicians about what they find online to check if the information is reliable and trustworthy. Alternatively, many individuals may feel embarrassed or reluctant to talk to their clinicians about using social media to find mental health information out of concerns of being judged or dismissed. Therefore, mental health clinicians may be ideally positioned to talk with their patients about using social media and offer recommendations to promote safe use of these sites while also respecting their patients’ autonomy and personal motivations for using these popular platforms. Given the gap in clinical knowledge about the impact of social media on mental health, clinicians should be aware of the many potential risks so that they can inform their patients while remaining open to the possibility that their patients may also experience benefits through use of these platforms. As awareness of these risks grows, it may be possible that new protections will be put in place by industry or through new policies that will make the social media environment safer. It is hard to estimate a number needed to treat or harm today given the nascent state of research, which means the patient and clinician need to weigh the choice on a personal level. Thus, offering education and information is an important first step in that process. As patients increasingly show interest in accessing mental health information or services through social media, it will be necessary for health systems to recognize social media as a potential avenue for reaching or offering support to patients. This aligns with growing emphasis on the need for greater integration of digital psychiatry, including apps, smartphones, or wearable devices, into patient care and clinical services through institution-wide initiatives and training clinical providers (Hilty et al. 2019 ). Within a learning healthcare environment where research and care are tightly intertwined and feedback between both is rapid, the integration of digital technologies into services may create new opportunities for advancing use of social media for mental health.

As highlighted in this commentary, social media has become an important part of the lives of many individuals living with mental disorders. Many of these individuals use social media to share their lived experiences with mental illness, to seek support from others, and to search for information about treatment recommendations, accessing mental health services and coping with symptoms (Bucci et al. 2019 ; Highton-Williamson et al. 2015 ; Naslund et al. 2016b ). As the field of digital mental health advances, the wide reach, ease of access, and popularity of social media platforms could be used to allow individuals in need of mental health services or facing challenges of mental illness to access evidence-based treatment and support. To achieve this end and to explore whether social media platforms can advance efforts to close the gap in available mental health services in the USA and globally, it will be essential for researchers to work closely with clinicians and with those affected by mental illness to ensure that possible benefits of using social media are carefully weighed against anticipated risks.

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Dr. Naslund is supported by a grant from the National Institute of Mental Health (U19MH113211). Dr. Aschbrenner is supported by a grant from the National Institute of Mental Health (1R01MH110965-01).

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Naslund, J.A., Bondre, A., Torous, J. et al. Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice. J. technol. behav. sci. 5 , 245–257 (2020). https://doi.org/10.1007/s41347-020-00134-x

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Received : 19 October 2019

Revised : 24 February 2020

Accepted : 17 March 2020

Published : 20 April 2020

Issue Date : September 2020

DOI : https://doi.org/10.1007/s41347-020-00134-x

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How Does Social Media Affect Your Mental Health?

Facebook has delayed the development of an Instagram app for children amid questions about its harmful effects on young people’s mental health. Does social media have an impact on your well-being?

By Nicole Daniels

What is your relationship with social media like? Which platforms do you spend the most time on? Which do you stay away from? How often do you log on?

What do you notice about your mental health and well-being when spending time on social networks?

In “ Facebook Delays Instagram App for Users 13 and Younger ,” Adam Satariano and Ryan Mac write about the findings of an internal study conducted by Facebook and what they mean for the Instagram Kids app that the company was developing:

Facebook said on Monday that it had paused development of an Instagram Kids service that would be tailored for children 13 years old or younger, as the social network increasingly faces questions about the app’s effect on young people’s mental health. The pullback preceded a congressional hearing this week about internal research conducted by Facebook , and reported in The Wall Street Journal , that showed the company knew of the harmful mental health effects that Instagram was having on teenage girls. The revelations have set off a public relations crisis for the Silicon Valley company and led to a fresh round of calls for new regulation. Facebook said it still wanted to build an Instagram product intended for children that would have a more “age appropriate experience,” but was postponing the plans in the face of criticism.

The article continues:

With Instagram Kids, Facebook had argued that young people were using the photo-sharing app anyway, despite age-requirement rules, so it would be better to develop a version more suitable for them. Facebook said the “kids” app was intended for ages 10 to 12 and would require parental permission to join, forgo ads and carry more age-appropriate content and features. Parents would be able to control what accounts their child followed. YouTube, which Google owns, has released a children’s version of its app. But since BuzzFeed broke the news this year that Facebook was working on the app, the company has faced scrutiny. Policymakers, regulators, child safety groups and consumer rights groups have argued that it hooks children on the app at a younger age rather than protecting them from problems with the service, including child predatory grooming, bullying and body shaming.

The article goes on to quote Adam Mosseri, the head of Instagram:

Mr. Mosseri said on Monday that the “the project leaked way before we knew what it would be” and that the company had “few answers” for the public at the time. Opposition to Facebook’s plans gained momentum this month when The Journal published articles based on leaked internal documents that showed Facebook knew about many of the harms it was causing. Facebook’s internal research showed that Instagram, in particular, had caused teen girls to feel worse about their bodies and led to increased rates of anxiety and depression, even while company executives publicly tried to minimize the app’s downsides.

But concerns about the effect of social media on young people go beyond Instagram Kids, the article notes:

A children’s version of Instagram would not fix more systemic problems, said Al Mik, a spokesman for 5Rights Foundation, a London group focused on digital rights issues for children. The group published a report in July showing that children as young as 13 were targeted within 24 hours of creating an account with harmful content, including material related to eating disorders, extreme diets, sexualized imagery, body shaming, self-harm and suicide. “Big Tobacco understood that the younger you got to someone, the easier you could get them addicted to become a lifelong user,” Doug Peterson, Nebraska’s attorney general, said in an interview. “I see some comparisons to social media platforms.” In May, attorneys general from 44 states and jurisdictions had signed a letter to Facebook’s chief executive, Mark Zuckerberg, asking him to end plans for building an Instagram app for children. American policymakers should pass tougher laws to restrict how tech platforms target children, said Josh Golin, executive director of Fairplay, a Boston-based group that was part of an international coalition of children’s and consumer groups opposed to the new app. Last year, Britain adopted an Age Appropriate Design Code , which requires added privacy protections for digital services used by people under the age of 18.

Students, read the entire article , then tell us:

Do you think Facebook made the right decision in halting the development of the Instagram Kids app? Do you think there should be social media apps for children 13 and younger? Why or why not?

What is your reaction to the research that found that Instagram can have harmful mental health effects on teenagers, particularly teenage girls? Have you experienced body image issues, anxiety or depression tied to your use of the app? How do you think social media affects your mental health?

What has your experience been on different social media apps? Are there apps that have a more positive or negative effect on your well-being? What do you think could explain these differences?

Have you ever been targeted with inappropriate or harmful content on Instagram or other social media apps? What responsibility do you think social media companies have to address these issues? Do you think there should be more protections in place for users under 18? Why or why not?

What does healthy social media engagement look like for you? What habits do you have around social media that you feel proud of? What behaviors would you like to change? How involved are your parents in your social media use? How involved do you think they should be?

If you were in charge of making Instagram, or another social media app, safer for teenagers, what changes would you make?

Want more writing prompts? You can find all of our questions in our Student Opinion column . Teachers, check out this guide to learn how you can incorporate them into your classroom.

Students 13 and older in the United States and Britain, and 16 and older elsewhere, are invited to comment. All comments are moderated by the Learning Network staff, but please keep in mind that once your comment is accepted, it will be made public.

Nicole Daniels joined The Learning Network as a staff editor in 2019 after working in museum education, curriculum writing and bilingual education. More about Nicole Daniels

Social media use can be positive for mental health and well-being

January 6, 2020— Mesfin Awoke Bekalu , research scientist in the Lee Kum Sheung Center for Health and Happiness at Harvard T.H. Chan School of Public Health, discusses a new study he co-authored on associations between social media use and mental health and well-being.

What is healthy vs. potentially problematic social media use?

Our study has brought preliminary evidence to answer this question. Using a nationally representative sample, we assessed the association of two dimensions of social media use—how much it’s routinely used and how emotionally connected users are to the platforms—with three health-related outcomes: social well-being, positive mental health, and self-rated health.

We found that routine social media use—for example, using social media as part of everyday routine and responding to content that others share—is positively associated with all three health outcomes. Emotional connection to social media—for example, checking apps excessively out of fear of missing out, being disappointed about or feeling disconnected from friends when not logged into social media—is negatively associated with all three outcomes.

In more general terms, these findings suggest that as long as we are mindful users, routine use may not in itself be a problem. Indeed, it could be beneficial.

For those with unhealthy social media use, behavioral interventions may help. For example, programs that develop “effortful control” skills—the ability to self-regulate behavior—have been widely shown to be useful in dealing with problematic Internet and social media use.

We’re used to hearing that social media use is harmful to mental health and well-being, particularly for young people. Did it surprise you to find that it can have positive effects?

The findings go against what some might expect, which is intriguing. We know that having a strong social network is associated with positive mental health and well-being. Routine social media use may compensate for diminishing face-to-face social interactions in people’s busy lives. Social media may provide individuals with a platform that overcomes barriers of distance and time, allowing them to connect and reconnect with others and thereby expand and strengthen their in-person networks and interactions. Indeed, there is some empirical evidence supporting this.

On the other hand, a growing body of research has demonstrated that social media use is negatively associated with mental health and well-being, particularly among young people—for example, it may contribute to increased risk of depression and anxiety symptoms.

Our findings suggest that the ways that people are using social media may have more of an impact on their mental health and well-being than just the frequency and duration of their use.

What disparities did you find in the ways that social media use benefits and harms certain populations? What concerns does this raise?

My co-authors Rachel McCloud , Vish Viswanath , and I found that the benefits and harms associated with social media use varied across demographic, socioeconomic, and racial population sub-groups. Specifically, while the benefits were generally associated with younger age, better education, and being white, the harms were associated with older age, less education, and being a racial minority. Indeed, these findings are consistent with the body of work on communication inequalities and health disparities that our lab, the Viswanath lab , has documented over the past 15 or so years. We know that education, income, race, and ethnicity influence people’s access to, and ability to act on, health information from media, including the Internet. The concern is that social media may perpetuate those differences.

— Amy Roeder

Gen Z mental health: The impact of tech and social media

Much like many relationships a person might have between ages 18 and 24, the relationship a young person has with social media  can be complicated. No matter where they live, respondents in a new global survey said social media usage can lead to a fear of missing out (FOMO) or poor body image, but it also can help with social connections and self-expression.

McKinsey Health Institute’s (MHI’s) 2022 Global Gen Z Survey asked more than 42,000 respondents in 26 countries across continents questions based on the four dimensions of health: mental, physical, social, and spiritual. 1 Participants were surveyed on the following nine key topics: overall health and well-being, mental health in the workplace, spiritual health and religion, social determinants of health, social media and digital health services, mental health service utilization, mental health among students, attitudes toward mental health, and global current events. As with all surveys, these data reflect a moment in time and MHI makes no long-term approximations about how these results will trend over time. MHI then analyzed differences and similarities across generations and countries, with a hope of informing the broader dialogue around Gen Z mental health.

Gen Zers, on average, are more likely than other generations to cite negative feelings about social media. 2 Social media is defined here as apps to connect, potentially broadly, with other users. It does not include direct messaging apps. They are also more likely to report having poor mental health. But correlation is not causation, and our data indicates that the relationship between social media use and mental health is complex. One surprise: Older generations’ engagement with these platforms is on par with Gen Zers. For example, baby boomers in eight of the 26 countries surveyed report spending as much time on social media as Gen Zers, with millennials being the most likely to post. And while negative impacts of social media were reported across cohorts, positive effects were even more common—more than 50 percent of all groups cited self-expression and social connectivity as positives from social media.

More than 50 percent of all groups cited self-expression and social connectivity as positives from social media.

There are also signs that technology provides access to supportive mental health resources for younger people. Gen Z respondents are more likely than other generations to use digital wellness apps and digital mental health programs. 3 Digital wellness apps are defined as consumer-driven digital applications that aim to reduce stress, improve well-being and productivity, and address nonclinical conditions for consumers, focusing on topics such as meditation, sleep tracking, cognitive behavioral therapy, and fitness. Digital mental health programs are telehealth programs that offer remote appointments with a healthcare provider (for example, physician, therapist), either over video or phone. Additionally, respondents indicate that certain aspects of social media use can benefit their mental health, such as using social media for self-expression. Young refugees and asylum seekers are among those most likely to cite social media as a tool to stay connected and decrease loneliness.

Methodology

To gain a better understanding of Gen Z in comparison with other generations, the McKinsey Health Institute conducted an internet-based survey in May 2022 in ten European countries (France, Germany, Italy, the Netherlands, Poland, Spain, Sweden, Switzerland, Türkiye, and United Kingdom), with approximately 1,000 completes per country (including around 600 Gen Z). In August 2022, an additional 1,600 completes per country (including 600 Gen Z) were collected from 16 mostly non-European countries (Argentina, Australia, Brazil, China, Egypt, India, Indonesia, Ireland, Japan, Mexico, Nigeria, Saudi Arabia, South Africa, United Arab Emirates, United States, Vietnam). In total, the survey collected responses from 42,083 people, including 16,824 Gen Z individuals (mostly 18–24-year-olds and including a negligible minority of 13–17-year-old non-European respondents), 13,080 millennials (25–40 years old), 6,937 Gen Xers (41–56 years old), 5,119 baby boomers (57–75 years old), and 123 from the Silent Generation (76–93 years old).

Within each country, the survey applied weights to match the distribution of age cohorts, gender, and share of population with tertiary education in the sample to the country’s national census. The sample was drawn from populations with access to the internet, which made the samples more representative of Gen Z respondents, in which nearly all individuals with access to the internet are active technology users; however, for other generations, this is less likely to be the case. This analysis reflects self-reported results in 2022.

Considerations for cross-generational surveys

The survey focused on how respondents—mainly Gen Z—were feeling at the time they were surveyed. Therefore, we cannot determine whether differences in answers between age cohorts are caused by an intrinsic change in attitudes and behaviors or are merely induced by age differences: it is possible that Gen Z will eventually think and behave like millennials, Gen X, or baby boomers, when they reach those ages.

Considerations for surveys conducted online

The survey was conducted online. Therefore, it may not accurately reflect the behaviors or attitudes of individuals who do not have reliable online access. This can be particularly significant in various aspects of life, given that the internet can have a profound impact on the information we access and how we process it.

Considerations for cross-country surveys

Cross-country, sociocultural differences can impact perceptions, scale usage, and affect other factors that may influence responses. However, we cannot automatically conclude that these differences are objective. For instance, the variations in answers on an agreement scale may be due to the respondent’s inclination to agree or disagree and their propensity to choose extreme answers such as “strongly disagree” or “strongly agree.”

Although we relied on cultural experts and youth reviewers to ensure equivalence of meanings across languages during translations, some observed differences across countries may still be induced by the translations.

To measure country differences, we computed country averages and used them to calculate simple averages across countries. By doing so, we treated each country equally, regardless of its population size.

In the six insights below, MHI delves deeper into the ways in which mental health, technology, and social media intersect for our respondents (see sidebar “Methodology” for further detail). This survey covered additional topics such as climate change and spiritual health (for selected insights, see sidebars “Climate change is a concern for many respondents” and “Gen Z and spiritual health: Insights”).

Gen Z respondents report challenges with health across most dimensions

Although many individuals around the world are struggling with their health, there are meaningful differences within groups.

Globally, one in seven baby boomers say their mental health has declined over the past three years, compared with one in four Gen Z respondents. Female Gen Zers were almost twice as likely to report poor mental health when compared with their male counterparts (21 percent versus 13 percent, respectively).

In most surveyed countries, a higher proportion of Gen Z respondents said their mental health was poor or very poor when compared with other dimensions of health (16 percent in Gen Z and 7 percent for baby boomers). However, in China, Egypt, Nigeria, Saudi Arabia, United Arab Emirates, and Vietnam, Gen Z respondents reported that they struggled most with their social health. Overall, mental health experiences varied by region, with Gen Z participants in Saudi Arabia, Egypt, and Nigeria rating their mental health as “very good” with the highest frequencies.

While Gen Z tends to report worse mental health, the underlying cause is not clear. There are several age-specific factors that may impact Gen Z’s mental health independent of their generational cohort, including developmental stage, level of engagement with healthcare, and familial or societal attitudes.

Almost everyone is using social media, but in different ways

More than 75 percent of respondents in all age groups said they use and check social media sites at least ten minutes a day.

Younger generations tend to engage with social media regularly, in both active and passive ways. Almost half of both millennial and Gen Z respondents check social media multiple times a day. Over one-third of Gen Z respondents say they spend more than two hours each day on social media sites; however, millennials are the most active social media users, with 32 percent stating they post either daily or multiple times a day.

Whether less active social media use by Gen Z respondents could be related to greater caution and self-awareness among youth, reluctance to commit, or more comfort with passive social media use remains up for debate. Studies have shown that passive social media use (for example, scrolling) could be linked to declines in subjective well-being over time. 1 Philippe Verduyn et al., “Passive Facebook usage undermines affective well-being: Experimental and longitudinal evidence,” Journal of Experimental Psychology: General , 2015, Volume 144, Number 2.

Gen Zers and millennials are more likely than other generations to say social media affects their mental health

Studies of young adults and their social media use have shown an inverse relationship between screen time and psychological well-being, 1 Jean Twenge et al., “Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study,” Preventive Medicine Reports , 2018, Volume 12. with higher utilization associated with poorer well-being. Other research indicates the nature of the relationship individuals have with social media can have a greater impact on their mental health than time spent. 2 Mesfin A. Bekalu, Rachel F. McCloud, and K. Viswanath, “Association of social media use with social well-being, positive mental health, and self-rated health: Disentangling routine use from emotional connection to use,” Health Education & Behavior , 2019, Volume 46, Number 2.

Our findings show a nuanced relationship between social media use and mental health. While around one-third of respondents across cohorts report positive impacts of social media on mental health, generations differ in reported negative impacts.

Negative effects seem to be greatest for younger generations, with particularly pronounced impacts for Gen Zers who spend more than two hours a day on social media and Gen Zers with poor mental health. Gen Z respondents from Europe and Oceania were most likely to report negative impacts from social media, and respondents from Asia were least likely (32 percent and 19 percent, respectively). 3 Participants were requested to rank 13 factors, including technology and social media, on how they perceive their impact on mental health. There is the possibility for varying interpretation of what classifies as negative or positive effects. Differences across generations and regions could be influenced in part by social media algorithms.

While the positive impact stays comparable, older generations report fewer negative effects

All generational cohorts in the survey said that social media use had the most positive impact on self-expression and social connectivity. Self-reported refugees and asylum seekers cite higher levels of positive impact than others across all aspects.

Across generations, there are more positive than negative impacts reported by respondents; however, the reported negative impact is higher for Gen Z. Respondents from high-income countries (as defined by World Bank) were twice as likely to report a negative impact of social media on their lives than respondents from lower-middle-income countries (13 percent compared with 7 percent).

When compared with their male counterparts, a higher proportion of female Gen Zers said social media had a negative impact on FOMO (32 percent versus 22 percent), body image (32 percent versus 16 percent), and self-confidence (24 percent versus 13 percent).

Positive aspects of technology may include increased access to health resources

Across generations, more than one in four respondents report using digital wellness apps as compared with one out of five using digital mental health programs (28 percent compared with 19 percent, respectively). Fifty percent more Gen Z respondents reported using digital mental health programs than Gen X or baby boomers (22 percent for Gen Z versus 15 percent for Gen X and baby boomers).

Among those respondents who report using digital mental health programs, most Gen Zers say they would likely keep using them (65 percent); other generations are even more committed, with 74 percent reporting that they would likely continue to use the programs. Four out of five respondents across all generations report that these programs benefit their mental health.

While evaluation of outcomes and effectiveness requires continued study, digital health resources may play an important role in supporting mental health globally, especially when in-person resources are limited or geographically inaccessible. For certain populations, digital health resources could be the preferred method of obtaining support.

Most find help on their own or by referral

Thirty-four percent of Gen Z respondents who use digital mental health programs and apps say they found them on their own. This proportion increases to approximately 50 percent in Brazil, Indonesia, Mexico, and South Africa. In other countries, primary care physicians and healthcare payers (insurance plans) were listed as primary access points to digital mental health programs.

No matter the geography, employers have growing  opportunities to promote workplace well-being and ensure employees have access to the evidence-based mental health resources they need.

At least a third of respondents in most countries and generational cohorts said physical, mental, social, and spiritual health resources were important or very important in choosing an employer, and Gen Z gave particular weight to mental health resources. Given that Gen Z is a growing percentage of the workforce, and that few Gen Z respondents cited employers as a primary access point for help, there may be room for employers to further  engage around mental health in the future.

Technology and social media can be a part of the solution

Climate change is a concern for many respondents.

Climate change appears to be a major concern across generations: in the McKinsey Health Institute 2022 Global Gen Z Survey, more than half of respondents across all age groups reported feeling highly distressed when asked about climate change, with females reporting a higher percentage compared with males. Many Gen Z respondents reported experiencing stress, sadness, anger, and frustration due to climate change and its related disasters. More than 50 percent of total respondents expressed fear and anxiety about the future, with Gen Z demonstrating greater concern than other generations. More than 50 percent of all respondents agree or strongly agree that “government leaders and companies have failed to take care of the planet.”

This fear is not purely existential about the fate of the world or “eco-anxiety,” but instead is often rooted in specific environmental risks that may impact their direct day-to-day livelihoods. When asked about which statements related to climate change resonated with them, 33 percent agree or strongly agree that climate change poses a threat to their family’s physical or financial security. Individuals with self-reported poor mental health are more likely to feel affected by climate change, with 67 percent of Gen Z in this group stating that the future is “frightening” when looking at climate change, compared with 47 percent of Gen Z with neutral or good mental health.

Given the complex and multifaceted nature of mental health and climate change threats and related disruptions, there are no simple answers to the challenges they pose. There is an opportunity for further understanding of how experiences and attitudes around climate change may be influenced by political and ecological factors. However, in order to help young people navigate these issues, healthcare providers, educators, and parents can take a proactive approach by exploring these topics through targeted questioning and solution-oriented discussions. By encouraging young people to think critically about mental health and climate change, the focus can become empowerment and active role-playing to promote personal well-being, climate resilience, and the health of the planet.

Social media and technology, while part of the broader dialogue around youth mental health, can be powerful tools in promoting well-being and offering scaled mental health support. For example, developers might consider embedding algorithms that make it easier for youth expressing psychological distress to find support groups, crisis hotlines, or emergency mental health services. Additionally, digital mental health companies could consider partnering with virtual and community-based providers to connect people with high-acuity needs to timely and culturally-appropriate crisis services.

Gen Z and spiritual health: Insights

According to the McKinsey Health Institute 2022 Global Gen Z survey, those between the ages of 18 and 24 report poorer spiritual health than older generations, with Gen Z respondents almost three times more likely than baby boomers to report poor or very poor spiritual health.

Spiritual health enables people to integrate meaning in their lives. Spiritually healthy people have a strong sense of purpose. While people who are experiencing poor mental health could have good spiritual health, or vice versa, Gen Z individuals who experienced poor mental health were five times more likely to report poor spiritual health than those with neutral or good mental health.

Responses varied widely by country, both in terms of overall ratings of spiritual health and in respondents’ perceived importance of spiritual health. For example, there was a 48-point range across countries in respondents indicating that spiritual health was “extremely important” to them. While 8 percent of total respondents in the Netherlands said spiritual health was “extremely important” to them, 56 percent of total respondents in Brazil said the same. Respondents in higher-income countries were half as likely to indicate spiritual health is “extremely important” to them versus lower-middle-income countries (23 percent versus 43 percent).

Respondents in Africa and South America were most likely to report that spiritual health was extremely important to them (46 percent and 41 percent, respectively); respondents in Europe were least likely (18 percent).

Given these data, it’s clear that spiritual health matters to young people around the world, and there may be important links to overall well-being. People seeking to support the mental health and psychological resilience of young people may want to inquire about how they are finding purpose in their homes, families, and at work.

Around the world, communities are struggling to provide young people with someone to call, someone to respond, or a safe place to get help during mental health, substance use, and/or suicidal crises . The availability of crisis supports globally is varied, with the majority of countries having no national suicide or mental health crisis line. In addition, communities in every geography lack adequate community mental health services infrastructure to respond to the volume of crises young people experience each year, instead relying on schools, emergency rooms, hospitals, law enforcement, or families to bridge a gap that could save lives and livelihoods. Dispatching specially trained mobile teams or providing a safe place to go in crisis is even more rare—a gap that technology could bridge.

Collaboration between technology companies, mental health professionals, educators, employers, policy makers, and the wider community is necessary. By prioritizing mental health and utilizing technology in a positive way, young people are more likely to achieve and sustain better health. Other strategies that could be considered include using social media to build supportive online communities for affinity groups and promoting youth leaders to create and disseminate content that promotes mental health. 4 Mizuko Ito, Candice Odgers, and Stephen Schueller, Social media and youth wellbeing: What we know and where we could go , Connected Learning Alliance, June 2020. Researchers and companies can explore evidence-based strategies such as mental health promotion and mindfulness programs to mitigate the negative effects of social media and to help young people use social media as a platform for authentic self-expression. 5 Julia Brailovskaia and Jürgen Margraf, “Positive mental health and mindfulness as protective factors against addictive social media use during the COVID-19 outbreak,” PLOS One , 2022, Volume 17, Number 11.

A “precision prevention” approach to talking with young people about the role of technology in their lives may help create a more informed, supportive, and healthful environment. By providing parents, educators, and healthcare professionals with these tools, they can become actively engaged in promoting the health of Gen Z and beyond. While addressing these issues may seem overwhelming, it is essential that stakeholders work together to help improve the mental health of young people.

MHI is an enduring, non-profit-generating global entity within McKinsey. MHI strives to catalyze actions across continents, sectors, and communities to achieve material improvements in health, empowering people to lead their best possible lives. MHI sees supporting youth mental health as essential to adding years to life and life to years.

If you would like to learn more about the McKinsey Health Institute (MHI) 2022 Global Gen Z survey and the additional data and insights the McKinsey Health Institute has from the survey, please submit an inquiry via the MHI “contact us” form . The McKinsey Health Institute, as a non-profit-generating entity of McKinsey, is creating avenues for further research that can catalyze action.

Erica Coe is a coleader at the McKinsey Health Institute and a partner in McKinsey’s Atlanta office. Kana Enomoto is a coleader at the McKinsey Health Institute and an associate partner in the Washington, DC, office, where Andrew Doy is a consultant and Cheryl Healy is an associate partner.

The authors wish to thank Nicolas Abi-Chacra, Lea Arora, Victoria Bennett, Abby Bloomfield, Ulrike Deetjen, Alexandru Degeratu, Martin Dewhurst, Joseph Jung, Abhishek Mahajan, Roxanne Sabbag, Emma Summerton, Pooja Tatwawadi, and Oliver Walker for their contributions to this article. They also wish to thank MHI geographical leaders Alistair Carmichael, Andira Putri, and Shriya Sethi. They also wish to thank the European Society for Child and Adolescent Psychiatry (ESCAP) affiliates and Orygen for providing their local expertise and helping shape the MHI Global Gen Z Survey (2022). They also wish to thank Megan Jones Bell, Murali Doraiswamy, Sharon Hoover, Roberta Katz, Shekhar Saxena, and Anil Thapliyal for their contributions.

This article was edited by Elizabeth Newman, an executive editor in the Chicago office.

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Assistant Professor of Psychiatry, University of Colorado Anschutz Medical Campus

Disclosure statement

Emily Hemendinger does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

University of Colorado Anschutz Medical Campus provides funding as a member of The Conversation US.

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Media influences and conventional beauty standards have long plagued society.

This issue took on new urgency in May 2023 when the U.S. surgeon general issued a major public advisory over the links between social media and youth mental health .

Research shows that images of beauty as depicted in movies, television and magazines can lead to mental illness , issues with disordered eating and body image dissatisfaction .

These trends have been documented in women and men , in the LGBTQ+ community and in people of different racial and ethnic backgrounds.

Experts have long suspected that social media may be playing a role in the growing mental health crisis in young people . However, the surgeon general’s warning is one of the first public warnings supported by robust research .

Social media can be toxic

Body dissatisfaction among children and adolescents is commonplace and has been linked to decreased quality of life, worsened mood and unhealthy eating habits.

As an eating disorder and anxiety specialist , I regularly work with clients who experience eating disorder symptoms, self-esteem issues and anxiety related to social media .

I also have firsthand experience with this topic : I am 15 years post-recovery from an eating disorder, and I grew up when people were beginning to widely use social media. In my view, the impact of social media on diet and exercise patterns needs to be further researched to inform future policy directions, school programming and therapeutic treatment.

The mental health of adolescents and teens has been declining for the past decade , and the COVID-19 pandemic contributed to worsening youth mental health and brought it into the spotlight. As the mental health crisis surges, researchers have been taking a close look at the role of social media in these increasing mental health concerns.

The pros and cons of social media

About 95% of children and adolescents in the U.S. between the ages of 10 and 17 are using social media almost constantly .

Research has shown that social media can be beneficial for finding community support . However, studies have also shown that the use of social media contributes to social comparisons, unrealistic expectations and negative mental health effects .

In addition, those who have preexisting mental health conditions tend to spend more time on social media. People in that category are more likely to self-objectify and internalize the thin body ideal . Women and people with preexisting body image concerns are more likely to feel worse about their bodies and themselves after they spend time on social media.

A breeding ground for eating disorders

A recent review found that, as with mass media, the use of social media is a risk factor for the development of an eating disorder , body image dissatisfaction and disordered eating. In this review, social media use was shown to contribute to negative self-esteem, social comparisons, decreased emotional regulation and idealized self-presentation that negatively influenced body image.

Another study, called the Dove Self-Esteem Project , published in April 2023, found that 9 in 10 children and adolescents ages 10 to 17 are exposed to toxic beauty content on social media and 1 in 2 say that this has an impact on their mental health.

Eating disorders are complex mental illnesses that develop because of biological, social and psychological factors. Eating disorder hospitalizations and the need for treatment have dramatically increased during the pandemic .

Some reasons for this include isolation, food scarcity, boredom and social media content related to weight gain, such as the “ quarantine15 .” That was a reference to the weight gain some people were experiencing at the beginning of the pandemic, similar to the “freshman 15” belief that one will gain 15 pounds in the first year of college. Many teens whose routines were disrupted by the pandemic turned to eating disorder behaviors for an often-false sense of control or were influenced by family members who held unhealthy beliefs around food and exercise.

Researchers have also found that increased time at home during the pandemic led to more social media use by young people and therefore more exposure to toxic body image and dieting social media content.

While social media alone will not cause eating disorders, societal beliefs about beauty , which are amplified by social media, can contribute to the development of eating disorders.

‘Thinspo’ and ‘fitspo’

Toxic beauty standards online include the normalization of cosmetic and surgical procedures and pro-eating-disorder content, which promotes and romanticizes eating disorders. For instance, social media sites have promoted trends such as “thinspo,” which is focused on the thin ideal, and “fitspo,” which perpetuates the belief of there being a perfect body that can be achieved with dieting, supplements and excessive exercise.

Research has shown that social media content encouraging “clean eating ” or dieting through pseudoscientific claims can lead to obsessive behavior around dietary patterns. These unfounded “wellness” posts can lead to weight cycling, yo-yo dieting , chronic stress, body dissatisfaction and higher likelihood of muscular and thin-ideal internalization .

Some social media posts feature pro-eating-disorder content , which directly or indirectly encourages disordered eating. Other posts promote deliberate manipulation of one’s body, using harmful quotes such as “nothing tastes as good as thin feels.” These posts provide a false sense of connection, allowing users to bond over a shared goal of losing weight, altering one’s appearance and continuing patterns of disordered eating.

While young people can often recognize and understand toxic beauty advice’s effects on their self-esteem, they may still continue to engage with this content. This is in part because friends, influencers and social media algorithms encourage people to follow certain accounts.

How policy changes could help

Legislators across the U.S. are proposing different regulations for social media sites .

Policy recommendations include increased transparency from social media companies, creation of higher standards of privacy for children’s data and possible tax incentives and social responsibility initiatives that would discourage companies and marketers from using altered photos.

Phone-free zones

Small steps at home to cut down on social media consumption can also make a difference. Parents and caregivers can create phone-free periods for the family. Examples of this include putting phones away while the family watches a movie together or during mealtimes.

Adults can also help by modeling healthy social media behaviors and encouraging children and adolescents to focus on building connections and engaging in valued activities .

Mindful social media consumption is another helpful approach. This requires recognizing what one is feeling during social media scrolling. If spending time on social media makes you feel worse about yourself or seems to be causing mood changes in your child, it may be time to change how you or your child interact with social media.

• Social media
• Eating disorders
• Youth mental health
• Body dissatisfaction
• Cyberbullying
• Self-esteem
• Eating disorders and pandemic
• Body dysmorphia
• Body image disorders

Deputy Social Media Producer

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• Open access
• Published: 22 June 2023

Social media and mental health in students: a cross-sectional study during the Covid-19 pandemic

• Abouzar Nazari   ORCID: orcid.org/0000-0003-2155-5438 1 ,
• Maede Hosseinnia   ORCID: orcid.org/0000-0002-2248-7011 2 ,
• Samaneh Torkian 3 &
• Gholamreza Garmaroudi   ORCID: orcid.org/0000-0001-7449-227X 4  

BMC Psychiatry volume  23 , Article number:  458 ( 2023 ) Cite this article

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Social media causes increased use and problems due to their attractions. Hence, it can affect mental health, especially in students. The present study was conducted with the aim of determining the relationship between the use of social media and the mental health of students.

Materials and methods

The current cross-sectional study was conducted in 2021 on 781 university students in Lorestan province, who were selected by the Convenience Sampling method. The data was collected using a questionnaire on demographic characteristics, social media, problematic use of social media, and mental health (DASS-21). Data were analyzed in SPSS-26 software.

Shows that marital status, major, and household income are significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Also, problematic use of social media (β = 3.54, 95% CI: (3.23, 3.85)) was significantly associated with higher mental health scores (a higher DASS21 score means worse mental health status). Income and social media use (β = 1.02, 95% CI: 0.78, 1.25) were significantly associated with higher DASS21 scores (a higher DASS21 score means worse mental health status). Major was significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status).

This study indicated that social media had a direct relationship with mental health. Despite the large amount of evidence suggesting that social media harms mental health, more research is still necessary to determine the cause and how social media can be used without harmful effects.

Peer Review reports

• Social media

Social media is one of the newest and most popular internet services, which has caused significant progress in the social systems of different countries in recent years [ 1 , 2 ]. The use of the Internet has become popular among people in such a way that its use has become inevitable and has made life difficult for those who use it excessively [ 3 ]. Social media has attracted the attention of millions of users around the world owing to the possibility of fast communication, access to a large amount of information, and its widespread dissemination [ 4 ]. Facebook, WhatsApp, Instagram, and Twitter are the most popular media that have attractive and diverse spaces for online communication among users, especially the young generation [ 5 , 6 ].

According to studies, at least 55% of the world’s population used social media in 2022 [ 7 ]. Iranian statistics also indicate that 78.5% of people use at least one social media. WhatsApp, with 71.1% of users, Instagram, with 49.4%, and Telegram, with 31.6% are the most popular social media among Iranians [ 8 , 9 ].

The use of social media has increased significantly in all age groups due to the origin of the COVID-19 pandemic [ 10 ] .It affected younger people, especially students, due to educational and other purposes [ 11 , 12 ]. Because of the sudden onset of the COVID-19 pandemic, educational institutions and learners had to accept e-learning as the only sustainable education option [ 13 ]. The rapid migration to E-learning has brought several challenges that can have both positive and negative consequences [ 14 ].

Unlike traditional media, where users are passive, social media enables people to create and share content; hence, they have become popular tools for social interaction [ 15 ].The freedom to choose to participate in the company of friends, anonymity, moderation, encouragement, the free exchange of feelings, and network interactions without physical presence and the constraints of the real world are some of the most significant factors that influence users’ continued activity in social media [ 16 ]. In social media, people can interact, maintain relationships, make new friends, and find out more about the people they know offline [ 17 ]. However, this popularity has resulted in significant lifestyle changes, as well as intentional or unintentional changes in various aspects of human social life [ 18 ]. Despite many advantages, the high use of social media brings negative physical, psychological, and social problems and consequences [ 19 ], but despite the use and access of more people to the Internet, its consequences and crises have been ignored [ 20 ].

Use of social media and mental health

Spending too much time on social media can easily become problematic [ 21 ]. Excessive use of social media, called problematic use, has symptoms similar to addiction [ 22 , 23 ]. Problematic use of social media represents a non-drug-related disorder in which harmful effects emerge due to preoccupation and compulsion to over-participate in social media platforms despite its highly negative consequences [ 24 , 25 , 26 ], which leads to adverse consequences of mental health, including anxiety, depression, lower well-being, and lower self-esteem [ 27 , 28 , 29 ].

Mental health & use of social media

Mental health is the main pillar of healthy human societies, which plays a vital role in ensuring the dynamism and efficiency of any society in such a way that other parts of health cannot be achieved without mental health [ 30 ]. According to World Health Organization’s (WHO) definition, mental health refers to a person’s ability to communicate with others [ 31 ]. Some researchers believe that social relationships can significantly affect mental health and improve quality of life by creating a sense of belonging and social identity [ 32 ]. It is also reported that people with higher social interactions have higher physical and mental health [ 33 ].

Scientific evidence also shows that social media affect people’s mental health [ 34 ]. Social studies and critiques often emphasize the investigation of the negative effects of Internet use [ 35 ]. For example, Kim et al. studied 1573 participants aged 18–64 years and reported that Internet addiction and social media use were associated with higher levels of depression and suicidal thoughts [ 36 ]. Zadar also studied adults and reported that excessive use of social media and the Internet was correlated with stress, sleep disturbances, and personality disorders [ 37 ]. Richards et al. reported the negative effects of the Internet and social media on the health and quality of life of adolescents [ 38 ]. There have been numerous studies that examine Internet addiction and its associated problems in young people [ 39 , 40 ], as well as reports of the effects of social media use on young people’s mental health [ 41 , 42 ].

A study on Iranian students showed that social media leads to depression, anxiety, and mental health decline [ 25 ]. A study on Iranian students showed that social media leads to depression, anxiety, and mental health decline [ 25 ]. But no study has investigated the effects of social media on the mental health of students from a more traditional province with lower individualism and higher levels of social support (where they were thought to have lower social media use and better mental health) during the COVID-19 pandemic. As social media became more and more vital to university students’ social lives during the lockdowns, students were likely at increased risk of social media addiction, which could harm their mental health. University students depended more on social media due to the limitations of face-to-face interactions. In addition, previous studies were conducted exclusively on students in specific fields. However, in our study, all fields, including medical and non-medical science fields were investigated.

The present study was conducted to determine the relationship between the use of social media and mental health in students in Lorestan Province during the COVID-19 pandemic.

Study design and participants

The current study was descriptive-analytical, cross-sectional, and conducted from February to March 2022 with a statistical population made up of students in all academic grades at universities in Lorestan Province (19 scientific and academic centers, including centers under the supervision of the Ministry of Health and the Ministry of Science).

Sample size

According to the convenience sampling method, 781 people were chosen as participants in the present study. During the sampling, a questionnaire was created and uploaded virtually on Porsline’s website, and then the questionnaire link was shared in educational and academic groups on social media for students to complete the questionnaire under inclusion criteria (being a student at the University of Lorestan and consenting to participate in the study).

The research tools included the demographic information questionnaire, the standard social media use questionnaire, and the mental health questionnaire.

Demographic information

The demographic information age, gender, ethnicity, province of residence, urban or rural, place of residence, semester, and the field of study, marital status, household income, education level, and employment status were recorded.

Psychological assessment

The students were subjected to the Persian version of the Depression Anxiety Stress Scale (DASS21). It consists of three self-report scales designed to measure different emotional states. DASS21 questions were adjusted according to their importance and the culture of Iranian students. The DASS21 scale was scored on a four-point scale to assess the extent to which participants experienced each condition over the past few weeks. The scoring method was such that each question was scored from 0 (never) to 3 (very high). Samani (2008) found that the questionnaire has a validity of 0.77 and a Cronbach’s alpha of 0.82 [ 43 ].

Use of social media questionnaire

Among the 13 questions on social media use in the questionnaire, seven were asked on a Likert scale (never, sometimes, often, almost, and always) that examined the problematic use of social media, and six were asked about how much time users spend on social media. Because some items were related to the type of social media platform, which is not available today, and users now use newer social media platforms such as WhatsApp and Instagram, the questionnaires were modified by experts and fundamentally changed, and a 22-item questionnaire was obtained that covered the frequency of using social media. Cronbach’s alpha was equal to 0.705 for the first part, 0.794 for the second part, and 0.830 for all questions [ 44 ]. Considering the importance of the problematic use of the social media, six questions about the problematic use were measured separately.

To confirm the validity of the questionnaire, a panel of experts with CVR 0.49 and CVI 0.70 was used. Its reliability was also obtained (0.784) using Cronbach’s alpha coefficient. Finally, the questionnaire was tested in a class with 30 students to check the level of difficulty and comprehension of the questionnaire. Finally, a 22-item questionnaire was obtained, of which six items were about the problematic use of social media and the remaining 16 questions were about the rate and frequency of using social media. Cronbach’s alpha was 0.705 for the first part, including questions about the problematic use of the social media, and 0.794 for the second part, including questions about the rate and frequency of using the social media. The total Cronbach’s alpha for all questions was 0.830. Six questions about the problematic use of social media were measured separately due to the importance of the problematic use of social media. Also, a separate score was considered for each question. The scores of these six questions on the problematic use of the social media were summed, and a single score was obtained for analysis.

Statistical analysis

Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 26.0 (SPSS Inc., Chicago, IL, USA). The normal distribution of continuous variables was analyzed using the Kolmogorov-Smirnov test, histogram, and P-P diagram, which showed that they are not normally distributed. Descriptive statistics were calculated for all variables. Comparison between groups was done using Mann-Whitney and Kruskal-Wallis non-parametric tests. Multiple linear regression analysis was used to investigate the relationship between mental health, problematic use of social media, and social media use (The result of merging the Frequency of using social media and Time to use social media). Generalized Linear Models (GLM) were used to assess the association between mental health with the use of social media and problematic use of social media. Due to the high correlation (r = 0.585, p = < 0.001) between the use of social media and problematic use of social media, collinearity, we run two separate GLM models. Regression coefficients (β) and adjusted β (β*) with 95% CI and P-value were reported.

A total of 781 participants completed the questionnaires, of which 64.4% were women and 71.3% were single. The minimum age of the participants was 17 years, the maximum age was 45 years, and about half of them (48.9%) were between 21 and 25 years old. A total of 53.4% of the participants had bachelor’s degrees. The income level of 23.2% of participants was less than five million Tomans (the currency of Iran), and 69.7% of the participants were unemployed. 88.1% were living with their families and 70.8% were studying in non-medical fields. 86% of the participants lived in the city, and 58.9% were in their fourth semester or higher. Considering that the research was conducted in a Lorish Province, 43.8% of participants were from the Lorish ethnicity.

The mean total score of mental health was 12.30 with a standard deviation of 30.38, and the mean total score of social media was 14.5557 with a standard deviation of 7.74140.

Table  1 presents a comparison of the mean problematic use of social media and mental health with demographic variables. Considering the non-normality of the hypothesis H0, to compare the means of the independent variables, Mann-Whitney non-parametric tests (for the variables of gender, the field of study, academic semester, employment status, province of residence, and whether it is rural or urban) and Kruskal Wallis (for the variables age, ethnicity, level of education, household income and marital status). According to the obtained results, it was found that the score of problematic use of social media is significantly higher in women, the age group less than 20 years, unemployed, non-native students, dormitory students, and students living with friends or alone, Fars students, students with a household income level of fewer than 7 million Tomans(Iranian currency), and single, divorced, and widowed students were higher than the other groups(P < 0.05).

By comparing the mean score of mental health with demographic variables using non-parametric Mann-Whitney and Kruskal Wallis tests, it was found that there is a significant difference between the variable of poor mental health and all demographic variables (except for the semester variable), residence status (rural or urban) and education level. (There was a significant relationship (P < 0.05). In such a way that the mental health condition was worse in women, age group less than 20 years old, non-medical science, unemployed, non-native, and dormitory students. Also, Fars students, divorced, widowed, and students with a household income of fewer than 5 million Tomans (Iranian currency) showed poorer mental health status. (Table  1 ).

The final model shows that marital status, field, and household income were significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Being single (β* = -23.03, 95% CI: (-33.10, -12.96), being married (β* = -38.78, 95% CI: -51.23, -26.33), was in Medical sciences fields (β* = -8.15, 95% CI: -11.37, -4.94), and have income 7–10 million (β* = -5.66, 95% CI: -9.62, -1.71) were significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Problematic use of social media (β* = 3.54, 95% CI: (3.23, 3.85) was significantly associated with higher mental health scores (a higher DASS21 score means worse mental health status). (Table  2 )

Age, income, and use of social media (β* = 1.02, 95% CI: 0.78, 1.25) were significantly associated with higher DASS21 scores (a higher DASS21 score means worse mental health status). Marital status and field were significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Age groups < 20 years (β* = 6.36, 95% CI: 0.78, 11.95) and income group < 5 million (β* = 6.58, 95% CI: 1.47, 11.70) increased mental health scores. Being single (β* = -34.72, 95% CI: -47.06, -38.78), being married (β* = -38.78, 95% CI: -51.23, -26.33) and in medical sciences fields (β* = -8.17, 95% CI: -12.09, -4.24) decreased DASS21 scores. (Table  3 )

The main purpose of this study was to determine the relationship between social media use and mental health among students during the COVID-19 pandemic.

University students are more reliant on social media because of the limitations of in-person interactions [ 45 ]. Since social media has become more and more vital to the social lives of university students during the pandemic, students may be at increased risk of social media addiction, which may be harmful to their mental health [ 14 ].

During non-adulthood, peer relations and approval are critical and social media seems to meet these needs. For example, connection and communication with friends make them feel better and happier, especially during the COVID-19 pandemic and national lockdowns where face-to-face communication was restricted [ 46 ]. Kele’s study showed that the COVID-19 pandemic has increased the time spent on social media, and the frequency of online activities [ 47 ].

Because of the COVID-19 pandemic, e-learning became the only sustainable option for students [ 13 ]. This abrupt transition can lead to depression, stress, or anxiety for some students due to insufficient time to adjust to the new learning environment. The role of social media is also important to some university students [ 48 ].

Staying at home, having nothing else to do, and being unable to go out and meet with friends due to the lockdown measures increased the time spent on social media and the frequency of online activities, which influenced their mental health negatively [ 49 ]. These reasons may explain the findings of previous studies that found an increase in depression and anxiety among adolescents who were healthy before the COVID-19 pandemic [ 50 ].

According to the results, there was a statistically significant relationship between social media use and mental health in students, in such a way that one Unit increase in the score of social media use enhanced the score of mental health. These two variables were directly correlated. Consistent with the current study, many studies have shown a significant relationship between higher use of social media and lower mental health in students [ 45 , 51 , 52 , 53 , 54 ].

Inconsistent with the findings of the present study, some previous studies reported the positive effect of social media use on mental health [ 55 , 56 , 57 ]. The differences in findings could be attributed to the time and location of the studies. Anderson’s study in France in 2018 found no significant relationship between social media use and mental health. This may be because of the differences between the tools for measuring the ability to detect fake news and health literacy and the scales of the research [ 4 ].

The present study showed that the impact of using social media on the mental health of students was higher than Lebni’s study, which was conducted in 2020 [ 25 ]. Also, in Dost Mohammad’s study in 2018, the effect of using social media on the mental health of students was reported to be lower than in the present study [ 58 ]. Entezari’s study in 2021, was also lower than the present study [ 59 ]. It seems that the excessive use of social media during the COVID-19 pandemic was the reason for the greater effects of social media on students’ mental health.

The use of social media has positive and negative characteristics. Social media is most useful for rapidly disseminating timely information via widely accessible platforms [ 4 ]. Among the types of studies, at least one shows an inverse relationship between the use of social media and mental health [ 53 ]. While social media can serve as a tool for fostering connection during periods of physical isolation, the mental health implications of social media being used as a news source are tenuous [ 45 ].

The results of the GLM analysis indicated that there was a statistically significant relationship between the problematic use of social media and mental health in students in such a way that one-unit increase in the score of problematic use of social media enhanced the mental health score, and it was found that the two variables had a direct relationship. Consistent with our study, Boer’s study showed that problematic use of social media may highlight the potential risk to adolescent mental health [ 60 ]. Malaeb also reported that the problematic use of social media had a positive relationship with mental health [ 61 ], but that study was conducted on adults and had a smaller sample size before the COVID-19 pandemic.

Saputri’s study found that excessive social media use likely harms the mental health of university students since students with higher social media addiction scores had a greater risk of experiencing mild depression [ 62 ]. A systematic literature review before the COVID-19 pandemic (2019) found that the time spent by adolescents on social media was associated with depression, anxiety, and psychological distress [ 63 ]. Marino’s study (2018) reported a significant correlation between the problematic use of social media by students and psychological distress [ 64 ].

Social media has become more vital for students’ social lives owing to online education during the COVID-19 pandemic. Therefore, this group is more at risk of addiction to social media and may experience more mental health problems than other groups. Lebni also indicated that students’ higher use of the Internet led to anxiety, depression, and adverse mental health, but the main purpose of the study was to investigate the effects of such factors on student’s academic performance [ 25 ]. Previous studies indicated that individuals who spent more time on social media had lower self-esteem and higher levels of anxiety and depression [ 65 , 66 ]. In the present study, students with higher social media addiction scores were at higher mental health risk. Such a finding was consistent with research by Gao et al., who found that the excessive use of social media during the pandemic had adverse effects on social health [ 14 ]. Cheng et al. indicated that using the Internet, especially for communication with people, can harm mental health by changing the quality of social relationships, face-to-face communication, and changes in social support [ 24 ].

A reason for the significant relationship between social media use and mental health in students during the COVID-19 pandemic in the present study was probably the students’ intentional or unintentional use of online communication. Unfortunately, social media published information, which might be incorrect, in this pandemic that caused public fear and threatened mental health.

During the pandemic, social media played essential roles in learning and leisure activities. Due to electronic education, staying at home, and long leisure time, students had more time, frequency, and opportunities to use social media in this pandemic. Such a high reliance on social media may threaten student’s mental health. Lee et al. conducted a study during the COVID-19 pandemic and confirmed that young people who used social media had higher symptoms of depression and loneliness than before the COVID-19 pandemic [ 67 ].

The present study showed that there was a significant positive relationship between problematic use of social media and gender, so that women were more willing to use social media, probably because they had more opportunities to use social media as they stayed at home more than men; hence, they were more exposed to problematic use of social media. Consistent with our study, Andreassen reported that being a woman was an important factor in social media addiction [ 68 ]. In contrast to our study, Azizi’s study in Iran showed that male students use social media significantly more than female students, possibly due to differences in demographic variables in each population [ 69 ].

Moreover, there was a significant relationship between age and problematic use of social media in that people younger than 20 were more willing to use social media in a problematic way. Consistent with the present study, Perrin also indicated that younger people further used social media [ 70 ].

According to the findings, unemployed students used social media more than employed ones, probably because they had more time to spend in virtual space, leading to higher use and the possibility of problematic use of social media [ 71 ].

Moreover, non-native students were more willing to use the social media probably because students who lived far away from their families used social media problematically due to the lack of family control over hours of use and higher opportunities [ 72 ] .

The results showed that rural students have a greater tendency to use social Medias than urban students. Inconsistent with this finding, Perrin reported that urban people were more willing to use the social media. The difference was probably due to different research times and places or different target groups [ 70 ].

According to the current study, people with low household income were more likely to use social media, most likely because low-income people seek free information and services due to a lack of access to facilities and equipment in the real world or because they seek assimilation with people around them. Inconsistent with our findings, Hruska et al. reported that people with high household income levels made much use of social media [ 73 ], probably because of cultural, economic, and social differences or different information measurement tools.

Furthermore, single, divorced, and widowed students used social media more than married students. This is because they spend more time on social media due to the need for more emotional attention, the search for a life partner, or a feeling of loneliness. This also led to the problematic use of social media [ 74 ].

According to the results, Fars people used social media more than other ethnic groups, but this difference was insignificant. This finding was consistent with Perrin’s study, but the population consisted of people aged 18 to 65 [ 70 ].

In the current study, there was a significant relationship between gender and mental health, so that women had lower mental health than men. The difference was in health sociology. Consistent with the present study, Ghasemi et al. indicated that it appeared necessary to pay more attention to women’s health and create an opportunity for them to use health services [ 75 ].

The findings revealed that unemployed students had lower mental health than employed students, most likely because unemployed individuals have lower mental health due to not having a job and being economically dependent on others, as well as feeling incompetent at times. Consistent with the present study, Bialowolski reported that unemployment and low income caused mental disorders and threatened mental health [ 76 ].

According to this study, non-native students have lower mental health than native students because they live far from their families. The family plays an imperative role in improving the mental health of their children, and mental health requires their support. Also, the economic, social, and support problems caused by being away from the family have endangered their mental health [ 77 ].

Another important factor of the current study was that married people had higher mental health than single people. In addition, divorced and widowed students had lower mental health [ 78 ]. Possibly due to the social pressure they suffer in Iranian society. Furthermore, they received lower emotional support than married people. Therefore, their lower mental health seemed logical [ 79 , 80 , 81 ]. A large study in a European population also reported differences in the likelihood of mood, anxiety, and personality disorders between separated/divorced and married mothers [ 82 ].

A key point confirmed in other studies is the relationship between low incomes with mental health. A meta-analysis by Lorant indicated that economic and social inequalities caused mental disorders [ 83 ]. Safran also reported that the probability of developing mental disorders in people with low socioeconomic status is up to three times higher than that of people with the highest socioeconomic status [ 84 ]. Bialowolski’s study was consistent with the current study but Bialowolski’s study examined employees [ 76 ].

The present study was conducted during the COVID-19 pandemic and therefore had limitations in accessing students. Another limitation was the use of self-reporting tools. Participants may show positive self-presentation by over- or under-reporting their social media-related behaviors and some mental health-related items, which may directly or indirectly lead to social desirability bias, information bias, and reporting bias. Small sample sizes and convenience sampling limit student population representativeness and generalizability. This study was based on cross-sectional data. Therefore, the estimation results should be seen as associative rather than causative. Future studies would need to investigate causal effects using a longitudinal or cohort design, or another causal effect research design.

The findings of this study indicated that the high use of social media affected students’ mental health. Furthermore, the problematic use of the social media had a direct relationship with mental health. Variables such as age, gender, income level, marital status, and unemployment of non-native students had significant relationships with social media use and mental health. Despite the large amount of evidence suggesting that social media harms mental health, more research is still necessary to determine the cause and how social media can be used without harmful effects. It is imperative to better understand the relationship between social media use and mental health symptoms among young people to prevent such a negative outcome.

Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to express their gratitude to all academic officials of Lorestan universities and Mr. Mohsen Amani for their cooperation in data collection.

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Abouzar Nazari and Maedeh Hossennia designed the study, collected the data and drafted the manuscript. Samaneh Torkian performed the statistical analysis and prepared the tables. Gholamreza Garmaroudi, as the responsible author, supervised the entire study. All authors reviewed and edited the draft manuscript and approved the final version.

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Nazari, A., Hosseinnia, M., Torkian, S. et al. Social media and mental health in students: a cross-sectional study during the Covid-19 pandemic. BMC Psychiatry 23 , 458 (2023). https://doi.org/10.1186/s12888-023-04859-w

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Studies highlight impact of social media use on college student mental health

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When Kyle Palmberg set out to design a research study as the capstone project for his psychology major at St. Mary’s University of M i nnesota in Winona, he knew he wanted his focus to be topical and relevant to college students.

His initial brainstorming centered around the mental health impact of poor sleep quality. 

“I wanted to look at college students specifically, to see the different ways that sleep quality can be harmed and how that can impact your mental health,” he said. As he reviewed the scientific literature, one variable kept appearing. “The topic that kept coming up was social media overuse,” he said. “It is such an important thing to my target demographic of college students.”

Palmberg, 22, grew up surrounded by social media. He’d heard plenty of warnings about the downsides of spending too much time online, and he’d seen many of his peers seemingly anchored to their phones, anxious or untethered if they had to put them down for more than a few minutes at a time.

“I think from my perspective as someone who’s been really interested in psychology as an academic discipline, social media addiction is also something I’ve been aware of personally,” Palmberg said. “I can tell within myself when things can become harmful or easy to misuse. I often see the hints of addictive behaviors in peers and coworkers.”

Palmberg found much of the published research on the topic inspiring, particularly a 2003 study on internet gambling addiction. 

“They were looking at how internet gambling addiction permeates a person’s behavior,” he said. Palmberg hypothesized that there may be behavioral similarities between people addicted to online gambling and those addicted to social media. 

“Social media provides this convenient platform for users to interact with others,” he said. “As users grow addicted, they learn that they can come back to that social platform more and more to get their needs met. The tolerance users have for gratifying that social need grows. Then they have to use social media more and more often to get those benefits.”

The negative impact of a growing dependence on social media is that time spent online takes away from real in-person interactions and reduces the time a person has available for basic personal care needs, like sleep and exercise, Palmberg said. This can ultimately have a negative impact on mental health.

“As a person builds a high tolerance for the use of social media it causes internal and external conflict,” he said. “You know it is wrong but you continue to use it. You relapse and struggle to stop using it.” Palmberg said that social media use can be a form of “mood modification. When a person is feeling down or anxious they can turn to it and feel better at least for a moment. They get a sense of withdrawal if they stop using it. Because of this negative side effect, it causes that relapse.”

Palmberg decided he wanted to survey college students about their social media use and devise a study that looked at connections between the different motivations for that use and potential for addictive behaviors. He ran his idea by his academic advisor, Molly O’Connor, associate professor of psychology at Saint Mary’s, who was intrigued by his topic’s clear connections to student life.

“We often notice social media addiction with our student population,” O’Connor said. She knew that Palmberg wouldn’t have a hard time recruiting study participants, because young people have first-hand experience and interest in the topic. “He’s looking at college students who are particularly vulnerable to that addiction. They are tuned into it and they are using it for coursework, socialization, entertainment, self-documentation.”

O’Connor said she and her colleagues at the university see signs of this addiction among many of their students. 

“They’ll be on their phones during class when they are supposed to pay attention,” she said. “They can’t help themselves from checking when a notification comes through. They say they had trouble sleeping and you’ll ask questions about why and they’ll say they were scrolling on their phone before they went to bed and just couldn’t fall asleep.”

The entertainment-addiction connection

Once his study was given the go-ahead by his advisor and approved by the university for human-subjects research, Palmberg had two months to recruit participants. 

To gather his research subjects, he visited classes and gave a short speech. Afterward, students were given an opportunity to sign up and provide their emails. Palmberg recruited 86 participants this way, and each was asked to fill out an anonymous survey about their social media habits.

Palmberg explained that the main framework of his study was to gain a deeper understanding of why college students use social media and the circumstances when it can become addictive and harmful to their mental health and well-being. He also hypothesized that perceived sleep quality issues would be connected to social media addiction.

After collecting the surveys, Palmberg said, “We essentially threw the data into a big spreadsheet. We worked with it, played with it, analyzed it.” He explained that his analysis focused on motivations for social media use, “including building social connections and self-documentation.”

What Palmberg discovered was that his subjects’ most popular motivation for social media use was for entertainment. While some participants listed other motivations, he said the most “statistically significant” motivation was entertainment.

“Not only was entertainment the most highly endorsed reason to use social media in the study,” Palmberg said, “for college students it was the only motivation we analyzed that was statistically connected to social media addiction and perceived stress. The entertainment motivation was also related to poor sleep quality.”

Mental Health & Addiction

A better way to deliver unexpected news, in her new book, ‘the rock in my throat,’ kao kalia yang shares her struggle with selective mutism, a community-based approach to suicide prevention.

He found connections between a reliance on social media for entertainment and addictive behaviors, like an inability to shut down apps or put a phone away for an extended period of time. “If a person is using social media for entertainment, they are more likely to be addicted to social media than someone who is not using it for entertainment,” Palmberg said.

The structures of popular social media platforms reinforce addictive behaviors, he said. “Current trends in social media lean more toward entertainment platforms like TikTok or Instagram. People are going on there just to pass time,” Palmberg said. These brief and repetitive formats encourage addiction, he said, because the dopamine high they create is short-lived, causing users to keep visiting to get those fleetingly positive feelings. 

O’Connor supports Palmberg’s conclusions. A reliance on social media platforms for entertainment encourages addiction, she said. This is backed up by student behavior.

“My big takeaway was the interest in the entertainment variable was the key predictor of addiction. It’s not necessarily the students that are using it to communicate with each other, but the ones that say, ‘I need to kill time between classes,’ or, ‘I’m bored before bed,’ or, ‘I am trying to relieve stress after working on homework.’” The addictive aspect comes in, O’Connor said, “because users want to be entertained more and more. They are constantly looking for the next thing to talk about with their friends.”

Palmberg said he believes that not all social media use among college students has to be addictive. “It is important for people to view social media as not only something that can be harmful but also something that can be used as a tool. I like to emphasize with my study that it’s not all negative. It is more of an emphasis on moderation. It is possible to use social media responsibly. But just like almost anything, it can be addictive.”

An emphasis on digital well-being

Twice a year, in an effort to get out ahead of digital addiction, students at Gustavus Adolphus College in St. Peter are encouraged to take a deeper look at their social media use and its impact on their mental health. Charlie Potts, the college’s interim dean of students, heads the effort: It’s a clear match with his job and his research interests.

During the semiannual event, known as “Digital Well-Being Week,” Gustavus students learn about the potentially negative impact of social media overuse — as well as strategies for expanding their social networks without the help of technology.

Potts said that event has been held four times so far, and students now tell him they anticipate it. 

“We’ve gotten to the point where we get comments from students saying, ‘It’s that time again,’” he said. Students say they appreciate the information and activities associated with Digital Well-Being Week, Potts continued, and they look forward to a week focused on spending less time with their phones.

“They remember that we put baskets on every table in the dining hall with a little card encouraging them to leave their phones there and instead focus on conversations with others,” he added. “We even include  a card in the basket with conversation starters. Students are excited about it. They know the drill. It is something they like to do that feels good.”

Potts’ own academic research has focused on mental health and belonging. Each fall, he also heads up a campus-wide student survey focused on digital well-being and how to balance phone use with other aspects of mental and physical health.

In the survey, Potts said, “We ask students, ‘How much time do you spend every day on social media? How does it make you feel?’ Students are blown away when they see the number of hours that the average Gustie spends online. The vast majority are in the 4-7 hours a day on their phone range.”

The survey, which uses a motivational style of interviewing to help participants get at the root of why altering their social media behaviors may be valuable to their overall health and well-being, focuses on small changes that might reduce participants’ reliance on technology in favor of face-to-face interaction. 

“We do a lot of conversations with students about strategies they could use,” Potts said. “Things like plugging your phone in across the room while you sleep, leaving it behind while you go to work out at the rec center, subtle changes like that. We also talk about mental health and mindfulness and how…you discern your values about what you are consuming and how that might affect you.”

Though Potts said he has encountered some resistance from students (“You roll with that and help them understand the value of that and think about how they are going to make that change,” he said), he’s also heard a lot of positive student feedback about his survey — and the twice-yearly focus on digital well-being.  

“What we found with our students is they realize deep down that their relationship with their phones and social media was not having a positive impact on their life,” Potts said. “They knew change would be good but they didn’t know how to make change or who to talk to about that or what tools were at their disposal. These options help them understand how to do that.”

Andy Steiner

Andy Steiner is a Twin Cities-based writer and editor. Before becoming a full-time freelancer, she worked as senior editor at Utne Reader and editor of the Minnesota Women’s Press. Email her at  [email protected] .

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Major psychology group says infinite scrolling, other social media features are ‘particularly risky' to youth mental health

The american psychological association is calling on technology companies to take more steps to protect adolescents, arguing age restrictions alone don’t address the dangers, by elizabeth chuck | nbc news • published april 16, 2024.

A top psychology group is urging technology companies and legislators to take greater steps to protect adolescents’ mental health, arguing that social media platforms are built for adults and are “not inherently suitable for youth.”

Social media features such as endless scrolling and push notifications are “particularly risky” to young people, whose developing brains are less able to disengage from addictive experiences and are more sensitive to distractions, the American Psychological Association wrote in a  report released Tuesday .

But age restrictions on social media platforms alone don’t fully address the dangers, especially since many kids easily find workarounds to such limits. Instead, social media companies need to make fundamental design changes, the group said in its report.

“The platforms seem to be designed to keep kids engaged for as long as possible, to keep them on there. And kids are just not able to resist those impulses as effectively as adults,” APA chief science officer Mitch Prinstein said in a phone interview. He added that more than half of teens report at least one symptom of  clinical dependency on social media . 

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“The fact that this is interfering with their in-person interactions, their time when they should be doing schoolwork, and — most importantly — their sleep has really important implications,” Prinstein said.

The report did not offer specific changes that social media companies can implement. Prinstein suggested one option could be to change the default experience of social media accounts for children, with functions such as endless scrolling or alerts shut off.

The report comes nearly a year after the APA issued a landmark  health advisory  on social media use in adolescence, which acknowledged that social media can be beneficial when it connects young people with peers who experience similar types of adversity offline. The advisory urged social media platforms to minimize adolescents’ online exposure to cyberbullying and cyberhate, among other recommendations.

But technology companies have made “few meaningful changes” since the advisory was released last May, the APA report said, and no federal policies have been adopted.

The report did not name any specific social media platforms. But a spokesperson for Meta, the parent company of Facebook, Instagram and WhatsApp, disputed the assertion that there have not been changes instituted on its platforms recently. In the last year, Meta has begun showing teens a notification when they spend 20 minutes on Facebook and has added parental supervision tools that allow parents to schedule breaks from Facebook for their teens, according to a list of  Meta resources for parents and teenagers . Meta also began hiding more results in Instagram’s search tool related to suicide, self-harm and eating disorders, and launched nighttime “nudges” that encourage teens to close the app when it’s late.

Prinstein said more is still needed.

"Although some platforms have experimented with modest changes, it is not enough to ensure children are safe," he said.

TikTok and X, formerly known as Twitter, did not immediately respond to a request for comment. A spokesperson for Snap Inc., which owns messaging app Snapchat, said it appreciated the APA’s recommendations and shares "their concerns about many of the key features of traditional social media."

"Snapchat was intentionally designed differently than other platforms and most people use it to communicate with their close friends and family," the spokesperson said in a statement, "That’s why Snapchat doesn’t offer public comparison metrics when you talk with your friends and our content platform is moderated, which means we don’t allow unvetted content to reach lots of people."

Tuesday’s report comes amid broader concern over the effects of social media on young people. In March, Florida  passed a law  prohibiting children younger than 14 from having social media accounts and requiring parental consent for those ages 14 and 15. California lawmakers have introduced a bill to  protect minors from social media addiction . Dozens of  states have sued  Meta for what they say are deceptive features that harm children’s and teens’ mental health. 

And last month, a  book was published by social psychologist Jonathan Haidt  that argues that smartphones and social media have created a “phone-based childhood,” sending adolescents’ rates of anxiety, depression and self-harm skyrocketing. 

The book, “The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness,” has been hotly debated. While it has  its detractors , it instantly became a bestseller.

Two tribal nations sue social media companies over Native youth suicides

Georgia joins states seeking parental permission before children join social media

Prinstein said that it’s up to technology companies to protect their youngest users, but parents can also help. He recommended all devices in a family’s household go on top of the refrigerator at 9 p.m. each night to help kids — and parents — get the amount of sleep they need. He also said there is no harm in limiting or postponing a child’s use of social media.

“We have no data to suggest that kids suffer negative consequences if they delay social media use, or if their parents set it for half an hour a day, or an hour a day,” he said. 

“If anything, kids tell us, anecdotally, that they like to be able to blame it on their parents and say, ‘Sorry, my parents won’t let me stay on for more than an hour, so I have to get off,’” he added. “It kind of gives them a relief.”

This story first appeared on NBCNews.com . More from NBC News:

• Fake Botox is the cause of bad reactions in 9 states, FDA says
• Skimpy Olympic track uniform from Nike criticized by women athletes
• Colorado funeral home owners accused of storing 190 decaying bodies are charged with Covid fraud

This article tagged under:

ORIGINAL RESEARCH article

Stalking, harassment, gendered abuse, and violence towards politicians in the covid-19 pandemic and recovery era.

• 1 Department of Psychological Medicine, University of Otago, Wellington, New Zealand
• 2 Mental Health, Addiction and Intellectual Disability Services, Te Whatu Ora Health, New Zealand, Capital, Coast and Hutt Valley, New Zealand

Background: High levels of harassment and threats against parliamentarians are being reported internationally, especially in the social media space. This is occurring alongside changes in our social landscape, with increasing political polarisation and the ongoing ramifications from the COVID-19 pandemic. Harassment of politicians has been shown to have implications for psychological wellbeing and physical safety.

Objectives: To investigate harassment and violence towards parliamentarians in the COVID-19 pandemic and recovery era, including whether there had been a change in its nature and quantity, and to explore the contribution of social media.

Methods: A survey of all New Zealand’s parliamentarians was fielded in 2022, focusing on their experiences of harassment analysed quantitatively and with manifest and latent content analysis of free text responses. Data were disaggregated and compared by gender. Secondary analyses were conducted on similar data collected from parliamentarians in 2014 to compare trends over time.

Findings: We obtained a cleaned achieved survey sample of 54 Members of Parliament (MPs). Harassment was reported by 98% of respondents, ranging from disturbing communication to actual physical violence. The vast majority of MPs endorsed multiple modalities of harassment occurring on multiple occasions. Ninety-six percent of MPs had been harassed over social media, with over half being threatened, including threats of physical violence (40%), sexual violence (14%), threats made towards MP’s family members (19%), threats towards staff (12%), and death threats (27%). Almost all forms of harassment had increased significantly since 2014. Most MPs reported experiencing abuse related to the Government response to the COVID-19 pandemic (e.g. lockdowns and vaccine mandates). Many MPs commented that the frequency and intensity of abuse increased markedly during the COVID pandemic and had not subsequently abated. Women were at significantly higher risk of certain types of social media harassment including gendered abuse, sexualised comments, threat of sexual violence, and threats toward their family.

Conclusion: Harassment of parliamentarians is an escalating issue. Online threats and misogyny are increasingly apparent. This harassment has significant psychosocial costs for victims, their family and staff, and for democratic processes.

Introduction

Politicians have been targets of harassment and threats since long before the emergence of social media. Owing to their public profiles and the nature of their job, politicians are susceptible to stalking and threats from disgruntled constituents with personal grievances, extreme ideologies or fixated views ( 1 , 2 ). In comparison to other public figures such as celebrities, politicians are also at greater risk of being physically attacked by those who harass them ( 3 ). This small but significant risk has been starkly highlighted over the last decade by fatal attacks on politicians, resulting in the deaths of Jo Cox and David Amess (United Kingdom, 2016; 2021), Walter Lübcke (Germany, 2019), and Shinzo Abe (Japan, 2022).

The emergence of social media has also changed the way politicians and citizens interact, offering a direct channel for communication and engagement. Political parties have been quick to see the advantages of this, with the international literature showing rapid uptake of social media by politicians over the last two decades ( 4 ). However, this shift has also enabled new channels for harassment. The anonymity of the digital landscape can embolden some users to engage in aggressive, derogatory, and threatening behaviour, directed towards people with viewpoints that diverge from their own ( 5 , 6 ). Politicians are ready targets for such harassment, which can manifest as hate speech, threats, personal attacks, doxxing (sharing private information online), and the dissemination of misleading content ( 7 – 9 ).

Studies of Members of Parliament (MPs’) experiences of threatening behaviour have been conducted in multiple jurisdictions including Canada, the UK, Australia, Sweden, Norway, and the Netherlands ( 8 , 10 – 14 ). In New Zealand, a previous survey we conducted in 2014 identified 87% of MPs had been harassed ( 7 ). This harassment occurred in multiple modalities and had significant associated harm. Half of those who were harassed believed that the people responsible for the harassment had a mental illness. Compared to surveys which had taken place before 2010, the New Zealand survey identified a higher rate of harassment via social media at 60%. This was attributed to the rapid growth in use of social media over the intervening time period. These results provided the impetus for the establishment of Ngā Purapura - the Fixated Threat Assessment Centre New Zealand (FTACNZ), a multidisciplinary collaboration between Health, Police and the Parliamentary Service to provide intervention to manage the threats presented to MPs by fixated people.

Some evidence suggests that the risk of MPs being harassed has changed over recent times. In New Zealand, where the current study is based, media has reported on the increasing concerns MPs have for their safety both generally ( 15 ), and for those who perceive that they have become a particular target because of their gender, ethnicity or other factors ( 16 ). This is consistent with international trends. An analysis comparing online abuse towards United Kingdom (UK) politicians in the month before the 2015 and 2017 election found a significant increase in abusive content on Twitter ( 17 ). A survey exploring the MP’s experiences of ‘trolling’ in the UK ( 18 ) found all participants reported online abuse. Male MPs reported a greater volume of online abuse, but women were more likely to experience racial and sexual abuse. The authors observed,

“Male MPs reported more concern about reputational damage, and females more concern about their personal safety. Moreover, the impact of this trolling seemed to have a greater effect on female MPs compared to male MPs”

( 18 ). In a qualitative study of European women MPs and their staff, most of those interviewed had encountered disparaging or sexual images or comments about them on social media ( 19 ).

Since the time those studies were conducted, the landscape has been further changed by the COVID-19 pandemic and an associated rise in expression of so-called alt right beliefs and conspiracy theories as such as Q-ANON ( 20 ). According to an examination of survey data from eight Western countries (n = 49,116) ‘pandemic fatigue’ increased between 2020 and 2021, engendering significant political discontent, including protest support and conspiratorial thinking ( 21 ). New Zealand had a particularly stringent lockdown, with significant associated distress reported in the community ( 22 ). During the pandemic, there was concerning evidence of proliferation of violent, misogynist and extreme rhetoric directed towards politicians that seeded on telegram channels and spread across other internet platforms like YouTube, Facebook and Instagram ( 23 ). On 9 February 2022, anti-vaccine mandate protestors occupied parliamentary grounds, where they remained for over three weeks until they were forcibly evicted by police in March 2022. Throughout the occupation, some protestors advocated for the public trial and execution of prominent politicians for ‘crimes against humanity’, and the protest ended in a violent riot, with police officers attacked, and public property burnt and damaged. ( 24 , 25 ).

The subsequent resignation of Jacinda Ardern as Prime Minister of New Zealand in January 2023 prompted speculation that harassment and threats contributed to her decision to leave politics ( 26 , 27 ). An analysis of anonymous posts about key high-profile figures on social media platforms from 2019–2022 found Ms Ardern had been the subject of online vitriol – posts classified by language analysis programs as negative, hateful, sexually explicit, or toxic – at a rate over 50 times higher than any other person studied ( 28 ).

The online vitriol translated into real world safety concerns. There was a marked increase in in threats towards the then Prime Minister and MPs more generally that attracted police attention reported in 2021 ( 29 ). From its establishment in July 2019 up until the time of Ms Ardern’s resignation, 53% of all referrals to FTACNZ arose from individuals who either targeted her individually, or as a prominent figure in their concerning and threatening communications (241 of 451 referrals). Further, it is the experience of one of us (JBW, the psychiatry lead for FTACNZ), that since the establishment of FTACNZ, there has been an increase in the seriousness of threats, and in their sexist and racist content toward women and parliamentarians from certain ethnic groups.

Given the documented evidence that the nature of abuse and trolling was changing, we considered it important to explore experiences of harassment with MPs. This included clarifying if there had been an increase in harassment and whether this harassment was causing measurable harm to individuals. From our previous research ( 7 ) and the ongoing work of FTACNZ, we appreciated this harm may not be borne solely by the targeted MP but also by their family members and staff. We were also mindful of the previous research findings that those that harass, stalk, petition or otherwise fixate on public figures may themselves incur significant harm, which can also spill over to those around them and their communities ( 30 ).

Thus, this survey aimed to establish whether there had been a change in the nature and quality of the harassment of MPs since the previous survey in 2014 and to explore the contribution from social media harassment. We aimed to establish whether there were differences in gender and ethnicity and to assess the extent to which this the harassment of MPs caused harm, physically, psychologically and socially to the MPs and to those close to them.

The survey was fielded through Qualtrics, a secure online survey platform which can be used to create customisable templates, question types, and survey logic, and to distribute survey link to eligible participants through email or other channels to facilitate anonymous response. Qualtrics is widely used in the international academic research community and is specifically geared to support online or offline data capture for research studies. We designed the survey to ensure compatibility with mobile phone, tablet or computer access.

Survey questions are available as a Supplementary File S1 . Demographic information collected included: age band, gender (male, female, gender diverse), ethnicity, band of time as an MP, and whether the participant had ever served as a Minister or Associate Minister. Ethnicity was collected using the NZ Census question on ethnicity, which allows individuals to specify multiple ethnic groups. For analysis, individuals were prioritised into ethnic groups following standard guidelines. The questions about harassment were based on our previous survey conducted in 2014, with additional questions added about social media harassment, some of which were adapted from other research ( 18 ). We pre-tested the questionnaire on a small sample of colleagues and further modified it to address respondents’ feedback.

The questionnaire was distributed by an email sent individually to each MP’s official parliamentary email during a week Parliament was sitting. It was sent to 119 MPs (New Zealand usually has 120 MPs, but there was an unfilled resignation at the time the survey was fielded). After viewing the information sheet and consenting to participate, MPs anonymously answered questions about their experiences of different types of harassment. The survey took approximately 8 minutes to complete. It was fielded between 18 October and 28 November 2022. This was approximately two years into a three-year parliamentary cycle and was not during an election year.

Ethics approval

The study was approved by the University of Otago Human Ethics Committee, and we undertook Māori consultation via the Ngāi Tahu Research Committee. Locality approval was given by Parliamentary Services.

Data analyses

Relative frequencies were calculated for categorical data and reported as percentages. Percentages reported represent the response to each question and not the total number of participants (participants could skip questions and a small number of participants did not respond to every question). Chi-Square analyses were used to evaluate Tests of Independence using crosstabulation (also known as a bivariate table) for categorical variables such as gender and time periods (2022 versus 2015). For measures where the absolute numbers were low (like ethnicity groups), analysis by group was not possible. Quantitative data preparation and analysis were conducted using SPSS v29.

Free text data were analysed using manifest and latent content analysis ( 31 ). Content analysis can capture the meanings within data, including data from questionnaires, and involves establishing categories and identifying the frequency by which they occur ( 32 ). Manifest content analysis involves the systematic coding and categorisation of visible and obvious themes, patterns, or meanings that are evident in the text or responses. Latent content analysis involves identifying underlying or implicit meanings, themes, or patterns that are not readily apparent in the text or responses. This involves a more in-depth analysis and interpretation of the data to uncover deeper insights. Where we provide illustrative quotes, parts of the quote may have been redacted to preserve participant anonymity.

In total, there were 58 survey responses. The non-completion rate, defined as those who opened and started but did not complete the survey before the cut-off time, was 7%. We obtained a cleaned achieved sample of 54 (a response rate of 45%), comprising 20 men and 34 women, an overrepresentation of female participants compared with parliament as a whole, where the gender balance is equal. In terms of prioritised ethnicity, 38 participants (70.4%) were NZ European, 10 (18.5%) Māori, four (7.4%) Pacific Peoples, and two were another ethnicity. Participants ranged in age between being in their twenties and their seventies. Eleven (20.4%) had served as a Minister or Associate Minister.

The frequency and nature of harassment

Harassment was reported by 98% of responding MPs, ranging from disturbing communication, through to actual physical violence. The vast majority of MPs endorsed multiple modalities of harassment occurring on multiple occasions. Harassment over social media and harassment by letters and emails were the two most common forms of harassment (both experienced by 96%), followed by public approaches (82%), distribution of malicious material (73%), and alarming behaviour at the electorate office (62%). The type and frequency of the different forms of harassment is shown in Table 1 . Compared with 2014, when we previously surveyed politicians on their experiences of harassment, almost all forms of harassment had increased.

Table 1 Percentage of MPs experiencing different forms of harassment in 2014 and 2022.

Content analysis of the free text descriptions of the nature and context of this harassment generated three overarching themes. First, participants described a ‘ changing landscape’ with racist, misogynistic, and extreme right rhetoric proliferating online over the preceding two years, which frequently expressed overtly violent ideation toward politicians. They felt this online discourse had emboldened threatening confrontations that occurred in person. The protest movement against COVID-19 restrictions was frequently cited as a watershed event in escalating the hostility against the Government and its representatives. Second, was the theme of ‘fear ’ in which participants described pervasive anxiety that they or someone close to them might be attacked and seriously hurt (or killed). Lastly, participants identified ‘ inadequate support’ , feeling that resources available in terms of security, training, cybersafety and specialist supports had not kept pace with the changing landscape and furthermore were often not available to their staff who were often at the coalface of the abuse.

Quotes from the free text responses illustrating these themes appear in the following paragraphs to provide richness to the quantitative data.

Location of harassment

Harassment commonly occurred at Parliament, the electorate office and online, but MPs reported they had been targeted at a wide variety of public places. Free text comments described a variety of disturbing and threatening approaches in public, which caused MPs to fear for the safety of themselves and those close to them.

“Intimidating protestors surrounded building and then car I was travelling in.”

“Followed in car around town. Had to wait in public lit place until car left and had dialled 111. The driver was yelling racial, homophobic and other insults whilst tailgating. Not isolated event.”

“A group of people were opposed to a policy I proposed as Minister, and they confronted me at a meeting in my hometown. Following the meeting I received death threats … The police were involved and I had to use a GPS tracker 24/7 … my children were living at home and they were distressed about this and my partner didn’t want me going anywhere on my own. I had difficulties sleeping for a while.”

Actual or attempted attacks were reported by 18% of MPs and almost half (48%) had been threatened with physical harm.

“Someone came to electorate office wanting to stab me. Police intervened.”

“I was assaulted on the way to work.”

“I was told I was responsible for the deaths of [redacted, not COVID related] and I would be captured and hung as a result.”

Property violations were relatively common, being reported by 43% of MPs. Several MPs reported attacks on their homes.

Social media

Being harassed over social media was experienced by 96% of participants, reported as occurring daily or weekly by 68%. The type of abuse MPs received included racial abuse, gendered abuse, sexualised comments, and abuse related to sexual orientation ( Table 2 ). Almost six in ten participants had been abused regarding the restrictions aimed at combating COVID-19. Over half of MPs had been threatened over social media. These threats included threats of physical violence, sexual violence, threats made towards MP’s family members, threats made towards staff, and death threats.

Table 2 Percentage of MPs experiencing different types of abuse over social media compared by gender.

MPs generally felt the frequency of social media harassment had increased over the last two years with 73% of participants reporting the number of abusive messages/threats they received over social media had increased (19% said they had not increased and 8% said they had decreased).

Harassment over social media often escalated into in person confrontations, with MPs reporting that their harassers had approached them in public (35%), or even turned up at their home (9%). Over half of MPs (53%) blocked people from their social media account.

As previously mentioned, a theme from the free text content analysis was an increase in abuse that was overtly misogynistic and/or racist. Statistical analysis of the quantitative data found women were at significantly higher risk of reporting certain types of social media harassment, including gendered abuse, sexualised comments, threat of sexual violence, and threats toward their family ( Table 2 ). Support for transgender rights was also seen as attracting a lot of vitriol.

“There was a focus on my gender - I found it more rattling than I expected.”

“Had [my electorate] office tagged with misogynistic and anti-trans messages.”

There was a trend of women being more likely to receive death threats over social media (34% of women had experienced this compared to 15% of men) but this did not reach statistical significance. Abuse on political grounds was high for both genders but was reported by 95% of men compared to 81% of women.

COVID-related abuse

Fifty-eight percent of MPs reported experiencing abuse related to the COVID-19 pandemic and the related Government response. A strong theme that came through in the free text comments was that the frequency and intensity of abuse had increased during the course of the anti-vaccine and anti-mandate occupation of parliament in February–March 2022, but this intensity had not subsequently subsided as many had hoped.

“[Harassment] has increased significantly, primarily driven by Covid conspiracism. As it stands, I think it likely someone may be seriously hurt.”

“Covid seems to have exacerbated the volume and nastiness of abuse. I had thought it might start decreasing by now, but it seems to have kept up.”

“Sitting in my office during the protests hearing people saying MPs should be killed day after day was stressful, even though I refused to stop coming to work. I watched the riots happen and it was freaky, knowing some of those people would likely take their violence out on an MP.”

Impact of harassment

The impact on those harassed included fearfulness for their own safety (reported by 72%), a reduction in social outings (40%), concern being alone at home (24%), a change in daily routines (41%), a change in personal relationships (18%) and lost time from work (10%). The deleterious consequences of this harassment on MPs’ professional and personal lives had increased since 2014 ( Table 3 ). In 2014, half the MPs reported having ever felt a degree of fear (this rose to 60% when considering the subgroup who had experienced harassment), but then only 20% had ever felt that their personal safety might be in jeopardy, compared to 72% in 2022. Some longstanding MPs reflected that they perceived the risks having changed substantially in the course of their careers.

Table 3 Impact of harassment on MPs in 2014 and 2022.

“Earlier in my career I prided myself on having a policy of accessibility and openness. Now I fear for my safety and the safety of my staff and have set up security measures at home and on site where my electorate staff operate.”

“The list is exhausting – it’s debilitating and sadly worse than when I first started.”

“I’ve been doing public facing politics for [a long time]. I’ve never, ever seen the tone of public discourse and the emboldening of aggressive, fringe conspiracy thinking like has occurred in the last six months…”

Women MPs in general were more likely to experience feeling unsafe. For example, as a result of threatening or abusive messages on social media specifically, 69% of female and 33% of male participants felt fearful for their safety (p<0.05) and 46% of female and 5% of males felt unsafe in their own homes (p<0.005).

“My red alert safehub didn’t work, the Police were significantly outnumbered and would have been unable to support me - and I had no safe exit. I got out of the situation safely, but I was petrified.”

A number commented in free text responses that their families and staff were more affected than they were.

“I’m fine to stand my ground, but my family and partner are terrified about me now going to events and things by myself.”

MPs worried about safety of those close to them such as partners, children and staff.

“My husband was physically attacked by someone launching at me in public. I have had security put up because I had abusive people turn up to threaten me, we’ve had graphic videos threatening ourselves and whānau [family].”

“… A local person was touting on Facebook claiming to know where I lived seeking to collect a group to go throw rocks at my windows that evening when I knew the only person there that evening was my [teenage] daughter…”

“The threats and harassment to my [redacted]-year-old daughter [were the worst]. She was subjected to social media trolling and harassment because I am her mother.

“Staff member threatened and [the perpetrator] is in jail awaiting trial — [they] threatened to bomb my office. Staff very shaken by this.”

“As a Minister [the most serious episode was] learning that departmental staff were being harassed by phone and personally, that departmental vehicles had been tampered with putting staff safety at risk, and that security had to increase at departmental offices because of intimidating and threatening behaviour by [redacted] individuals who had ready access to firearms.”

Some wanted to acknowledge that although there were risks to their job, many other professions carried similar levels of risk.

“We are elected to represent. That means our jobs can be difficult, but no more so that a police officer or paramedic, for example.”

“MPs need to harden up. They are in no greater danger of actual harm than people who work in, say, forestry, then recognise they have a responsibility to serve the public instead of complaining about them.”

Several MPs emphasised that although their harassers had challenging behaviour, the contact could represent an opportunity for intervention.

“Many of the people who are regarded as harassing us are actually people who require help, which we try to give.”

“Emails are threatening but clearly show this person’s mental state. At once stage I had to ask the support agency to contact him as I believed he was homeless and without food for several days.”

Sixty-four percent of MPs had increased their security at home and 51% had increased their security at work. Some reported sadness at becoming less available to their constituents.

“It is sad for me that this has to happen, because as MPs we are representatives of our community, and the community should be able to access us freely.”

MPs often reported that the harassment they experienced took its toll on their wellbeing and personal life and that this could be a heavy burden to carry.

“It’s been awful and has been detrimental to my physical and psychological and emotional health but more importantly it has detrimentally affected my family relationships … [my children] have as a result distanced themselves … to protect and shield themselves. That has been extremely difficult.”

“It is wearying to routinely experience harassment because of who I am and the Party I stand for.”

Sources of support

Participants had sought assistance from different sources including the Parliamentary security enablement team (56%), the Police (48%), a private security company (28%), and the Fixated Threat Assessment Centre (26%). Eight MPs (16%) reported seeking help from a health professional. MPs felt there was insufficient support to meet an increased risk and that additional supports should also be available to staff.

“The security response from parliament … is poor with little meaningful support provided given the enhanced risk.”

“The consistent message is that we are significantly vulnerable, and insufficient resources and effort is put into making and keeping us safe. It is not reassuring to hear colleagues talk of ‘not if but when’ an MP is seriously harmed, and that when this happens, there will be a report commissioned that says exactly what we have been saying over and over to deaf ears for far too long.”

“Moderating social media can be draining and very unpleasant for staff who help MPs do this. It can have a negative and stressful effect on them having to regularly see hateful comments, respond to some of them; and block or hide others. These staff are often relatively young and being exposed to an overload of negative comments can affect their mental wellbeing.”

“It would be good to get more support for staff and AI tools to moderate social media. Knowing that others are monitoring social media to identify extremists helps. So would tools and training around the use of language to help avoid using triggering language.”

This study showed high rates of harassment that was impacting on the wellbeing of politicians, their staff and families. Harassment was reported by 98% of participants, ranging from disturbing communication to actual physical violence. The vast majority of MPs endorsed multiple modalities of harassment occurring on multiple occasions. Women were at significantly higher risk of certain types of social media harassment including gendered abuse, sexualised comments, threat of sexual violence, and threats toward their family. The qualitative data emphasised the disturbing nature of some of the harassment, including implicit and explicit threats to MPs and their families. The nature of the harassment appeared to be driven by a combination of personal grievances, extremist ideologies, and mental health challenges.

Almost all forms of harassment had increased significantly since 2014. It was not just the frequency of threats that had increased, but their psychological impact. In 2014, MPs were often phlegmatic when talking about their experiences of harassment, reporting a lower degree of distress than expected ( 7 ). The 2022 survey found a marked increase in harms arising from harassment/trolling, for example, feeling fear about personal safety had risen by a factor of three. Additionally, nearly two thirds of the participants reported mental or emotional stress, and staff and families were also affected. These findings speak to the high cost of holding public office and the risk to vital democratic activity are similar to those found in the UK ( 18 ) and are consistent with the described pernicious psychological effects of sustained harassment ( 33 ). Previous research has raised the spectre of harassment and threats to change in the behaviour of elected representatives to lessen engagement with their communities or to decide not to continue in politics if they are subject to harassment and abuse ( 17 , 18 , 34 ). If this is the case, then the damage to our democratic institutions may be considerable. This seems to be playing out in the international reports of online abuse and threats of violence deterring elected representatives from participating in politics, especially for women ( 35 – 37 ).

Fifty-nine percent of MPs reported experiencing abuse related to the Government response to the COVID-19 pandemic, many considering this to be a watershed event in terms of the online vitriol towards parliamentarians that ensued, which then spilled into actual violence during the 2022 occupation of parliamentary grounds. Participants felt the level of the abuse that intensified over the COVID pandemic had not abated at the time of the survey, despite the removal of the restrictions that had provoked the escalation of online hostility.

The online environment with its apparent anonymity, invisibility, and perceived lack of consequences may result in an ‘ online disinhibition effect ’ ( 5 ). The online disinhibition effect refers to the phenomenon wherein individuals engage in behaviours on the internet that they might not typically display in face-to-face interactions. This may embolden some individuals to engage in harassment online, even though they would not have behaved that way in person.

Overall, the current political climate, characterised by heightened polarisation and the amplification of extreme viewpoints through digital platforms, seems to be exacerbating threats against politicians. Internationally there is evidence that support for violence to achieve political ends is increasing amongst Western democracies. For example, in a 2023 American study, 38% of Republican supporters agreed violence was acceptable as a means to stop political opponents from reaching their goals ( 38 ).

The emergence of disaffected online communities can attract and validate fixated individuals who align with extremist ideologies, leading to intensified online harassment and real-world threats. Notwithstanding the fact that harassment and stalking causes considerable psychological harm, irrespective of any physical violence that may eventuate ( 33 , 39 ), for many participants, the fear of being hurt or killed, or having a family member harmed by a fixated individual was a live concern.

Concerningly, in our study, it was not just online abuse which had increased, but also threatening approaches toward politicians, which were reported by four out of five politicians and one in five had been attacked.

Strengths and limitations of this study

The strengths of the study include the repetition of many of the questions used in a 2014 survey of New Zealand MPs, allowing comparison over time. The wealth of free text data provided important insights that could be analysed qualitatively and triangulated with the quantitative data.

However, the study methodology also has obvious limitations. The study design was an anonymous survey, meaning we could not identify the people subjected to harassment or those perpetrating the harassment. Actual harassing communications were not analysed. The threshold of what constituted harassment was subjective, with the concept generally operationalised in the survey by asking participants whether they had experienced abusive or threatening contacts. The sample size was relatively small and the response rate was below 50%, raising the risk of selection bias, although it is to be noted that the response rate is similar to, or exceeds, the rates from similar international studies.

Future actions and research priorities

It is not appropriate to just monitor and report on this issue. MPs were clear that they and their staff require support and resources to manage these threats. This necessitates a multi-pronged approach and expansion of existing services. For new politicians, de-escalation, safety and cybersecurity training should be part of the induction package, and resources made available to increase home and office security measures. MPs experiencing harassment benefit from easy and rapid access to specialist advice and support. Provision of such services requires not only resource but also regular education and liaison with affected MPs and their staff, from specialist services. In the demanding, fluid and time poor environment MPs work in this can be difficult to deliver. In New Zealand at least, the Government appears increasingly cognisant of this issue, with the public service budget in 2023 containing additional funding earmarked for ‘enhancing security measures for MPs and their staff’.

In addition to MP-centred interventions, early identification and risk assessment of fixated individuals, including thorough background checks and monitoring of online behaviour, can aid in proactive intervention. Collaboration between law enforcement agencies, mental health professionals, and political entities can be effective in identifying, assessing and managing potential threats. In New Zealand, the establishment of FTACNZ, and the roll out of mental health co-response teams involving police, paramedics and mental health professionals responding in tandem, are both good examples of interagency approaches ( 40 – 42 ) but it is evident from our research that more could be done.

Moderation of the online environment is a thorny issue. There needs to be greater engagement with technology companies and the development of algorithms that can quickly identify and remove dangerous content, but achieving this is not simple. One initiative aimed at advancing this is the “Christchurch Call.” This originated in 2019 when the New Zealand Prime Minister and French President brought together political and technology sector leaders in a commitment to work toward eliminating violent extremist content online, after the horror of the live-streamed fatal shooting at two Christchurch mosques ( 43 ). This work continues, but complex issues such as balancing free speech and security, and achieving consensus and cooperation among diverse nations and corporations with different legal systems, cultural norms, and priorities, means that progress has been slow.

In terms of future research, factors such as age, gender and ethnicity should be examined in more depth. Our sample was too small to be able to consider ethnicity or age as predictive variables, although we showed that women were at higher risk of concerning harassment such as threats toward their families and being threatened with sexual violence. Other research suggests racism and sexism are common drivers of abuse of politicians. For example, an analysis of Twitter abuse against female MPs in the United Kingdom found in the run up to the 2017 election, nearly half of the abusive tweets were directed at Diane Abbott, the first black woman to be elected to the British parliament. When Abbott was excluded from the sample, black and Asian women still received 30% more abuse than their white colleagues ( 44 ).

The survey was fielded shortly after the majority of the COVID pandemic restrictions had ended (including vaccine mandates and mask wearing requirements except in healthcare facilities) ( 45 ). There was little doubt in many of our participants’ minds that the pandemic and the Government response to this had contributed to an increased frequency and intensity of abuse. Repeating the survey in a couple of years’ time to track the trajectory of abuse over time is advised.

Conclusions

Harassment of parliamentarians is an increasingly serious issue. Almost all MPs reported harassment, often via multiple modalities and on multiple occasions. Women were at significantly higher risk of certain types of social media harassment including gendered abuse, sexualised comments, threat of sexual violence, and threats toward their family. Almost all forms of harassment had increased significantly since this survey was last fielded in 2014. Overall, the extent and medium by which this harassment occurs is shifting. This harassment has significant psychosocial costs and requires a multi-pronged response.

Data availability statement

The datasets presented in this article are not readily available because of the sensitive and confidential nature of the raw dataset. Data will only be made available to researchers with approval of the University of Otago Ethics Committee. Requests to access the datasets should be directed to [email protected] and [email protected].

Ethics statement

The studies involving humans were approved by University of Otago Ethics Committee. The studies were conducted in accordance with the local legislation and institutional requirements. The participants consented to participate in this study.

Author contributions

SE-P: Conceptualization, Data curation, Formal Analysis, Investigation, Methodology, Project administration, Resources, Software, Writing – original draft, Writing – review & editing. OH: Conceptualization, Data curation, Formal Analysis, Investigation, Methodology, Project administration, Resources, Software, Writing – original draft, Writing – review & editing. JB-W: Conceptualization, Data curation, Investigation, Methodology, Project administration, Resources, Software, Writing – original draft, Writing – review & editing.

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1357907/full#supplementary-material

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Keywords: stalking, politicians, fixated threat assessment, violence, mental health, gender, social media, COVID-19

Citation: Every-Palmer S, Hansby O and Barry-Walsh J (2024) Stalking, harassment, gendered abuse, and violence towards politicians in the COVID-19 pandemic and recovery era. Front. Psychiatry 15:1357907. doi: 10.3389/fpsyt.2024.1357907

Received: 18 December 2023; Accepted: 15 March 2024; Published: 16 April 2024.

Reviewed by:

Copyright © 2024 Every-Palmer, Hansby and Barry-Walsh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Susanna Every-Palmer, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.