(CNN) – According to a new opinion from the US surgeon general, there is insufficient evidence to determine whether social media is safe enough for children and young people when it comes to their mental health.
Tuesday’s statement noted that while there are some benefits to using social media, it poses “a significant risk of harm” to children. It calls for more research into the impact of social media on young people’s mental health and for action by policymakers and technology companies.
The 25-page recommendation comes as more states seek tightening regulations on social media platforms, including efforts in Montana to ban TikTok.
General guidance for surgeons is intended to draw attention to pressing public health issues and provide recommendations on how to address them, the new report says. Previous advice has focused on young people’s broader mental health, health misinformation and the use of the opioid overdose antidote naloxone.
“We are in the midst of a mental health crisis in young people and I am concerned that social media is contributing to the damage that children are suffering,” said Surgeon General Dr. Vivek Murthy to CNN.
“For too long we’ve placed the entire burden of managing social media on the shoulders of parents and children, even though these platforms were designed by some of the world’s most talented engineers and designers to maximize the time they dedicate to ours.” Kids spend on it,” he said. “So this is not a fair fight. It’s time we got our backs on parents and kids.”
The Recommendation reviews the available evidence on the impact of social media on young people’s mental health and finds that social media use among children is “nearly universal”: up to 95% of children aged 13-17 give report using social media, with more, and more than a third say they use it “almost constantly”. And while 13 is typically the minimum age for using social media sites in the US (an age Murthy previously called too young), the recommendation notes that nearly 40% of children are also aged from 8 to 12 years use the platforms.
“We must acknowledge the growing body of research on potential harms, improve our collective understanding of the risks associated with social media use, and take urgent action to create safe and healthy digital environments,” the recommendation reads.
The report cites several ways that social media can harm young people’s mental health, noting that the teenage years are a particularly vulnerable time for brain development. It details studies that have found links between social media use and depression and anxiety, as well as poor sleep, online harassment and low self-esteem, particularly among girls.
A study of 6,595 U.S. youth between the ages of 12 and 15 found those who spent more than three hours a day on social media were twice as likely to develop symptoms of depression and anxiety as non-users, according to the the report. It also cites studies that found that reducing social media use led to improved mental health.
Using social media carries the risk of exposure to dangerous content, including depictions of self-harm, “which may normalize such behaviors,” the recommendation said. It also cites 20 studies that found a significant association between use of social media and concerns about body image and eating disorders.
Murthy told CNN that the three most common things he hears from kids about social media are: “First, it makes you feel worse; Second, it makes them feel worse about their friendships. But thirdly, they can’t get away from it.”
Excessive social media use can disrupt important healthy behaviors, including sleep, the guide warns, noting that platforms are often designed to preoccupy users with push notifications, autoplay and infinite scrolling capabilities, and algorithms that use user data to customize content recommendations. It cites the belief of some researchers that being on social media with overstimulation of the brain’s reward centers can “trigger signaling pathways akin to addiction.”
The five-page summary of the potential risks of social media use for young people’s mental health. The description of the potential benefits only takes up half a page. It notes that social media can create a positive community and connection with others, which can be particularly important for children, who are often marginalized. It cites studies demonstrating the mental health of lesbian, gay, bisexual, asexual, transgender, queer, intersex and other youth through the use of social media through peer connections, as well as “identity-affirming content” related to race that positively impacts affect teenage girls of color . Finally, it is noted that social media can be helpful in linking some children to mental health care.
The guide provides recommendations for families exploring social media, including creating family media plans, encouraging children to develop personal friendships, and being a role model for good behavior on social media.
Murthy said it was something he and his wife discussed for their children, who are now 5 and 6 years old.
Her plan is to postpone social media use until at least after middle school; to try to find other families to work with who have a similar inclination, “because strength is in numbers”; and when the kids go into high school, there will be another review to see if better safety standards have been put in place “and actually enforced,” he said.
“It’s not easy for parents,” he admitted. “That’s why we are so committed to this recommendation that there is an urgent need for action.”
Adam Kovacevich, founder and CEO of the tech coalition Chamber of Progress, said online platforms have taken note of concerns from parents and researchers and have implemented features to protect younger users, such as limiting nightly notifications.
“I’m sure efforts to protect children are well intentioned, but we shouldn’t compromise the privacy of teenagers by requiring them to verify their age or blocking them from access to supportive online communities ‘ Kovacevich said in a statement.
Murthy hopes the report will spur action at multiple levels, such as more research and funding, policy changes, and particularly more transparency and action by tech companies.
“Independent researchers keep telling us that they have a hard time getting full access from technology companies to the information they need about the health effects on children,” he said.
Murthy said social media companies should adhere to similar child protection standards as other industries.
“We’re taking this safety-first approach to other products that children use, from medicines to car seats to toys,” Murthy said. “We have to do that here too.”
