The urgent need for evidence-based research to understand the impact of online technology on young people's mental health
Professor Dubicka, a Consultant in Child and Adolescent Psychiatry at the Greater Manchester Mental Health Trust, has witnessed first-hand the negative impact of online technology on young people, including online bullying, exposure to harmful content, and even sexual abuse. She has dealt with cases of porn addiction and encountered primary school children with access to the dark web, who have been sexually exploited by adults and exposed to graphic sexual and violent content without their parents' knowledge.
Professor Dubicka explained that the experience for children and young people can have a very detrimental impact on young people's mental health and trauma. “If you see something that's distressing online, you can't then un-see that. It's very difficult to get rid of those sorts of images.”
Her experience reinforced the importance of considering the potential harm that technology can cause, and the need for responsible and ethical use of technology to ensure the safety and wellbeing of individuals.
There is a growing body of research on the impact of online technology on mental health and wellbeing, especially for young people. However, there is still much more to be learned and further research is needed to fully understand the effects of online technology on mental health and wellbeing, and to inform policy.
However, the increasing speed of the digital revolution is hard to keep up with. Without research, we cannot understand how online activity including interactions, algorithms, and content, can lead to children and young people being adversely affected, including self-harming or, in the most tragic cases, dying by suicide.
In 2020, Professor Dubicka - who was then Chair of the child and adolescent faculty of the Royal College of Psychiatrists - led a position statement from the Royal College of Psychiatrists around technology use and the mental health of children and young people. It generated a huge amount of interest, with half a billion hits worldwide in the first week, demonstrating the level of interest and anxiety around online safety for young people.
The paper highlights that the evidence base is still emerging and there is an urgent need for studies which explore the context and content of technology use, including how technology can be harnessed for its positive benefits.
Professor Dubicka said, "When we were creating our position statement, we found that previous research was largely focused on the impact of screen time on children's mental health. This is outdated – the current use of technology by young people is very different, with various platforms and content, and of course, different sorts of young people who might be very vulnerable to the impact of different types of usage. Yet there has been very little research around these particular groups of young people and the sorts of content they might be accessing and how that might be affecting them."
They found that there is not enough evidence on the impact of online use on mental health, and the available research is limited to general population samples without considering vulnerable groups. Therefore, sweeping conclusions that online behaviour has no impact on children and young people's mental health are being made, based on very limited evidence.
Professor Dubicka explained, "Research can't keep up with the pace of developments online, but how many decades are we going to wait? We need a starting point, which is the Online Safety Bill. At the Royal College of Psychiatrists, we can keep shouting out for those particularly vulnerable people."
The College also called for the regulators to establish a protocol for the sharing of data from social media companies with universities for research into the benefits and harms on children and young people. This research would provide a comprehensive understanding of both the benefits and risks of social media use. A recent amendment to the Online Harms Bill proposes that Ofcom will develop a report and publish guidance on how researchers can access data in a safe and secure way.
Professor Dubicka emphasises the importance of evidence-based policymaking in online safety. She acknowledges that there is a lack of evidence-based research in this area, but at the same time, there is a tension between the need for generating sufficient evidence and the urgency to address the adverse consequences of online activities.
Professor Dubicka explained, "There is this tension about generating sufficient evidence, whilst potentially watching really adverse consequences. It needs to be an iterative process and evaluated and updated on an ongoing basis."
Lack of clinical guidelines for assessing online activities and mental health
Another issue is that clinicians and practitioners have no guidelines to assess how young people's online activities affect their mental health. To address this, Professor Dubicka and colleagues have published a paper with suggestions and recommendations, to provide a starting point for use in clinical assessments.
Professor Dubicka also acknowledges that the current situation seems like a vicious circle. Adults can feel disempowered because often children and young people know a lot more than they do about how to navigate online spaces. There is insufficient training and too much expectation of people like teachers and other professionals.