In several countries, rates of teenage suicide attempts and suicidal thoughts have surged significantly over the past decade, painting a grim picture of an adolescent mental health crisis. Hospital admissions for suicide attempts and suicide ideation among adolescents in the United States doubled between 2008 and 2019, with increases reaching a staggering 500% for the youngest girls. According to the NHS, the United Kingdom also witnessed a disheartening rise, as episodes of admission for self-harm and self-intoxication among boys aged 11 to 17 increased by 42% and girls of the same age experienced a 60% increase between 2005 and 2019, predominantly occurring after 2010. These disconcerting trends predate the Covid pandemic and extend beyond these nations, with, for example, Spain, Italy, South Korea, Australia, New Zealand, and Canada also reporting similar patterns.
Since 2010, life-threatening incidents such as self-harm and attempted suicide have witnessed an alarming rise and, more importantly, deaths related to suicide have increased significantly among teenagers in many countries. Social media, often at the forefront of public debates, is frequently cited as a possible culprit due to its influence on teenagers and their exposure to potentially harmful content. The US Surgeon General recently issued a public advisory, warning that social media may harm children and adolescents, while legislators in Utah passed a law prohibiting social media platforms from allowing users under the age of 18 to create accounts without explicit parental consent.
In her new film I Am Ruth, Kate Winslet takes on the role of a mother who grapples with her daughter’s deteriorating mental health amidst the overwhelming influence of social media. In an interview with the BBC, Winslet said the decision to focus on children’s mental health followed a conversation with the film’s creator Dominic Savage about how parents can help “when they can clearly see there’s a problem.”
Although the correlation between the rise of mental health disorders among adolescents and the increased exposure to online media further supports these responses, correlation does not necessarily mean causation. And the fact is that empirical evidence establishing a causal link in this realm remains scarce. Previous studies examining the effects of online media on mental health have focused on earlier periods and older demographics, for example college students in the US, or young individuals before the surge of online media content and of severe mental health disorders. While these studies are relevant, they do not directly address the teenage population or the specific time period characterized by a significant increase in mental health issues—namely, since 2010, coinciding with the proliferation of new media and content platforms immensely popular among teenagers, including Instagram, TikTok, Netflix, HBO, and more.
In a recent study, my colleagues Esther Arenas-Arroyo of Vienna University of Economics and Business and Natalia Nollenberger of IE University and I use data from Spanish hospital records to analyze the impact of fiber optics expansion on adolescents’ mental health. We focus on fiber optics because previous studies have determined that teens access online media mainly through their smartphones while at home, not when they are outside the house because much of the popular online media they access (video streaming, audio, etc) needs a high-speed internet connection.
To establish a causal relationship, we capitalized on the exogenous variation in the rollout of optic fiber across Spanish provinces between 2007 and 2019. Spain, with more than 80% of its population covered by fiber networks in 2019, stood at the forefront of optic fiber implementation. However, the rollout of fiber infrastructure was not uniform throughout the country. Telefónica, the industry leader, strategically determined the deployment based on historical and political factors, and the heterogenous implementation of government subsidies, rather than socioeconomic or demographic considerations. This variation in fiber infrastructure deployment served as a plausible exogenous shock to gauge the impact of online media exposure on adolescent mental health.
Adolescents struggle to process and cope with the overwhelming influx of information and stimuli they encounter through online media.
Our study finds a significant increase in behavior and mental health cases among adolescents aged 15 to 19 as a result of fiber penetration. In fact, fiber penetration increases the incidence of anxiety, mood disorders, drug abuse, self-harm, and suicide attempts. These incidences are driven almost entirely by teenage girls. There are no statistically significant occurrences among boys or individuals aged 20 to 24.
Some might speculate that these results merely reflect heightened awareness of mental health problems among adolescents, but our study finds that high-speed internet is indeed a contributing factor to a notable increase in deaths related to suicide or self-harm among Spanish teenagers. Once again, it is important to note that girls are disproportionately affected.
The detrimental impact of online media on the mental health of teenagers can be attributed to several mechanisms. Firstly, adolescents struggle to process and cope with the overwhelming influx of information and stimuli they encounter through online media, often leading to confusion, emptiness, low self-worth, anxiety, and even depression. From the dissemination of self-harm and suicide techniques to platforms that foster social comparisons, the consequences of this information overload are significant. Secondly, the anonymity provided by internet use can lead to pathological and compulsive behaviors, such as “digital self-harm,” FOMO (fear of missing out), the “online disinhibition effect,” and addiction. Finally, the internet indirectly affects happiness by displacing healthier activities, such as in-person interactions, exercise, and sleep.
It is crucial to recognize that these mechanisms are not mutually exclusive; rather, they often interact and compound one another. For instance, the bombardment of stimuli from the internet can cause confusion and emptiness, leading to compulsive and addictive internet use as a coping mechanism, perpetuating a vicious cycle. Additionally, the displacement of healthier activities by excessive internet use can result in progressive isolation and heightened addiction. Consequently, evidence of a combination of these mechanisms is expected.
To explore these mechanisms further, we used data from a biannual cross-sectional survey that targets Spanish adolescents between the ages of 14 and 18, to understand their habits regarding drug use, internet usage, and relationships with friends and family. Our analysis finds support for the crowding-out hypothesis, as access to high-speed internet led to increased addictive internet use and significantly reduced time dedicated to sleep, homework, and socializing with family and friends. Girls were the primary drivers and fiber expansion resulted in a higher proportion of girls relying on the internet as a coping mechanism for negative emotions or when feeling low. Interestingly, there is no evidence of increased online bullying.
Lastly, we examined the association between online media exposure and the quality of the parent-adolescent relationship. Through analysis of survey data focusing on questions related to the parent-adolescent relationship, we find that fiber penetration had a negative effect on the relationship between parents and girls, but no significant impact for boys. Moreover, online media exposure had a greater negative impact on the parent-girl relationship in the cases in which there was prior conflict.
Given that adolescence is a critical period for social and emotional development, understanding the effects of online media on the mental health of teenagers is of paramount importance. Previous research has established that mental health problems during adolescence significantly contribute to adverse educational and employment outcomes later in life. Consequently, policy interventions are necessary to mitigate the adverse impact of social media on the mental health of adolescents.
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