U.S. Surgeon General Dr. Vivek H. Murthy wants social media platforms to include a parental advisory warning that using the sites could be harmful to the mental health of adolescents. Such a warning, he said, would remind parents and their children that social media has “not been proved safe.”

Congress would have to sign on before a label could be required. But in an essay published in The New York Times on Monday, America’s top doctor wrote that “the mental health crisis among young people is an emergency, and social media has emerged as an important contributor.”

He wrote that “adolescents who spend more than three hours a day on social media face double the risk of anxiety and depression symptoms, and the average daily use in this age group, as of summer 2023, was 4.8 hours. Additionally, nearly half of adolescents say social media makes them feel worse about their bodies.”

Murthy likens the call for warning labels to the warnings of harm from smoking or the push for seat belts in vehicles that succeeded because of awareness campaigns. Those saved lives and this could, too, he suggests.

“Why is it that we have failed to respond to the harms of social media when they are no less urgent or widespread than those posed by unsafe cars, planes or food?” he wrote. “These harms are not a failure of willpower and parenting; they are the consequence of unleashing powerful technology without adequate safety measures, transparency or accountability.”

In the essay, Murthy warned: “There is no seatbelt for parents to click, no helmet to snap in place, no assurance that trusted experts have investigated and ensured that these platforms are safe for our kids. There are just parents and their children, trying to figure it out on their own, pitted against some of the best product engineers and most well-resourced companies in the world.”

U.S. Surgeon General Dr. Vivek Murthy speaks as he joins first lady Jill Biden and first lady of Utah Abby Cox during a visit to Hunter High School in West Valley City on Tuesday, Jan. 16, 2024. | Scott G Winterton, Deseret News

A good first step

One of the earliest experts to warn of social media risk to the mental well-being of teens and young adults was Jean Twenge, author of the books “iGen” and “Generations.” Monday, she heralded the surgeon general’s call for labels, though she warned that more is needed.

“The surgeon general is right that it’s time to take action. We’ve known for at least seven years that social media is a key cause of the adolescent mental health crisis. Dr. Murthy’s call for a warning label is the latest sign that the tide is turning. Parents — and many teens — are increasingly aware that it’s not healthy to spend nearly five hours a day on social media, which is now the average, according to Gallup,” she told Deseret News.

“Still, many people are not aware that heavy social media users are twice as likely to be depressed as nonusers. The surgeon general’s idea of a warning label, if adopted by Congress, will go a long way toward raising awareness. We still need to do more. It’s still possible for 10-year-olds to open social media accounts without their parents knowing. But it’s a good step,” she said.

“Last year I called on the government to treat Big Tech like Big Tobacco,” Brad Wilcox, senior fellow at the Institute for Family Studies, told Deseret News on Monday. “Therefore, it’s encouraging to see the new surgeon general taking a page out of the Big Tobacco playbook and challenging the nefarious hold that Big Tech has over our teenage children. I’m looking forward to seeing both the federal government and states take more aggressive action to protect our children from the emotional and social negative effects of social media.”

Both Wilcox and Twenge are experts on social media use and the impact on youths. They also are Deseret News contributors.

Warning label won’t be enough

Murthy acknowledges that a warning label won’t make social media safe for teens. For that, he points to recommendations he made in an advisory last year. That, too, calls for congressional action, he wrote.

“Legislation from Congress should shield young people from online harassment, abuse and exploitation and from exposure to extreme violence and sexual content that too often appears in algorithm-driven feeds. The measures should prevent platforms from collecting sensitive data from children and should restrict the use of features like push notifications, autoplay and infinite scroll, which prey on developing brains and contribute to excessive use.”

The surgeon general also wants companies to share with independent scientists and the public the results of their research on the health effects of social media on young people. And he’s calling for independent safety audits, too.

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The next teen epidemic

Two years ago, Murthy said youth mental health is a national emergency. At the time, it was also being exacerbated by the pandemic’s isolation, but experts including Murthy said social media also played a role.

As Deseret News reported then, no mental health crisis is guaranteed to be a single event, as Dr. Samuel Goldstein, psychologist and adjunct professor of psychiatry at the University of Utah, as well as author of “Tenacity in Children,” said during the peak of the pandemic when adolescents were also struggling mightily with mental health and often relied heavily on social media to stay connected.

Mental health issues like anxiety and depression tend to resurface. “Once your body kindles that kind of an extreme response, under stress the body regresses to that again. So about 50% to 70% of teens who have a depressive episode before 18 will have another one before 18. And if you have two, then you’re in the club. You may not always be in the building, but you have a membership card. You’re going to cycle in and out of depressive episodes,” he said.

Holding social media platforms accountable

Of Monday’s announcement, Utah Gov. Spencer Cox said, “Thank you, Dr. Murthy, for protecting our kids. We hope Congress will follow suit.”

During the past session of the Utah Legislature, lawmakers overhauled its previous efforts — the nation’s first — to hold social media platforms accountable when young people are harmed. The new versions, which take effect in October, are expected to hold up to legal challenges, Cox said in January, calling them “still the strongest social media bills in the country right now.”

The bill said that social media companies must enable the strictest default privacy settings on Utah children’s social media accounts, verify the age of users and provide parents with supervisory tools on their minor children’s accounts.

The companies would also have to restrict the ability of Utah minors to send or receive messages from accounts with whom they do not have a direct connection. A second bill created a private right of action for parents and gives social media companies an affirmative defense.

Per the Deseret News article after the bills passed, “The bill makes it so Utah children and their parents can bring a private right of action forward. The person bringing forward the action would need to demonstrate a child was harmed directly by ‘excessive use of algorithmically curated social media.’”

Social media companies would have a defense “if they can show that they limited use of the algorithmically curated content on a child’s account to three hours and a parent or guardian consented to the child account holder using the service, among other measures.”

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The alterations were made after the state was sued by a consortium of social media companies under the name “NetChoice.”

Boundaries to protect mental health

Murthy and other experts, including Wilcox and Twenge, said that it’s vital to prevent mental health issues among adolescents when possible and to tackle them quickly when they do appear. Among recommendations from Murthy and others:

  • Get cellphones out of classrooms.
  • Parents should set boundaries on times children do and don’t have access to social media.
  • Parents should not give children smartphones before the kids are done with middle school.
  • Health care providers should talk to parents and young people about digital use and its potential pitfalls.
  • Parents should talk to young people about what they’re seeing and feeling as they are on social media.

For example, research suggests that mindset matters, when it comes to social media and mental health. A study by Ohio State University experts found that messages on social media can help or hurt those who struggle with anxiety and depression. The study was published in the Journal of Clinical Psychology.

Key was whether social media is approached with a “growth mindset” or a “fixed mindset,” meaning that mental health can get better with effort or treatment, as opposed to thinking that a mental health condition is set in stone.

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