On this encore episode, we revisit and update one of the most-read articles on the CMAJ website.
The article is titled, “Smartphones, social media use, and youth mental health.” It reviews the extensive literature linking poor mental health in adolescents with smartphone and social media use. The article details a variety of studies that implicate smartphone and social media use in increased mental distress, self-injurious behaviour, and suicidality among youth. It also indicates that there's a dose-response relationship, with the effects appearing to be most pronounced among girls.
The lead author of the paper is Dr. Elia Abi-Jaoude. He is a psychiatrist and researcher at The Hospital for Sick Children in Toronto. He delves into recent research exploring how social media and smartphone use negatively impact the mental health of young individuals.
Later in the episode, Dr. Michelle Ponti offers practical tips that physicians can provide parents to effectively manage their children's smartphone and social media use. Dr. Ponti is a paediatrician in London, Ontario, and Chair of the Digital Health Task Force for the Canadian Paediatric Society.
Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.
You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole
X (in English): @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca
The CMAJ Podcast is produced by PodCraft Productions
On this encore episode, we revisit and update one of the most-read articles on the CMAJ website.
The article is titled, “Smartphones, social media use, and youth mental health.” It reviews the extensive literature linking poor mental health in adolescents with smartphone and social media use. The article details a variety of studies that implicate smartphone and social media use in increased mental distress, self-injurious behaviour, and suicidality among youth. It also indicates that there's a dose-response relationship, with the effects appearing to be most pronounced among girls.
The lead author of the paper is Dr. Elia Abi-Jaoude. He is a psychiatrist and researcher at The Hospital for Sick Children in Toronto. He delves into recent research exploring how social media and smartphone use negatively impact the mental health of young individuals.
Later in the episode, Dr. Michelle Ponti offers practical tips that physicians can provide parents to effectively manage their children's smartphone and social media use. Dr. Ponti is a paediatrician in London, Ontario, and Chair of the Digital Health Task Force for the Canadian Paediatric Society.
Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.
You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole
X (in English): @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca
The CMAJ Podcast is produced by PodCraft Productions
Dr. Mojola Omole:
Hi, I am Mojola Omole, fresh from vacation.
Dr. Blair Bigham:
And I'm Blair Bigham. This is the CMAJ Podcast.
Dr. Mojola Omole:
Blair, all of us have hopefully had a restful summer full of adventures. And across the country, most kids are heading back to school this week.
Dr. Blair Bigham:
They are. And so we thought it'd be interesting to revisit and update one of the most read articles on the CMAJ website.
Dr. Mojola Omole:
The article is “Smartphone, social media use, and youth mental health,” which is a huge topic back when it came out in 2020 and even more so now. And it's a comprehensive survey of the evidence that social media and smartphone use drives poor mental health outcome for young people.
Dr. Blair Bigham:
Jola, you have a kid?
Dr. Mojola Omole:
Yes, I do, Blair. Yes, Blair. I have a child.
Dr. Blair Bigham:
I don't have a kid.
Dr. Mojola Omole:
I would say that when we talk... He's young, so I'm not overly worried about social media, but I definitely will say that I can't even blame him. It's me. I am an overworked single mom, and so oftentimes I just plop on YouTube. I'm not going to even lie. And I'm lucky that he just likes dinosaurs and horses, and he's actually very good at self-regulating. Usually within half an hour he still wants it on, but he'll just start playing with his toys. I've been lucky in that aspect. But there are some times where I see other people and their kids are just reading a book and I'm like, "Oh, I wonder what that's like when your kid just reads a book." What's always in my mind is he's so young, he knows how to scroll. He can scroll and find his favorite show. What's that going to look like when he's a teenager or when he's 10? What are we going to be talking about in terms of, I can't say, "Well, you've had your iPad all these years," and now he wants a smartphone. Am I going to say...
Well, obviously I'm going to say no, but I do think I'm going to struggle with saying no.
Dr. Blair Bigham:
And it's not just toddlers who are being exposed to new technologies like this or new for their age group, I guess I should say. We're going to focus on teenagers for the most part. And while doing that, we're going to be looking at some of the harms they can face from over overexposure to social media. Dr. Michelle Ponti is going to be with us to discuss practical steps that both physicians and parents and youth can take to help control their smartphone use and stay mentally well. She's chair of the Digital Health Task Force with the Canadian Paediatric Society.
Dr. Mojola Omole:
But first an update on the evidence.
Dr. Blair Bigham:
A study in CMAJ in 2020 reviewed the extensive literature connecting poor mental health in adolescents to smartphone and social media use. It described a variety of studies that implicated smartphone and social media in the increase in mental distress, self-injurious behavior, and suicidality amongst youth. It also found that there's a dose response relationship and that the effects appear to be greatest among girls. The lead author of that study was Dr. Elia Abi-Jaoude. He's a psychiatrist and researcher at the University of Toronto. Elia, thanks for joining us.
Dr. Elia Abi-Jaoude:
Thank you for having me.
Dr. Blair Bigham:
You published your study about two years ago, and it painted a pretty troubling picture for youth mental health. What was it that you were seeing in your practice that made you want to do that study?
Dr. Elia Abi-Jaoude:
It's an interesting question because in fact, I've gotten into this, the whole area of social media and smartphone news, not because I was ever necessarily particularly interested in it, but really because of what I was seeing. My main area of clinical focus is tics and Tourette syndrome, which seems completely unrelated to this. However, I also work in an inpatient psychiatric unit, an adolescent psychiatric unit, and I started doing that in 2015, not because I wanted to do it, if I'm honest, more because there was a high need for it. And so I started working on the unit. And working in this setting gave me a frontline seat, if you will, to witnessing the dramatic rise, I must say, in youth mental health struggles in the past decade. I think I'm sure, Blair, you as an emergency physician have probably seen something very similar. I think anyone working with kids in any setting really will have been seeing that.
Dr. Blair Bigham:
It really has been overwhelming. Ever since residency, everyone would just keep talking about how this is a new phenomenon. This wasn't 20% of the workload before the last decade, and it really is crushing a lot of emergency departments and paediatric emergency departments and inpatient services.
Dr. Elia Abi-Jaoude:
Exactly. Exactly. And in fact, this has been the focus from the medical system is we need to increase access to care, access to therapy, increased number of beds and such. And while I think there's merit in that, I think we're missing is asking the question, "What the heck is going on here?" And so this is where, as disturbing as this was, I also found it very intriguing and, I started really trying to figure out what's going on among young people.
Dr. Blair Bigham:
This is definitely a multifactorial problem. How clear is it that social media and smartphone use are major contributors to this multifactorial problem?
Dr. Elia Abi-Jaoude:
Most of the evidence has been in the form of large epidemiological studies. There've been many different such studies and different settings and different groups, different designs, and the findings have been fairly consistent. The other thing is if we think of the Bradford criteria for Bradford Hill criteria for causality, there are many things that tick the boxes, basically. There are studies that show temporal associations. There are time lag analysis where you show that social media and smartphone news proceeded rise in youth mental health difficulties. It's true the other way around as well. There's a bidirectional relationship, but it is not as big as the mental health struggling youth spending more time on social media as it is of spending more time on social media and having more difficulties. Another one is the dose sponsored relationship. There's a clear cut dose response relationship. There's specificity to it. It affects girls more than boys. Even with the observational studies, the evidence I would say has been compelling.
Dr. Mojola Omole:
We keep on saying smartphones, what do we... because I mean I'm currently on my smartphone to help me with this interview. When we talk about smartphones, which part of the usage are we talking about?
Dr. Blair Bigham:
I always assumed it was just the portal into the social media, the immediacy of the social media.
Dr. Elia Abi-Jaoude:
I think this is really good, Jola, in terms of needing to clarify the specifics here. I'll say not all screen time is equal. Not all smartphone use is equal. We are using technology here. I happen to be at my computer, but could have been doing this on a phone, and it's not the same as some of the other usage. One thing is, as you say, Blair, it's the device that allows you to interact through these specific social media platforms. One is the social media interaction, that's one, but the other is the device itself has issues with it in terms of negative impact. So it's not even just the media itself, it's the device itself. And I can even start off with that as one of the-
Dr. Blair Bigham:
Start with that. That's interesting.
Dr. Elia Abi-Jaoude:
I mean, there are many mechanistic factors here or ways in which smartphone and social media use can have negative impact on people. But the one that is probably the most robust in terms of the evidence behind it is sleep, the impact on sleep. And this is not theoretical, there's robust evidence even where they measure people's melatonin levels when they're interacting with a digital media device in bed versus interacting with a book. And then people's melatonin levels are measured. For example, this particular study I'm thinking of where they actually measured people's melatonin levels, they measured people's sleep architecture, and then they measured their alertness the following day. And this was a randomized controlled study again, and basically it decreased melatonin levels or delayed their rise, it delayed sleep onset, delayed the REM sleep onset, and then decreased alertness the following morning. This is not just theoretical, the impact of sleep is very robust.
For example, I'll give you another one here where they randomized people into three groups. One group is allowed to use their cell phone ad-lib as much as they wanted in bed. The other group, the phone had to be off on the bedside table. And then third group, the phone had to be outside of the room. Not surprisingly, the condition where participants are actively using their devices had the worst sleep. Well, what's interesting, even the mere physical presence of the phone in the bedroom had a negative impact. Those that slept the best were the ones with the phone outside the room.
Dr. Blair Bigham:
Good God. Not just off, but out of mind.
Dr. Elia Abi-Jaoude:
Because for some reason even it might be some conditioned association, it's a temptation to check. The empirical data is quite compelling at this point. And then coming back to the mechanism, I would say sleep is a huge one.
Dr. Blair Bigham:
Moving beyond the device, tell me more about what's happening on social media through those devices that is leading to this generation of distressed youth.
Dr. Elia Abi-Jaoude:
Lots is happening on these devices. The medium itself has an impact because when you're interacting with someone through these media as opposed to let's say face-to-face, where you get the real time feedback in terms of body language, facial expression, tone of voice, that kind of thing, it can really make interactions more tricky. For example, it's harder to assume negative intentions, a lot of room for miscommunication. And then it's also easier to make negative remarks, because you're not facing the person right away. That's one thing. And then it can grow and blow into cyber bullying, which we know is common, and then people ganging up on someone through social media. These are things that are common. It's easier to assume negative intentions, easier to make negative comments and misunderstandings are easier.
But the other thing is, it's mere accessibility as a window to what's happening with your peers can be quite tricky because it's not necessarily a realistic window all the time. For example, people will have a lot of posts about things happening in their lives, and they're not going to just post mundane things. They're going to post the highlights of their lives, whereas you're aware of everything in your life, the highlights, but also the mundane. And so it might make you feel like you're missing out. And another big impact is on body image. People posting images that are unrealistic and then make you feel inadequate that way. The other thing is, let's say some friends of yours, they go out and they don't include you, and then they're posting things from their outing. Pre-digital media, you might have not heard about it, even not known about it, or if you had known, and then that's it, it passes, but now you're taking it with you to bed. It's constantly staring you in the face, literally.
Dr. Blair Bigham:
It sounds like a lot of what happens when youth are on their phones is a very passive thing. It's not like they're directly being bullied or harassed, but that it's more just the way they interpret what they're seeing in other people's social media posts. Is it fair to call that a social contagion? Is there something almost harmful just about the mere experience of seeing what other people post?
Dr. Elia Abi-Jaoude:
Yes. That's a huge one, I think. And then it's become especially apparent in recent years. These days you will see a lot of young people who are coming and seeking care for one mental health label or another. They're self-diagnosed, they self-identify as this, that or the other. And when you try to tell them let's say, "You don't have bipolar disorder," you think it'll be reassuring. No, it's disappointing. There are many popular labels out there, autism, ADHD, even ticks and Tourette's. This ties into my main area of clinical focus, which is ticks and Tourette's, which is another fascinating phenomenon we've seen in recent years, is there's been a dramatic increase in young people, in particular girls, not exclusively girls, but in particular girls going into the emergency room because they're having sudden onset, severe, I'm going to put in quote "ticks." They're not actual ticks, but they're very functionally impairing and very dramatic to see.
A lot of them are getting labels of having severe Tourette syndrome, some of them being admitted and getting all sorts of fancy workup. And this has been a global phenomenon, and it's a fascinating, disturbing, but fascinating thing that's happened. And in the past, these kinds of contagious kinds of ticks could happen in little pockets. Let's say in a high school somewhere, some girls would start experiencing similar abnormal kinds of movements and it'll get a little bit of attention and then it dies off. However, given the reach of social media, this is no longer isolated pockets. This is happening at a global phenomenon, at a global level, and we're seeing this kind of things and all sorts of labels. In terms of the emotional contagion, social contagion, it's a big part of what's going on.
Dr. Mojola Omole:
I guess I feel slightly validated because every time I'm on social media, I hear everyone say, "I'm neuro diverse. Us people with ADH..." I'm like, "Does everybody have ADHD?" But I guess I'm just trying to understand is, why is this happening? Why does everybody want to be labeled as neuro diverse? I'm just trying to understand what is this?
Dr. Elia Abi-Jaoude:
I think each of these labels in terms of its rise among the young people has its own story in terms of what's happening. ADHD is a particularly interesting one. And the other thing I'll say, it's not to take away that these people are not struggling, and even those functional tick like behaviors that I mentioned earlier on also can be quite impairing. But I think knowing these things for what they are is key to... because it guides you in terms of what's the best way to address them. ADHD, for example, is a particularly big one. It gets a lot of attention, a lot of people's self labeling. And you can see how a lot of people are struggling with maintaining attention. One is, they're on these devices, these devices are distracting, they're pings and pongs and notifications and whatnot. Good luck getting your schoolwork done.
They are designed to capture your attention and to engage you. That's how, it's basically the monetization of our young people's attention. It happens they spend excessive amounts of time on these devices at the expense of things they need to do, schoolwork, time with family, friends, physical activity and whatnot. Now they're falling behind, plus they're stressed because of the difficult social interactions and whatnot. Plus they're sleep-deprived, so it's harder to focus. And then plus expectations in general in society, things keep getting more and more competitive. Expectations keep getting higher and higher. I mean, try to buy a house in Toronto these days, but this is just symbolically. But we always feel like we're needing to do more and more with less and less. And so all of a sudden you're behind, you're feeling inadequate, you're struggling, you're having trouble focusing and whatnot, and then you're bombarded with ADHD on social media, on TikTok.
We did a study actually published last year where we looked at the top 100 most popular videos on ADHD on TikTok. A lot of them are misleading, first of all. And the other thing, the volume, the exposure these videos get is unbelievable. It's out of this world. When we collected our data, the hashtag ADHD had over four billion views, not million. I'm talking in the billions. Last year was over 10 billion. This year it's over 20 billion views. Just for you to see how much exposure this stuff is getting, okay, and you're looking... and then the algorithm is designed to give you more and more of whatever... more extreme to keep you engaged. Now to add to this, users get targeted ads from now these private companies, a lot of them online companies, that for a few hundred bucks will give you an ADHD assessment. And you have to wonder about the quality of these boutique ADHD clinics.
And in fact, there's a... recently, not long ago, there's a BBC journalist who went in the UK and he got an assessment for ADHD at the NHS, their public health service. He got a thorough assessment. He was told he did not have ADHD, and then he sought an assessment from three different ones of these private ADHD companies. And he answered very honestly the questions. He only just did not tell them the purpose of the assessment. Anyhow, all three ended with a diagnosis of ADHD and an offer of stimulant medication. Basically, this would be one story in terms of the contagion and how these devices and media are contributing to the rise of these labels. And the problem is then it floods the system, and it becomes harder for the system to manage and give care to those that really mostly need it, need a medical kind of intervention.
It's a missed opportunity to address the issues that are happening in the person's life that are leading to the struggles, whether we're talking about ADHD or whatever other struggles are. You're pathologizing your experiences, you're taking on an illness identity. This is part of the problem with letting these labels run rampant as seems to have been happening now, especially recently.
Dr. Blair Bigham:
Elia, this is fascinating. We could talk all day. Thank you so much for joining us. Dr. Elia Abi-Jaoude is a psychiatrist and researcher at the University of Toronto.
Dr. Mojola Omole:
It's one thing to know the risk for young people of social media and smartphone use, but it's another thing to know what to do about it. That's why we wanted to speak with Dr. Michelle Ponti. She's a paediatrician in London, Ontario, and the chair of the Digital Health Task Force for the Canadian Paediatric Society. Thanks so much for joining us today, Michelle.
D., Michelle Ponti:
Oh, you're welcome.
Dr. Mojola Omole:
Let's just start off with what are just some practical steps physicians can suggest to parents to manage smartphone and social media use by their children?
Dr, Michelle Ponti:
I think my best advice is that I like to use a very easy to remember four M model that I helped develop alongside the digital health task force with the CPS. And one of the Ms stands for manage. And so managing screen time, we have to help our kids learn the appropriate uses of screen. A 3-year-old is not going to know how to manage their time. That takes a lot of higher cognitive executive functioning. You are doing that for your child.
Dr. Mojola Omole:
Sometimes.
Dr, Michelle Ponti:
For older kids and teens, which was the focus of this paper that we were discussing is number one, keep tech out of the bedrooms. If we think about a teenager with solitary isolated screen time locked away in a bedroom, that's very risky versus that same teenager that may be doing the same activity but sitting on the couch in a family area, a family living room where the parent is in the vicinity so the parent can observe, parent can notice, can ask, inquire like, "What's going on?" And just open up that conversation to help that child or teenager, whatever it is they may be struggling with. You can't do that if you don't know what's happening. Big tip, keep tech out of the bedrooms.
Another way to manage, and this goes for your 3-year-old as well as older kids and teenagers, is think about developing a family media plan. And there's good templates available on the internet. A great one is through the American Academy of Pediatrics, and we actually have a link to it on the CPS website as well. And you can go into these templates and develop a media plan for each member of the family, depending on their age, depending on the uses. For you yourself, you might have a plan that revolves around work related activities. Your older kids, school related activities, recreation, what kind of limits you want to put on there. It's a really great way to manage.
Dr. Mojola Omole:
And so if some kids are maybe more receptive to this, I can remember probably I was probably more receptive when I was a teenager, probably my brother a little less. What are some ways that parents can set up the discussion for their kids?
Dr. Michelle Ponti:
First of all, start early. Start as early as possible. And even with young parents, I ask them to think about... even prenatally, prenatal classes could consider bringing these discussions in. How are we going to incorporate screens and screen uses into our family life? But I think one of the most important M’s from the four M model is to model. If an adult is actually modeling healthy use of screens, it makes that conversation just so much easier because it's happening in the moment, whether again, you're a physician or a parent or if you're both, we all have to take a long, hard look at our own habits and educate ourselves on the effects that it's having on us for better or for worse, right? Before we can open up that conversation with our kids. And we actually need to learn how this stuff works.
Parents have a hard job. We're making healthy meal plans and buying bike helmets and making all these safety plans and toy regulations, and now we have to learn all about this screen use and privacy settings. But it's so important to educate ourselves so that we can then have those conversations with our kids.
Dr. Mojola Omole:
I know that when I hang out with my nephews, they're using their... they don't have smartphones, but they have their tablets and it's not just... they're not playing video games on it, they're socializing. This is how they talk, they're talking over their video games. They're not really into Snapchat yet, but as people are getting older, they're talking over Snapchat and this is how they connect with their peers. How do we limit the use of the smartphone or iPads without limiting the opportunities for them to actually connect with each other?
Dr, Michelle Ponti:
This is a fantastic real life question because it's not the screen itself that's inherently risky, it's actually how we're using it. And so you gave a great example. These kiddos, your nephews are using the screen for a healthy purpose. They're socializing with friends. And so most kids will socialize with their offline friends online as well. That's the most way they use it to socialize. They're actually friends in real life, and that's important. If it's a social use, which is the one that you just gave, if it's an educational use... Hey, when we were all in lockdown through the pandemic, we all had to educate our kids online, great use of the screens. Thankfully we had that. And then active uses, some of those apps that you can use to download information and go out and explore nature or a hiking app, the geocaching, even like WeFit, all of those active uses. If it's a social use, an educational use or an active use, then I think then we can teach our kids that it's not the screen that's causing the problem, it's choosing how we're using it.
Dr. Blair Bigham:
Can I dig into that a little bit? It seems like the benefits of social media around socialization are blended with the harms of passively seeing other people's excellent lives and excellent bodies, and then internalizing how yours might not be as good. What are some of the early signs that we can watch out for that kids might be becoming distressed by their social media use? Because I can't see us being able to carve out the black and white, "This is what we want you to use your phone for. This is what we want you to avoid." What are those warning signs that make us go, "Okay, we're not getting it right, we're not using our phone ideally here. We're starting to see some harms come up."?
Dr, Michelle Ponti:
Oh, absolutely. It's such a grey area, and there is really no one size fits all, right? Each child, teenager is impacted differently. I ask parents to really monitor their child's mood, and that's an early indicator of problematic screen use, problematic social media. Are they more irritable than normal? Are you finding that there's oppositional behaviors around screen limits? Are they really upset and angry and frustrated when they can't access their screen time? Those are all signs of potential problematic screen use, but most kids will display those signs at any given time, and it doesn't actually necessarily mean it's going to be a problem or it's become an addiction that's out there, but it just means, "Hey, there might be some red flags." I think the biggest red flag for parents is the screen use or the social media actually interfering with other healthy routines. And so those are the healthy routines that we would expect any teenager to move through their 24-hour day would be sleep. Huge one. Teenagers, they need 10 to 12 hours of sleep. Are they getting it? No.
Dr. Mojola Omole:
They need that much sleep?
Dr, Michelle Ponti:
The recommendation for teenagers is at least minimum eight hours, but most teens need nine, ten hours. But the point is that it's a big chunk of a 24-hour day that kids need to sleep. Then school, right? Eight hours getting to school, getting up and ready for school, being at school. There's another big chunk of time. Then we talk about physical activity. Kids need at least an hour of vigorous activity a day, a couple hours of moderate exercise and socializing, social face-to-face interactions, whether that be over a family meal, within family context or an organized sport or an organized activity. If you add up all those hours, it really doesn't leave much left. If screen time and social media is actually interfering in all of those other daily activities, and if you've noticed... I've put them into S's, so again, it's easy to remember, sleep, school, social and sports. Really easy to remember. Those are the daily routines that we really need to reinforce, and then the additional recreational screen time can fit in afterwards.
Dr. Mojola Omole:
Do you think physicians should be proactive raising these issues with parents?
Dr, Michelle Ponti:
100%. In fact, the community paediatricians and family physicians, nurse practitioners across Canada will use the Rourke Baby Records for monitoring vaccines and anticipatory guidance and so on, right up until the age of six, those Rourke guidelines. And then there's some ones developed for adolescents as well, but we're actually adding screen time counseling to anticipatory guidance that should take place at every well-child visit.
Dr. Mojola Omole:
That's great.
Dr, Michelle Ponti:
But often in my interactions with families, parents, kids in clinical practice, I actually like to leave them with tips that they can use and start doing right now today. For example, your 3-year-old child on the iPad, on the smartphone, you're handing it to him so you can get some work done. Make sure you've put guided access on the settings, turn it on, which requires a passcode so that you can set him up on an app and he can play it. You've curated his content and you say, "Yes, this is educational. I'm happy that you're watching this show or interacting with this app," but then he can't then all of a sudden start browsing the web inadvertently. Guided access. Right in the office, I will take the phone and show parents how to turn that on. Try turning your phone to grey scale, instead of the color. Get into settings-
Dr. Mojola Omole:
I did that. I was miserable for 20 minutes. I was like, "No."
Dr, Michelle Ponti:
Right. It's less appealing, it's less amusing, it's less attractive, especially to young developing brains or teenagers that are just so enthralled with that rush of what they're seeing online. Turn it to grey scale, give it a try. I always ask parents, "Try it out first for yourself. Try it out and see if it works. And if not, go back and reinvent the wheel." We're not looking for perfection right away. We're just looking for progress. Are we moving in the right direction? And you know what? I always say to parents lose the guilt. There is to be no concern about that. We're just trying our best. And it's never too late to start, ever.
Dr. Mojola Omole:
That's great. Thank you so much.
Dr, Michelle Ponti:
Oh, thank you. It was my pleasure.
Dr. Mojola Omole:
Dr. Michelle Ponti is a paediatrician and the chair of the Digital Health Task Force for the Canadian Paediatric Society.
Dr. Blair Bigham:
Jola, what do you think?
Dr. Mojola Omole:
The first thing that came to me is that I know this was about youth mental health, but obviously I'm a surgeon, so slightly a narcissist, so I thought about myself. And the first thing I realized is that I need to get my phone out of my room because I do doom scroll because after a day of work and parenting, I literally just want to empty my mind before I go to bed. But realizing the effect that it has on my sleep, maybe that's why I'm always tired. And so I'm going to go on Amazon to get an alarm clock and get the phone out of my room because also I just need to model that for my kid because he does see me with my phone going to bed. He sees me when I wake up, he sees me with the phone in my hand scrolling and checking email, and maybe just creating a little bit of space and boundary about phone usage that way, and being the model is going to be good for me, but also modeling for him.
Dr. Blair Bigham:
And Jola, you and I have seen this in our journalism training and in some of the media reports out there around child and youth suicidality, child and youth mental health, how mental health counselors at universities and colleges are overwhelmed. How the public school system is now facing challenges. And of course, hospitals and family doctor offices completely overwhelmed by this challenge.
Dr. Mojola Omole:
And I think that it was fascinating talking to Elia about the contagion, and I thought I was just turning into a boomer by thinking, "Okay, all these kids and all their trauma." But it was interesting to see that this actually is happening, and we're pathologizing so many normal human experiences. And even addressing that part of it and being present. And I thought that Michelle made a great point, is that if you're going to be sitting there doom scrolling, well, you get to doom scroll beside your parent. And there's something to that because you can watch and see how your child is changing as they're doom scrolling and be like, "Hey, what are you looking at? What's that about?"
Dr. Blair Bigham:
There's been a lot of theory around how parenting is maybe part of the problem and the solution to the youth mental health crisis outside of smartphones too.
Dr. Mojola Omole:
And a hundred percent. And I think that us, growing up in the '90s and we all had eating disorder because we all read Cosmo Magazine that told us that we have to look like Claudia Schiffer or you have to look like Naomi Campbell, this other thin person. But we weren't always bombarded by that. And then it was also like, "Well, these are older people," but now your friends are also part of this. And so I think being able to be present and create those types of boundaries that, "Okay, this is the space where we use a smartphone together," I think is really fascinating, and I think will have a great impact. And also the grey scale. I've done the grey scale, I hated it. But after this conversation, I might actually say, "You know what, Jola, if you're going to spend three hours on your phone because you don't want to do anything else, you're trying to procrastinate work, then it has to be in grey scale."
Dr. Blair Bigham:
That's it for this week at the CMAJ Podcast. We look forward to our next season with you. And while we're at it, we'll ask you to like or share our podcast so that we can get even more listeners for the year ahead. I'm Blair Bigham.
Dr. Mojola Omole:
I'm Mojola Omole, until next time, be well.