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Technology and Youth Mental Health: Opportunities and Challenges

March 19, 2024

By Harold S. Koplewicz, MD
President of the Child Mind Institute

Michael P. Milham, MD, PhD
Vice President and Director of Research

As part of our mission to transform children’s lives, the Child Mind Institute relentlessly pursues solutions to one of the defining public health crises of our time: a youth mental health epidemic, coupled with a substance abuse epidemic, that results in a staggering loss of life and degradation in quality of life for our young people.

Our kids are not okay.

During the COVID-19 pandemic, the prevalence of anxiety and depression symptoms among teenagers globally nearly doubled. The suicide rate among 10- to 24-year-olds in the United States increased by 60% between 2007 and 2018. And in 2023, twice as many teens went to the ER for self-harm and suicidality as did in 2017.

This dire situation for our children certainly has many contributing factors, including the pandemic, widening inequality, availability of opiate drugs, the climate crisis, and a broken health care system. But one concern has captured the attention of researchers, parents, and policymakers: the ubiquity of technology in young people’s lives. This generation has grown up alongside mobile phones and social media. It is vital for them: as a social connector, a tool for education and entertainment, and even an access point for mental healthcare. It is also a channel for harmful content, conduct, or contact (such as bullying or harassment). And tech addiction (or what researchers call problematic internet use, or PIU) has been associated with family dysfunction, worse mental health symptoms, and substance use.

At the Child Mind Institute, we believe that countering the youth mental health epidemic requires a research revolution – and that this revolution requires us to embrace the same tech our digitally native youth rely on. Today, research on youth mental health relies on a combination of data collected in laboratory settings and through survey data. But increasingly, we understand mental health symptoms in youth to be variable across timeframes – hours, days, months. Even a child with severe depression may seem fine at some points in the day, while some disorders, like bipolar disorder, are incredibly seasonal. The “snapshot” in time provided by a survey, a pediatrician screener, or a time-limited clinical trial risks missing the overarching clinical picture. When it comes to understanding the mental health impact of technology, these snapshots are not detailed or continuous enough to disentangle the role of technology from other determinants of mental health, or to validate the effectiveness of proposed interventions, such as modifying specific features on social media platforms. Perhaps most significantly, laboratory and survey data alone will not allow us to evaluate the real-world effectiveness of emerging digital therapeutics, which may hold the key to expanding access to care for young people.

There is a solution. In addition to laboratory and survey data, we need to study young people’s behavior and interactions as they go about their daily lives – what researchers call an “ecological” approach – by leveraging social media, smartphones, and games. And to do this, we must clear a handful of significant hurdles, including technology and data gaps, unclear policy guidelines, and not least of all the proprietary hold technology companies have over critical sources of data.

The Child Mind Institute has been a leader in the collaborative generation, sharing and use of large, open data sets to accelerate research into youth mental health. We are also now investing in building technology-based interventions to transform clinical care. These efforts put us on the front-lines of using technology to tackle this mental health crisis. As we look ahead to this paradigm shift to ecological youth mental health research, we see the need for collaborative leadership to set the technological and policy stage for a new era.

Over the course of this year, we are engaging with a group of deeply experienced researchers, advocates, and tech thinkers to elevate awareness of the need for ecological research into youth mental health risk factors and symptoms. We will work with these experts to identify the barriers to performing this type of research, explore what it will take to overcome them, and clearly articulate the reasons we need to do so. Enabling researchers to study ecological data will allow us to validate the effectiveness of proposed technology interventions in preventing youth mental illness, as well as clinically validate the use of digital therapeutics in treating youth mental illness.

Working with our colleagues, we have surfaced five key questions that we suggest will guide progress in the field for researchers, policymakers, and industry alike:

How can researchers gain access to data collected by apps and services?

Technology companies collect and store a wide range of data that could be transformative in understanding the mental health effects of their products on young minds. Currently, researchers face tremendous hurdles to collecting similar data, which limits the type of studies they can undertake.

What can we do to ensure research is representative of the entire population, including vulnerable, minority, and traditionally marginalized groups?

We must be intentional about the “who” of the populations we study. Ensuring diversity, equity, inclusion, and belonging in the design of studies, and will require recognizing disparities in both access to mental healthcare and use of technology.

How can we ensure research is done ethically?

Existing privacy guidelines do not envisage the full range of ethical considerations involved in studying children and youths as they go about their daily lives, or the impact of technology on particularly vulnerable populations.

What technical infrastructure is necessary for real-world digital research?

Tremendous advances have been made in creating and opening access to robust, longitudinal data sets that characterize young people, their mental health, and their brains. As more real-world data is acquired for research purposes, the complexity of these data sets will dwarf prior efforts and demand new approaches to infrastructure.

How do we ensure that research is rigorous and reproducible?

There is a lack of consensus regarding best practices for ecological data acquisition, processing, or analysis methods, let alone standardization. Use of this data could dramatically accelerate research, but, without consensus, risks creating a reproducibility crisis like the ones that have plagued psychology and neuroimaging.

We will be hosting a series of events this year delving into these questions, and we hope to bring our wider community along this journey with us. These questions cannot be answered without a broad cross-section of expertise, including that of researchers, technologists, clinicians, policymakers, as well as young people and their families whose lived experience must inform this work. Our hope is that these events bring this cross-section of expertise together in dialogue to identify specific challenges in advancing ecological research on youth mental health and begin to scope out possible solutions. If you’d like to hear about and be able to join us for these events, please register using the link below.

Learn More About the Event

Harold S. Koplewicz, MD
Harold S. Koplewicz, MD
Harold S. Koplewicz, MD, is the founding President and Medical Director of the Child Mind Institute and is a senior … Read Bio
Michael P. Milham, MD, PhD
Michael P. Milham, MD, PhD
Michael P. Milham, MD, PhD, is an internationally recognized neuroscience researcher, the Chief Science Officer and the founding director of the … Read Bio