Youth and Digital Technology Use
Jazmin Reyes-Portillo, Ph.D., Montclair State University
Over the past decade digital technology has become ubiquitous in the lives of teens and young adults (youth). A national survey conducted by the Pew Research Center in 2018 found that 95% of youth have a smartphone or access to one, and 45% of teens reported being online on a near-constant basis. At least 92% use social media, with YouTube, Instagram, and Snapchat being the most common platforms. Given such high utilization, digital health interventions may be a promising avenue for suicide prevention efforts.
Impact of Digital Technology on Youth Mental Health
Many adults are concerned about the personal and societal consequences of the surge in and reliance on digital technology. Recent research finds that engaging in 5 or more hours of digital-screen activities (e.g., playing video games, social media use, TV watching) increases risk for depressive symptoms and suicidal ideation among youth. Some researchers, however, argue that rather than focusing on the amount time youth spend on digital activities alone, we should also focus on how youth spend their time since this can have a greater impact on mental health outcomes. On the one hand, digital-screen activities like social media use may exert a negative influence through cyber-bullying, normalizing self-harm, and even discouraging help-seeking. On the other hand, social media use has been found to be linked with lower levels of loneliness and greater feelings of belonging, actual and perceived access to social support, and life satisfaction. Given the positive and negative findings recent research has yielded, more research is needed that examines and defines the boundaries of “healthy” digital technology use among youth.
Digital Health Interventions for Suicide Prevention
Digital health interventions are defined as interventions that provide information, support and therapy for physical and/or mental health problems through a technological or digital platform. Access to appropriate mental health services, when and where it is needed, is vital for the prevention of suicide. It is estimated that only 39.4%, 17.8%, and 30% to 45% of youth with depression, anxiety, or suicidality, respectively, enter face-to-face treatment. This gap may be partly due to the limited availability of mental health services, as well as youths’ beliefs that treatment is not warranted and/or is likely to be ineffective, fear of stigma, and wanting to handle problems on own.
Digital health interventions allow for opportunities to improve the provision of mental health treatment for youth by addressing some of the barriers to face-to-face treatment. Possible advantages of digital health interventions include their ability to reach a larger and more diverse audience across a wider geographic area, 24-hour access, little or no cost, user autonomy and anonymity, and minimal waiting lists. Digital health interventions for suicide prevention can take many forms, including the use of texting for crisis intervention like the Crisis Text Line, mobile apps for safety planning like MY3, and online interventions to reduce symptoms of depression like MoodGym.
Research examining the effectiveness of digital interventions for suicide prevention is rapidly expanding. A recent systematic review and meta-analysis examined the effectiveness of digital health interventions in reducing suicidal ideation or self-harm. The researchers analyzed data from 14 published studies including a total of 3,356 adolescent and adult participants. Most of the studies included evaluated online interventions, but two examined mobile apps. Of the 14 interventions identified, only five were developed for the self-management of suicidal ideation. The remaining studies were developed for the self-management of depressive symptoms or self-harm, but examined suicide-related outcomes, like suicidal ideation. Most interventions were based on the principles of cognitive behavioral therapy. Eight studies reported significant reductions in suicidal ideation at post-intervention. Despite limitations in the research designs of the included studies, such as small sample sizes, poor levels of adherence, and lack of control groups, there is some evidence that digital health interventions can help reduce suicidal ideation in depressed individuals.
In recent years, there has been a proliferation of online and mobile interventions for mental health problems in youth and adults. However, the small numbers of available studies indicate the continuing need to rigorously evaluate the effectiveness of digital interventions for suicide prevention and other mental health problems. Digital health interventions have the potential to reach more youth at-risk for suicide, and may be useful in breaking down some of the current barriers that prevent those in need from accessing mental health care.
