Wednesday, July 17, 2024
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Are smartphones a problem for teen mental health in developing countries?

The last 15 years have witnessed the collapse of mental health among adolescents—especially girls—in the United States and other high-income countries. Three in 10 teenage American girls have a major depressive episode each year—a more than doubling of the rate of the early 2000s.

New York University professor Jonathan Haidt argues in his recent book, The Anxious Generation, that this has been driven by the decline of play-based childhood and the rise of smartphones, which have rewired the brains of young and old alike and been particularly damaging for adolescents, whose developing brains are the most vulnerable to the ills of social media.

The book has received extensive media coverage. Some social scientists have pushed back, arguing that the evidence of a causal connection between social media and mental health is weak. The vast and varied extent of the literature makes it difficult to parse, with more than 30,000 papers and dozens of systematic reviews on “adolescent mental health” and “social media” appearing on Google Scholar. While the magnitude of the relationship is open to debate, a fair reading of the literature is that social media has had at least some impact on mental health, particularly for teenage girls.

Smartphones and mental health: not just a rich-country problem

Have mobile phones and social media also affected adolescent mental health in countries where the World Bank works? The short answer is we don’t know for sure. Few developing countries collect data to track mental health trends, but rough evidence suggests that the anxious generation is not just a rich-country problem.

The Programme for International Student Assessment (PISA) surveys 15-year-old students worldwide, covering a wide swath of countries (but, unfortunately, none that are low-income). For a small set of middle-income countries, mostly in Latin America, we have data from repeated PISA rounds for the question, “Overall, how satisfied are you with your life as a whole these days?” Responses are on a scale from 1 to 10. Average satisfaction dropped by nearly a full point for these countries between 2015 and 2022.

We see that adolescent well-being appears to be falling in middle-income countries, too, but is there any indication that smartphones could be a factor? In 2022, PISA included questions on mobile phone experiences that provide some insights. The figure below shows two key numbers for all middle-income countries in PISA.

The first number is the share of students who own a smartphone for their own personal use. These figures are unexpectedly high. For example, we are surprised to learn that in Colombia, a country both of us know well, it is 82 percent. Remarkably, on average across 31 middle-income countries, 89 percent of 15-year-old students have their own smartphone. Basic smartphones have now become so cheap that they are nearly ubiquitous in all these countries.

The second number is the share of students who say digital devices distract them in math class all or most of the time. It averages 29 percent, ranging from 14 percent in Guatemala to 54 percent in Argentina. These figures make it clear that as is the case in high-income countries, for many teens in the developing world, smartphones are a near constant presence in their lives.

What can we do to address this mental health threat?

Haidt has four bottom-line suggestions: 1) No smartphones before high school; 2) no social media before age 16; 3) phone-free schools; and 4) more free play in the real world. Amidst uncertainty as to the magnitude of social media impacts, implementing these low-cost measures seems sensible.

In addition, in many developing countries, access to mental health services is limited. Governments worldwide are increasingly asking the World Bank to help them address this burgeoning challenge in our work. Most accepted strategies focus on reducing social stigma and increasing public awareness, offering early support services through models close and acceptable to the youth, de-institutionalizing patients and strengthening community-based, ambulatory care. Digital innovations in both screening and early diagnosis are also advancing. In sum, prioritization and investments in mental health are starting to take form.

As a just-published NBER working paper says, the vanishing well-being of the young appears to be global. Given that mental health is at the core of our human capital, we need to work to protect our children from the dangers of smartphones and simultaneously help countries build their systems to prevent and treat mental health. Many are already taking in action. Precisely in Colombia, in the past weeks, an important group of 27 schools in Bogota decided to ban smartphones in their premises during classes, and on school buses.

Gabriel Demombynes is the manager of the Human Capital Project at the World Bank. Juan Pablo Uribe, MD, is the global director for Health Nutrition and Population at the World Bank and director of the Global Financing Facility for Women Children and Adolescents (GFF). 

Contributed by Gabriel Demombynes

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