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the digital dilemma: helping canadian children navigate mental health crisis is a ‘collective responsibility’

although the long-term consequences of an overreliance on digital devices are far from conclusive, doctors can spot the symptoms almost immediately.

according to a survey conducted by media matters near the end of 2022, 86 per cent of canadian kids between the ages of nine and 11 had at least one account on a digital platform that requires users to be at least 13 years old. getty images
in retrospect, the warning signs were always there.

even as steve jobs and bill gates, the co-founders of apple and microsoft, respectively, were creating some of the most influential technology of our time, they were careful to keep the addictive devices away from their children . a decade and a half later, parents, psychologists and healthcare workers are witnessing the fallout among those who weren’t so lucky.

although the long-term consequences of an overreliance on digital devices are far from conclusive, doctors can spot the symptoms almost immediately. “kids walk into appointments with their faces buried in a screen,” says dr. michelle ponti, a pediatrician and chair of the canadian paediatric society’s (cps) digital health task force. “it’s often used as a calming strategy to help support them through an appointment.”

the task force was created in 2016 to help anyone working with children manage the risks that come with digital devices . it is comprised of a group of canadian experts, including representatives from from child psychiatry, psychology, speech-language pathology and mediasmarts, a non-profit group that focuses on digital and media literacy. while there are still gaps in the evidence connecting excessive screen time to mental health, pediatricians have seen enough red flags to take action.

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“we’re seeing associations between screen use and attentional deficits,” she says. “we’re seeing increasing diagnoses of adhd, we’re seeing executive functioning delays, social skills delays and kids with poor working memories. we’re also seeing physical impacts as well —screen use before bed is having an effect on sleep patterns.”

from bad to worse

the pandemic, of course, was a big part of the problem. according to a survey conducted by mediasmarts in 2021, 86 per cent of canadian kids between the ages of nine and 11 had at least one account on a digital platform that requires users to be at least 13 years old. almost 80 per cent of kids between the age of nine and 17 said they had their own phone , with the majority first receiving one between the ages of 11 and 13.

“our screentime definitely went up during the pandemic,” dr. ponti says. “pediatricians saw an increase in mood and anxiety symptoms. there was a huge spike in eating disorders and issues with body image. now we’re seeing screentime returning closer to pre-pandemic levels — primarily for boys, not so much for girls. girls tend to use social media apps more and boys tend to gravitate toward video games.”
social media use is particularly concerning because it is associated with more negative outcomes than other forms of screentime. “if you’re binging a tv series or enjoying a video game competition with a group of offline friends, there’s actually positives that come out of those types of screen use. social media is a bigger concern. that’s where you’re more likely to see inappropriate content, such as violence or bullying. then there’s the sexual content and unrealistic body images that are just pushed out to kids through these apps.”

the cps urges physicians to talk to parents about the “4ms” of screentime : minimizing, mitigating, mindfully using and modelling healthy behaviour. this means children under the age of two should not be able to access screens at all and those between the ages of two and five should be limited to less than an hour per day. it means mitigating the risks of screentime by prioritizing educational, age-appropriate content and watching it with your kids. perhaps most importantly, it means being mindful of how you’re using your own screens and making an effort to model healthy behaviour for those who may not have the impulse control to do so themselves.

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“a big tip is to keep screens and mobile devices out of bedrooms,” dr. ponti says. “no. 1, it does impact sleep and, no. 2, you can’t help your child if they’re struggling with something while they’re locked away in their room on a device. if they learn how to use screens to their advantage, they can enhance their lives rather than detract from them.”

mind over matter

the problem with social media, according to dr. viviane poupon, a neuroscientist and the president and ceo of brain canada , is that it is intentionally addictive. “it could have been designed differently,” she says. “we’re dealing with something that’s actually changing the behaviour of teenagers during a really critical window of brain development.”

although it’s “quite likely” that excessive screentime is fuelling the youth mental health crisis, dr. poupon says the “big, unwanted experiment” that is covid-19 has clouded the issue. “it’s a very tangled situation right now,” she says. “what we still need to understand is if there is direct causality between increased screentime and mental health issues or if it is correlational and these two things are just happening together. the best way to do this is to conduct longitudinal studies to look at whether or not structures in the brain are changing over time.”

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until we have more conclusive data, she says, it’s important to exercise caution before overreacting. “there might be protective factors to some forms of screen use,” she says. “there might be teens who are heavy users of social media who are thriving. we need to understand these issues before taking away tools that might help kids who are struggling. we also want to avoid generalizations, such as saying that all screen use is bad.”
if schools or parents feel it is necessary to limit the use of devices, dr. poupon recommends having an open discussion that puts the onus back on kids. “it has to be a more balanced approach about collective responsibility and what works for you versus what doesn’t,” she says. “don’t just forbid it, but say it’s being limited and these are the reasons why. getting them to question their own screen use might be just as good as prohibiting it.

finding the right balance

it’s an approach that finley hurst, a 17-year-old high school student, would likely appreciate. hurst, like most of her friends, got her first phone when she was around 12. she says her school briefly tried to ban the devices when she was in grade 10 but the experiment quickly fell apart. “they still don’t want you on your phone, obviously, but they won’t take it away,” she says. “so, the teachers are competing against phones. sometimes, they’ll just give up because no one is listening. i feel bad for them.”

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hurst, who is heading to university in the fall, says she has, at times, felt the downside of the ubiquitous digital devices. “when i’m on my phone too much, i’ll get grumpy when i’m off it,” she says. “i’m like, ‘oh, this like sucks. i’d rather be on my phone.’ it got to the point where i always wanted to be on my phone. i’m better now.”
one of the biggest issues hurst sees with excessive screentime is how quickly kids are growing up. “i’ll see 10-year-olds that look my age,” she says. “they’ll be doing their makeup and it’s very jarring to see. they’re talking about things that i would be talking about and it’s all because of what they see on social media.”
but she also finds a lot of positives online and enjoys the way these experiences can bring her closer to her sister. “i get a lot of baking content in my feed,” she says. “it really inspires me to get up and go to the kitchen. my sister saw a tiktok recently and said she really wanted to make these cookies and it made her so happy. i feel like that’s like a really big part of it, too.”

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