Priorities for policy action to address the digital determinants of youth mental health and well-being

Childhood and adolescence are critical periods for mental health: more than half of adult mental disorders have their onset before or during adolescence. As young people spend increasing amounts of their time in digital environments controlled by a handful of powerful tech companies, concern has grown that their use of digital technologies particularly social media may be contributing to worsening mental health and well-being. In response to requests from policymakers, the WHO?s Regional Office for Europe and Digital Transformations for Health Lab (DTH-Lab) reviewed scientific literature and policy responses to inform recommendations for addressing the digital determinants of young people?s mental health and well-being.
Objective: Develop evidence-based policy recommendations for member states in the WHO European region to address the digital determinants of youth mental health and well-being.
Methodology: A scoping review examined 226 studies on young people?s technology use and its impact on mental health and well-being. Analysis of policy documents from 42 countries to understand different policy approaches across Europe and worldwide.

Results/Major Findings:
Mixed Evidence on Digital Impacts

• Research shows both positive and negative associations between technology use and youth well-being.
• Some online activities have dual impacts (e.g., self-expression opportunities vs. exposure to harmful content).

Vulnerability is Uneven

• Most vulnerable young people (e.g., those with pre-existing mental health issues, body dissatisfaction, low self-esteem, or offline vulnerabilities) disproportionately experience negative impacts.
• Younger children struggle more with managing digital use due to limited cognitive development and digital literacy.

Bidirectional Relationship

• Technology use and mental health influence each other: Increased screen time can exacerbate mental health issues. Pre-existing mental health problems can drive heavier technology use.

Factors Shaping Outcomes

• Individual factors: age, gender, self-esteem, resilience, and motivations for going online.
• Environmental factors: family education level, parental mediation, social support, and household rules.
• Protective factors: digital literacy, body positivity, supportive family/peer relationships.
• Risk factors: passive use, appearance-focused content, cyberbullying, harmful marketing, and poor sleep.

Policy Landscape

• Policy responses across Europe are fragmented and varied.
• Many policies place responsibility on users and caregivers (e.g., parental controls, age restrictions).
• More recent policies target platform design features and call for industry regulation.
• Limited involvement of health ministries and youth voices in policy development.

Conclusion/Lessons Learnt/: In the context of scientific uncertainty and a plausible public health threat posed by poorly regulated digital platforms, countries have a responsibility to adopt a precautionary governance approach that seeks to protect young people from potential harms and ensure the safety of online environments. Acknowledging the crucial influence of digital platforms on young people's well-being, recommendations advocate for more robust regulation of these platforms and greater accountability within the tech industry. Greater youth participation in designing policies and public health responses is a guiding principle to implement the recommendations.

Policy Recommendations

• Make young people?s digital well-being a policy priority
• Apply proven, intersectoral public health strategies
• Develop clear guidance on healthy technology use
• Hold industry and commercial interests accountable
• Support future laws and regulations for safe digital environments
• Bolster health workforce capacity
• Increase research into social media?s impacts
• Invest in offline alternatives for play, parenting, and social connection