Last summer there was a lot of Black Lives Matter and the massacre of Black people circulating online… In a matter of 2 weeks there were four or five people that had been killed. That was really exhausting. I couldn’t even go on social media – Gabrielle
In her research on Black girls’ online engagement, Tanksley heard from teens about the psychological toll of exposure to depictions of racialized violence. Even as this traumatizing content circulates widely through digital networks, Tanksley found Black girls going online to seek “spaces of refuge” to cope with stress, fatigue, and anxiety. These spaces of refuge include relatable humor on Black Twitter, social media self-care resources, and private text groups. “I’m in a bunch of Black student union pages and a bunch of artist pages and a bunch of Black artists pages. A bunch of little mini communities of resistance,” explains one teen.
Social media and video games are routinely blamed as the cause of growing youth mental health problems (Odgers & Jensen, 2020; Orben, 2020; Orben & Przybylski, 2019). Their potential to provide spaces of refuge has been less recognized. The pandemic has offered an opening for a more balanced narrative as families, mental health providers, and educators have turned to digital platforms to provide positive support, connection, and resources for youth wellbeing as they shelter at home (Bowles, 2020; Flake, 2020; Kamenetz, 2020; Shapiro, 2020). The visibility of the Black Lives Matter movement during the pandemic has also forced a public reckoning about structural inequities in health, and the digital divide in access to resources such as tele-therapy and online education (Altiraifi & Rapfogel, 2020; Chandra et al., 2020).
In our 2020 report, Social Media and Youth Wellbeing, we argued for a pressing need to amplify and leverage the positive potential of social and digital media to support youth wellbeing and mental health (see also Odgers, Schueller, & Ito, 2020). 2021 offers a unique window of opportunity to push for new innovation, policy, communications, and partnerships that can make social and digital media a positive influence on wellbeing for more youth, particularly those not well served by traditional mental health and wellbeing supports and services.
This post is the first in the Spaces of Refuge series from our Youth Connections for Wellbeing project that outlines an agenda, offers guiding principles, and provides case studies of how to tap youth agency and social and digital media to support mental health and wellbeing for vulnerable youth. This initial post summarizes the evidence for inequities and gaps in mental health supports and identifies opportunity areas for correcting these problems. It then lays out guiding principles for design, policy, and partnerships.
In the coming months, we will release a series of posts that will include key learnings from design and deployment efforts during the pandemic, and case studies of interventions and projects that illustrate these guiding principles in action. These cases will include efforts such as creating safe and supportive digital spaces for minoritized youth; embedding wellbeing supports in online esports coaching and practice; digital clubhouses hosted by youth development organizations; partnerships for involving minoritized youth in developing positive social media practices and improving digital mental health apps; and more examples as we find them. Please reach out to us if you have cases that we should be aware of!
Vulnerable Youth are Under Stress and Underserved
The pandemic has fueled greater innovation, use, investment, and public support for digital mental health services, but this has not meant more support for vulnerable youth. With few exceptions, these services have not been tailored to the needs of youth, nor targeted to vulnerable populations such as low income, LGBTQ+ and youth of color. Even before the pandemic minority youth had less access to care and carry the burden of systemic factors that might contribute to mental health issues (Whitney & Peterson, 2019). On average, nearly half of youth who have a mental health disorder do not receive treatment, but this number varies widely based on location and population (Cuddy & Currie, 2020). These rates are much worse among populations such as low income, Black, and Latinx youth (Alegria & Green, 2015; Corona et al., 2020; Kann et al., 2018) who have traditionally experienced greater systemic health inequalities, a trend that has accelerated during the pandemic.
The tendency in the field of digital mental health has been towards one-size-fits-all solutions that are weighted towards adult and dominant groups (Kauer, Mangan, & Sanci, 2014; Rideout & Fox, 2018). Few digital mental health products are designed or tailored for youth or underserved populations, and those that are often engage in only surface level tailoring, changing visuals, but not language, or burying tailored-content within a general platform. Groups who have suffered less from the pandemic, and who are better served by traditional clinical and wellbeing services, are the first to reap the benefits of new solutions. The blossoming of telehealth platforms and digital wellness and self-care apps and social media content can potentially benefit diverse youth, but have disproportionately benefited adults and those who are already actively engaged in mainstream self-care and wellbeing content and practices (Altiraifi & Rapfogel, 2020).
Researchers and practitioners who work with minoritized youth have noted how they are retreating to more private and safe networked spaces of refuge to escape racist and hateful content on open platforms like Twitter or YouTube. This might take the form of queer youth participating with relative anonymity on Tumblr (Byron, 2019; Cavalcante, 2016; Cho, 2015), or Black girls setting up private text messaging groups to support one another (Tanksley, 2019). It is imperative that interventions meet vulnerable youth in their spaces of safety and belonging, rather than assuming that they will seek out support in traditional adult-focused and expert-driven forums and marketplaces.
Even as the pandemic has widened equity gaps in youth mental health, it has also created new opportunities to challenge the screen time narrative, tap youth agency, and form new coalitions.
Challenging the Screen Time Narrative
As families sheltering at home became dependent on digital communications for even the most basic needs for social connection, the tenor of debates around screen time and wellbeing have shifted to increasingly recognize both risks and benefits. Prior to the pandemic, the public discourse about screen time and young people was overwhelmingly negative (George & Odgers, 2015; Odgers & Jensen, 2020). Fear and panic over screen time did not recognize diversity of youth engagements, backgrounds, risks and opportunities in their digital media engagement, leading to blunt and ineffective time-based rules and guidelines (Blum-Ross & Livingstone, 2016).
While the pandemic has not erased concerns over screen time, parents, educators and health practitioners have more first-hand experience with how digital media can support social connection. A New York Times reporter who had written extensively about screen time fears wrote, “Coronavirus ended the screen-time debate. Screens won.” “The screen is my only contact with my parents, whom I miss but can’t visit because I don’t want to accidentally kill them with the virus. It brings me into happy hours with my high school friends and gives me photos of people cooking on Facebook. Was there a time I thought Facebook was bad?” she writes. Another parent describes how she was against her daughter playing video games until she realized, during the pandemic, that Roblox had become her primary social outlet.
Even after the pandemic is behind us, we look forward to a more nuanced public narrative about how social media and digital games can be harnessed for positive wellbeing support as well as ways to mitigate the downsides and risks.
Youth Engagement with Online Wellbeing Content and Support
In our earlier report, we reviewed an extensive body of literature indicating how young people are actively supporting one another and seeking support for wellbeing in digital networks. For example, one student shared how they experienced a supportive community online, saying: “I think a lot of my mutuals on Instagram, they’re very open to being emotionally vulnerable on Instagram, so they’ll actually say, ‘I’m not doing fine.’ I like it because it’s a very nice community, just spreading love whether it be through comments or someone will actually say through messages like, ‘Are you okay?’” During the pandemic, youth also flocked to gaming platforms to stay connected to their friends. In a survey of 3000 teens on their platform that Roblox conducted in the summer of 2020, over half reported spending the same or more time with their real life friends via gaming platforms.
Digital spaces are also where young people are seeking out information and content related to wellbeing, self-care, and mental health. Young creators and influencers are increasingly incorporating wellbeing content into their content and feeds. For example, influencers such as Bitter Brown Femmes, Wednesday Holmes, and anzalduingit routinely feature self-care and wellbeing content that serves specific groups of minoritized youth. The Hi Anxiety Instagram account features celebrity interviews and curated content for how to cope with anxiety. Even before the pandemic, 87% of U.S. teens reported having gone online for mental health information, 64% reported having used a mental health app, and 39% reported going online to seek out others with similar conditions (Rideout & Fox, 2018).
These high levels of youth engagement with mutual support and online self-care content offers a unique and largely untapped opportunity to amplify youth voices and agency through these channels. Professional providers of mental health and wellbeing services and content are not currently tapping this opportunity, however. Rarely are youth leaders and affinity networks tapped to be part of the development and dissemination of wellbeing interventions and content.
New Public-Private Coalitions
This shifting narrative about digital media has also meant greater awareness of the role, for better and for worse, that social media and gaming platforms play in shaping wellbeing, culture, and civic engagement. In parallel with growing public scrutiny of the role of social media platforms in political life, we see growing public awareness of the role of digital platforms and applications in health and wellbeing. For young people, social gaming platforms such as Roblox, Fortnite, and Minecraft are also front and center in these concerns. Before the pandemic these platforms were largely irrelevant to initiatives to support youth citizenship and wellbeing, but today we see an emerging awareness among health and educational practitioners about the role these platforms can and do play in supporting youth wellbeing.
Gaming companies are increasingly recognizing their role in supporting wellbeing and mental health. This includes offering wellbeing support as well as addressing problems in toxicity and harassment. For example, Riot Games is partnering with Active Minds and Crisis Text Line to provide mental health supports and referrals to their players. A games industry coalition, including My.Games, Take This, the Fair Play Alliance, and the International Game Developers Association is conducting research on the mental health of players and industry professionals.
Digital health and educational technology companies received unprecedented amounts of private investment in 2020, driven by the pandemic. Most digital health interventions, even with their growth during the pandemic, are not targeted to youth, although they are a particularly vulnerable population. These massive new investments in consumer-facing and commercial ventures have been proceeding in tandem with a growing recognition of disparities in access to health and educational services. It is now blindingly obvious that commercial digital platforms have become infrastructure for civic life and essential public services, and thus need to address equity issues and serve the public interest. Emerging efforts, such as the Help@Hand coalition in California, are seeking to knit together partnerships across digital mental health providers and communities to support more equitable care delivery.
This growing awareness of the centrality of digital infrastructures in public life is leading to a mounting appetite for public regulation and involvement in commercial digital platforms. We see this as an opportunity to forge new coalitions that challenge silos between entertainment, health and education, as well as between public and private sectors.
The current landscape of problems and opportunities suggests that we are at a key moment to design and spread new technologies, programs, and partnerships to tap digital networks to address the equity gap in youth wellbeing. The involvement and leadership of youth and organizations reflecting diverse communities and perspectives are essential to tapping these opportunities and ensuring equity. We suggest a set of guiding principles for design, intervention, and partnership for addressing these problems and opportunities, informed by research and grounded in well-established approaches in equity and youth-centered research, co-design, and organizing.
Meet Youth Where They Are
In contrast to a “if you build it, they will come” approach, we see a growing movement for centering innovations and investments on youth and spaces where they are already engaged and connected. Too often, experts and adults have designed technologies and programs, only to struggle to have youth, and particularly minoritized youth, engage with them. This guiding principle draws from traditions in youth participatory action research and youth co-design efforts (Harrington, Erete, & Piper, 2019). Youth populations that innovators are seeking to serve should be involved from the start, with their interests, practices, and lived experience informing and driving the development and deployment of new efforts. Maria J. Anderson-Coto and Rose O’Leary have described this culturally responsive approach to co-design as “design from within.” This can take a variety of forms, such as including youth as part of a design team, investing in young innovators, partnering with young influencers, or connecting with youth online affinity networks of gaming or popular culture as contexts for supporting wellbeing.
Tailor to Diverse Groups and Ages
Youth are often described as a monolithic group, even though we know that young people’s backgrounds and interests are just as diverse as we see in the adult world. One-size-fits-all solutions, particularly when designed by adults from the dominant culture, will tend to be less tailored to young people in vulnerable, marginalized and minority groups. In addition to characteristics such as ability, race, gender, sexual orientation, and socioeconomic status, we must also recognize important developmental differences between different age groups. For example, 8-12 year olds who are taking their first steps into social participation in public and networked spaces need different forms of support than older teens who participate in ways more akin to adults. While still emerging, a growing body of research and design efforts recognize these different developmental differences and how they are changing over time in relation to technology (Kidron & Rudkin, 2017). We see this principle as part of a growing movement for culturally-responsive, participatory and community-centered design approaches that recognize the importance of tailoring to and drawing from the needs and assets of specific populations and communities in order to work towards equitable solutions (Fagrell Trygg, Gustafsson & Månsdotter, 2019).
Build Connections Between Existing Assets
Despite an explosion of apps and online content for mental health, wellbeing, and self-care, the evidence is clear that vulnerable youth are not connecting to these assets (Dreyfuss, 2019; Fish et al., 2020; Schueller et al., 2019). The critical gap in the ecosystem is the connection, translation, and tailoring of expert content and wellbeing resources for vulnerable youth, where and when they need them (Burgess et al., 2021). While content and applications are necessary, we argue for at least as much focus on building more connectivity between both offline and online assets and supports and between different settings and organizations in young people’s lives, such as peer groups, family, school, community-based organizations, and health-oriented settings. For example, community-based educational organizations that serve marginalized youth or online gaming communities can embrace self-care practices and be better connected to wellbeing programs and mental health services. Online popular culture influencers and social media accounts can be avenues for referring and connecting youth to wellness supports as well. These connective practices tend to happen as an afterthought or in the fumes of other organizational priorities, but we argue that funders and organizations should consider this as an essential guiding principle and priority.
Tap Youth Agency and Peer-to-Peer Support
More often than not, wellness programs and assets are designed for youth rather than by youth. Youth, particularly those who do not identify with the dominant culture, are experts of their own experience, and can be more savvy than adults in how to navigate and leverage the strengths of a digitally networked world. Youth leadership, knowledge, and lived experience in supporting each other in times of distress, amplifying positive practices, and working against toxicity online, are largely untapped in the design of wellbeing apps and interventions, even when they are intended for youth. In both health and education, we see a growing number of efforts that recognize the need and benefit of tapping youth expertise and agency in designing and deploying new interventions, particularly ones that are technology-intensive and require youth buy-in and engagement. For interventions centered on social and gaming media, it is particularly important to recognize peer-to-peer influence and near peer mentorship in how young people learn about, share, and support wellbeing practices.
In the coming months, we will be publishing reflections on and case studies of emerging efforts that are centered on these guiding principles and will make them come to life. Please reach out to us with feedback on this emerging framework, which is a work in progress, and examples you might have of other efforts in this area.
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