Factors impacting the mental health of children and young people are rapidly attracting the interest of policymakers across the WHO European Region and globally, given the increasing prevalence of mental health conditions and help-seeking among this population observed at the European regional level and internationally [1]. Alongside traditional determinants of mental health for young people such as family environment, emerging determinants including climate change, unemployment, and housing affordability are gaining prominence in young people’s lives [2]. In particular, the rising use of digital media and devices by children and young people has generated significant concerns about the effects of digital determinants—defined as the characteristics, features, uses, and governance of digital technologies and digital ecosystems that influence health-related behaviors, health outcomes, and health care delivery—on mental health and well-being [3]. Social media and digital platforms are now embedded in the lives of young people, with the potential to influence their social interactions, self-esteem, and mental well-being [4]. Data from the Health Behaviour in School-aged Children survey report from 2021 to 2022 found that 36% of adolescents reported continuous online contact with friends and others, and 11% of adolescents were classified as problematic social media users—up from 7% in 2017-2018 [5].

The need to develop effective, implementable policy responses to help protect young people’s mental health from the potential harms associated with digital technologies—while balancing the benefits they afford for individuals and society—is acknowledged by governments throughout Europe and the world. Yet, decisive action is hampered by a limited and inconsistent evidence base both for the impacts of digital technologies on youth mental health and well-being and for effective policy interventions to prevent avoidable harms [6]. While there is unquestionable need for policymaking to be grounded in evidence, there are equally high potential costs for public health associated with waiting for convincing proof of harm, as demonstrated through previous responses to environmental exposures including lead, tobacco, and asbestos [7]. In the context of scientific uncertainty and indications of plausible harms, adoption of the precautionary principle in policymaking to mitigate risks associated with digital determinants of youth mental health and well-being is critical and warranted [8].

This rapid scoping review was initiated by WHO Europe in response to requests from Member States for guidance on the current state of the evidence on the impact of social media and digital technologies on youth mental health and policy actions to mitigate harms. The review also supported activities of the Polish Ministry of Health under the Polish Presidency of the European Council in 2025, where youth mental health and digital technologies were identified as a priority area for action at the European Union level [9]. Alongside this review, researchers also conducted a policy mapping and analysis to understand how countries in the WHO European Region and internationally are already responding to these issues. Together, the evidence review and policy analysis informed the development of a policy brief to guide evidence-informed policy, programs, and a regulatory environment which is protective of young people’s mental health in the digital world [10].

The objective of this review was to gather, summarize, and critically appraise current evidence on the impact of digital technology use on young people’s mental health and well-being, with a particular focus on social media in order to develop recommendations for policy action.

Four overarching questions guided the evidence review, with several subquestions to facilitate a detailed understanding of the evidence base (Multimedia Appendix 1):

A rapid scoping review method was selected for this evidence review due to the exploratory nature of the research and compressed time frame. Scoping reviews investigate the breadth and scope of available evidence on a topic, providing an overview of the literature and identifying key concepts, gaps, and potential future research directions. Drawing on the scoping review framework developed by Arksey and O’Malley [11], and on best-practice PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocols, we used structured and systematic approaches to provide an overview of the current body of literature [12]. Given the time constraints for this review and our decision to include both reviews and individual studies, it does not meet the formal requirements of a traditional scoping review or review of reviews (see the Limitations section). A PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist was completed to document reporting against applicable items (Multimedia Appendix 2).

A study protocol was developed in November 2024 for a review of evidence on the impact of social media and digital technology use on young people’s mental health and well-being and identification of possible policy implications. The review was carried out by 2 researchers (LH and PV) between December 2024 and February 2025. Ongoing supervision and technical support were provided by members of the WHO Regional Office for Europe’s mental health team and the Digital Transformations for Health Lab.

Our search strategy was based on combining 3 groups of terms: population terms, technology terms, and outcome terms (Multimedia Appendix 1). We ran our initial searches in PubMed, PsycNET, and Google Scholar on November 29, 2024. These 3 databases were selected because they cover both health-specific and interdisciplinary academic fields. We supplemented our systemic search with references from previous research studies and through citation searching. A PRISMA flow diagram was used to keep track of records.

We used a thematic analysis approach to extract and analyze data from the selected studies. Data were recorded in a Microsoft Excel spreadsheet, which organized data according to the research questions. After all relevant information had been extracted from the studies, the content of the studies was analyzed for recurrent themes and notable findings. Data were exported to a Microsoft Word document to enable descriptive and narrative synthesis.

Emerging themes from the data analysis were shared at regular intervals with the wider project team from the World Health Organization and the Digital Transformations for Health Lab. Preliminary findings from the study were also presented for feedback and validation at an expert consultation workshop with European and global experts convened by WHO Europe in February 2025. Based on the feedback from this meeting, data related to evidence quality in the included studies were revisited, and additional thematic analysis was conducted.

Our search revealed that a huge volume of literature has been published on issues related to the health and well-being impacts of young people’s technology use over the 5-year period of 2020 to 2024.

Our initial literature search yielded 7420 articles. Title screening, abstract screening, and deduplication were conducted using the Rayyan platform [13]. Two researchers (LH and PV) screened titles and abstracts in Rayyan to identify 419 records for full-text screening. Full-text screening against inclusion and exclusion criteria was conducted in parallel by the 2 reviewers (LH and PV), who met frequently during the screening period to ensure consensus on which studies met the inclusion criteria and to resolve any disagreements. This process resulted in a total of 226 articles being selected for data extraction and analysis (Figure 1) [14,15].

Of the 226 included articles published, 63 were reviews, and 163 were individual studies. The individual studies included 107 cross-sectional studies and 37 longitudinal studies (Tables S1 and S2 in Multimedia Appendix 3). The large proportion of reviews within this sample reflects the high volume of research activity on this evolving topic as well as uncertainty and disagreement over how to interpret evidence (Figures 2 and 3).

A significant number of moderating and mediating factors were identified in the literature that may shape the relationship between social media use and mental health outcomes and influence the extent or direction (positive or negative) of its impact (Figure 2). Moderators are variables that change the strength or nature of the relationship, such as gender: girls and gender-diverse youths often face worse outcomes, particularly around body image-related content [28,32,34,48]. Mediators, on the other hand, explain how or why social media use affects well-being, such as engagement in upward social comparison leading to depressive symptoms [27,62]. Researchers have extensively studied these factors to understand how and why social media use affects mental health and well-being.

Psychosocial and behavioral factors—like low self-esteem, social anxiety, and excessive investment in online self-presentation—were found to exacerbate negative outcomes, especially among vulnerable groups [44,53,63,64]. Resilience and emotional self-regulation may temper these harms [32,65]. Additionally, motivations for using social media, importance given to peer feedback, and perceived self-control moderate the relationship [16,42,66-69]. Sociodemographic factors such as socioeconomic status, age, and digital literacy also play a key role in moderating risks and benefits, highlighting the complexity of understanding social media’s effects or association with mental health [23,32,49,51,65,70,71].

New affordances of social media and smartphones can shape young people’s developmental experiences in several ways. While a limited number of studies explored the impact of specific design features or affordances of social media, the importance of these factors was identified in the literature.

Several studies applied theoretical frameworks to try and explain how using digital technologies, particularly social media, may impact young people’s well-being. Five potential impact theories dominated within the studies: (1) transformations and affordances [82,104], (2) socioecological model of development [26,109], (3) uses and gratification theory [63,66,83], (4) development of sociocultural framework [27,34,35,38,92], and (5) time displacement theory [31,34,62,71,83]. Many of these theories consider the complex interactions between the individual characteristics of the user, how technologies are used, and how they are designed (Figure 5).

The majority of studies included in this review concluded with recommendations for future research as well as some recommendations for actions to be taken by technology companies, policymakers, caregivers, educators, and clinicians to both protect young people from digital harms and encourage positive uses of technology. The compilation of these recommendations are summarized in Textbox 2.

Researchers have identified several limitations in the current evidence base regarding the impact of technology use on young people’s well-being and mental health. One primary concern is the rapid evolution of social media platforms, which causes research to quickly become outdated. As such, more recently popularized platforms like Snapchat and TikTok, as well as the integration of AI within digital platforms, are often underrepresented in studies, creating gaps in our understanding of these social media applications.

Another major limitation is the lack of longitudinal or experimental evidence. The majority of studies are cross-sectional, preventing the establishment of causation or the direction of relationships and failing to capture the transient, momentary effects of technology use. Additionally, there is still a strong focus on screen time as a measure, which does not account for the quality and context of user experiences. The ubiquity and increasingly personalized nature of social media makes it difficult to study the relationship between exposure and outcomes.

A lack of high-quality evidence in this field was a concern for many scholars. Many of the review articles included in this study discussed methodological limitations that they believe diminish the overall quality of the evidence base and may have resulted in conflicting findings on the relationship between young people’s technology use and mental health. Many studies rely on self-reported data about technology use and mental health status, which may be subject to bias or inaccuracy. The diversity in reporting measures and definitions used for well-being or mental health and levels or types of technology use further complicates comparisons across studies. This lack of standardization, coupled with differences in study characteristics such as sample populations, study design, and measurement tools, often limits the generalizability of findings.

Another issue is that the impact of different social media platforms or types of technology use is often grouped together, potentially disguising their distinct effects. Studies tend to focus on a small number of variables, neglecting many possible confounding, mediating, and moderating factors. Few studies consider young people’s personal vulnerabilities, characteristics, and environmental factors, either at baseline or over time. Moreover, other stressors that may have a significant influence on the relationship between digital technology use and well-being and mental health, including those related to the COVID-19 pandemic, are understudied.

Finally, many studies are based on small and nonrepresentative samples, frequently characterized by an overrepresentation of girls among study participants. Considering the differing effects of digital technology use on boys and girls, the generalizability of these findings is constrained. These limitations highlight the need for more comprehensive, longitudinal, and diverse studies to better understand the complex relationship between technology use and young people’s mental health and well-being.

This scoping review adds to a growing body of literature exploring the digital determinants of young people’s mental health and well-being. Our analysis of studies published in the past 5 years supports previous interpretations of the complex and bidirectional relationship between young people’s technology use and mental health outcomes. Methodological limitations and insufficient consideration of the multiple factors shaping young people’s digital experiences continue to limit our ability to make robust causal claims about technology use and different types of digital harms. Nevertheless, studies continue to expand our understanding of risks associated with social media and digital technology use and demonstrate that young people who use digital platforms are encountering a range of online risks that pose harm to their mental health and well-being including addictive design, cyberbullying, violence, pornography, pressure to obtain an unrealistic or unhealthy physical appearance or lifestyle, sextortion, self-harm and disordered eating triggers, marketing of harmful products, and gambling.

Certain features of social media and other digital platforms are inherently harmful by design, posing risks to every user’s mental health and well-being. However, the literature indicates that there are a wide range of individual and environmental factors that can increase or decrease the degree of risks that young people may encounter. Furthermore, there are a diverse set of factors that will influence a young person’s resilience or vulnerability to experiencing harm when exposed to these risks. Any policy response to the digital determinants of young people’s mental health and well-being must therefore take such complexities into account. The benefits and risks of digital technology use vary significantly both within and between individuals depending on the specific context in which they occur. Therefore, simplistic, one-size-fits-all governance approaches are unlikely to be effective, particularly for protecting the most vulnerable youths.

The lack of definitive causal evidence on social media use and negative mental health outcomes has led to disagreement within the academic community about the most effective policy responses. Scientific publications claiming that there is no evidence that social media is a driver of worsening mental health and well-being do not resonate with the lived experiences of many young people or their families [110]. At the other end of the spectrum, bold claims about social media being a major driver of poor mental health and well-being have given rise to fears about reactive policy responses that may have harmful unintended consequences for young people. Despite different views, our review identified a number of common recommendations for policymakers and other stakeholders, which aim to minimize harms associated with technology use while also enabling young people to enjoy the benefits offered by social media and digital platforms (Textbox 2).

Lack of scientific consensus has frustrated politicians who are under growing public pressure to protect young people from digital harms and curb the power of technology companies. While policy responses have been slowed by concerns around evidence quality, new laws and guidelines are nonetheless being developed around the world to protect young people and regulate digital platforms. The health sector has historically played a limited role in shaping these governance instruments [111]. However, many health ministries and public health agencies now recognize that young people’s technology use is a public health issue and are pushing for action.

In the face of mixed and inconclusive evidence on the health impacts of technology use, the need for a precautionary governance approach that draws on existing public health knowledge is gaining support. The former US Surgeon General was one of the earliest public health leaders to call for the burden of evidence to be flipped toward proving that social media is safe, rather than proving it is harmful, as is the case in the vast majority of studies that we reviewed [112]. In a report on childhood in the digital age, the Organisation for Economic Co-operation and Development argues that stronger regulation of digital media is warranted even if it is potentially just one of many factors contributing to mental health issues [113]. The Council of the European Union has also concluded that it is prudent for countries to take preventative measures to mitigate the potential risks of digital technologies, even when the scope and consequences of the threat to young people are still partly unknown, given that the associated risks for children’s and adolescents’ mental health may be high [9].

Taking preventative action to protect young people’s health is a common public health approach in situations where there are plausible risks but scientific evidence is not fully established [7]. For example, bans on the use of potentially hazardous chemicals such as bisphenol A and lead in children’s products were enacted in several countries ahead of conclusive evidence of their harmful effects. Restrictions on sales of vapes and vaping in public spaces are also being adopted in some countries ahead of evidence on their long-term health effects.

Based on the findings from this evidence review, and a concurrent analysis of policy interventions across the WHO European Region and globally, 8 recommendations have been proposed to guide future policy actions to promote youth mental health and well-being in a digital age [10]. These recommendations focus on improving young people’s digital well-being by supporting balanced and healthy uses of social media and other digital technologies and making digital environments safer for young people. They recognize that a range of actors from different sectors have a role to play in supporting young people’s mental health and digital well-being. The recommendations also reflect the power of industry and commercial interests in shaping digital environments, thereby calling for stronger regulatory instruments to incentivize young people’s health and safety by design and hold digital technology companies to account.

Our decision to include both evidence reviews and individual primary studies within this scoping review under a single set of eligibility criteria is recognized as a significant methodological limitation. Our approach differs from that expected of a formal umbrella review, which requires distinct research questions and eligibility criteria and a formal assessment of overlap between included reviews. It is therefore possible that some primary studies contributed to our findings both directly, as an included primary study, and indirectly, through their inclusion within one or more of the 63 evidence reviews also included in this review, which may have inflated the apparent volume or consistency of evidence for some findings. We also included a broad range of study types, which vary in their own methodological rigor, and we did not appraise or weigh included reviews by quality or type. We sought to partially mitigate these limitations through transparency: findings from reviews and from primary studies are extracted and reported separately in our supplementary data extraction table, allowing readers to identify which findings derive from which evidence type. Given the rapid time frame and the exploratory, policy-oriented objectives of this review, this inclusive approach reflected a pragmatic trade-off between breadth and methodological precision. We recognize that this limits the extent to which our findings can be treated as a precise quantification of the evidence base. To build on this work with greater methodological rigor, researchers could usefully separate the study types brought together in this review: for example, by undertaking a dedicated umbrella review of the reviews identified here, with formal overlap and quality assessment, alongside a systematic or scoping review of primary studies restricted to those not already synthesized within an included review, or published since the most recent relevant review.

Other methodological restrictions further limited this scoping review. Strict inclusion and exclusion criteria were introduced so that a manageable number of studies were considered for review. This resulted in the omission of literature published in languages other than English and from countries outside the WHO European Region,barring Australia, Canada, and the United States, limiting the generalizability of our findings to the global context. The review only included peer-reviewed publications and omitted other sources of evidence that could provide more timely and granular information on young people’s digital experiences and their effects [114]. Digital trace data, for example, can capture and provide accurate insights into the user’s momentary effects and true nature of use, an ongoing challenge for traditional data collection methods such as self-reported surveys. Internal data and proprietary research held directly by social media companies can provide valuable insights into the effects of particular platform features. Future research should explore the use of such data sources for academic research while following ethical guidelines around user privacy and confidentiality. Finally, the compressed time frame for the review also limited our ability to conduct a full assessment of evidence quality.

Over 200 articles on the impact of social media and digital technology use on young people’s mental health and well-being were reviewed to inform policy recommendations. Through systematic data extraction and thematic analysis, key findings and limitations from the current evidence base have been summarized and translated into an agenda for action and future research.

Our scoping review also demonstrates that social media and other digital platforms are an important part of many young people’s daily lives and may offer benefits for their health and well-being. Overly restrictive policy responses, for example, blanket bans on smartphones or social media, risk undermining young people’s right to enjoy the positive aspects of these technologies [115]. Policymakers across the WHO European Region and beyond are committed to protecting and promoting the health of young people in digital environments. A pressing challenge is to design and implement regulation that is nuanced, taking into consideration children’s age, developmental stage, and other vulnerabilities, and can balance the positive and negative digital determinants of young people’s health and well-being. Co-designing policies with young people and involving them in ongoing research and accountability efforts are critical to ensure that policy interventions support their rights and respond to their diverse needs and experiences.

As digital technologies continue to develop at a rapid pace, research and policy must proactively monitor and adapt to the changing landscape. Many of the studies included in this review call for continued and longitudinal research to understand the dynamic relationship between technology use and young people’s well-being. In particular, further studies are needed to understand why some young people are more vulnerable than others to negative impacts of digital technology use and to explore which aspects of digital design and use characteristics most significantly impact young people’s mental health and well-being. Academics have called for new approaches to research on digital technologies and their potential harms in situations where innovation and reports of negative effects outpace the ability of scientists to assess them [116]. Such an approach would empower policymakers to take more timely action in the future. However, while further evidence on the digital determinants of young people’s mental health continues to emerge, it is clear that there is sufficient evidence to act now.