Original Manuscript
Clinical Child Psychology
and Psychiatry
2022, Vol. 0(0) 1–15
© The Author(s) 2022
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/13591045221106573
journals.sagepub.com/home/ccp
Exploring the potentially positive
interaction between social media and
mental health; the perspectives of
adolescents
Michelle O’Reilly1
, Diane Levine1
, Verónica Donoso2
, Liam Voice3
,
Jason Hughes1
and Nisha Dogra1
1
University of Leicester, Leicester, UK
2
University of Leuven, Leuven, Belgium
3
University of Leeds, Leeds, UK
Abstract
Adolescents are spending significant time online. Consequently, concerns are consistently raised
about potential negative impacts on their mental health. Potentially, these concerns minimise their
autonomy and reify the construction of the vulnerable adolescent. Using template analysis, we
explored adolescents’ perspectives (N = 54) of the relationship between social media and mental
health. We centrally considered the wide array of uses made of different social media by the
participants, focusing on their understandings of the potentially positive effects these might have.
Focus group discussions showed social media could be used to reduce stress, have value for social
connectivity, were an important source of information about mental health, and provided a
platform for peer-to-peer support. Our conclusion indicated adolescents are generally socially
competent online and are often experimenting with their emergent sense of agency.
Keywords
Social media, adolescents, qualitative, mental health, positive wellbeing
Introduction
“The question is no longer whether adolescents are using mobile technologies but rather how, why, and with
what effects”
(George & Odgers, 2015, p.832, p.832)
Corresponding author:
Michelle O’Reilly, University of Leicester, The Greenwood Institute, Leicester LE3 0QU, UK.
Email: mjo14@le.ac.uk

Trajectories of childhood are increasingly mediated online, with transitions to adulthood
mapped, created, expressed, and negotiated digitally via use of internet-based digital technologies,
especially social media. While social media are technically defined as social networking sites
allowing individuals to construct a profile, share connections with others, and communicate via the
internet (boyd & Ellison, 2007), adolescents themselves tend to utilise more encompassing def-
initions, including digital platforms mediated via the internet to find information, entertain, and to
communicate with others (O’Reilly et al., 2018a). Although such conflation of mediums creates
challenges for research (Valkenberg et al., 2022), appreciating adolescents’ understanding of what
social media mean to them illuminates how they are using such platforms. Consequently, this
engenders new tensions for adults in their seeking to balance the protection and empowerment of
adolescents online, particularly as adult supervision during adolescence is gradually reduced.
Adolescence is a period marked by the development of identity and an emerging sense of
independence (Erikson, 1968). In late-modern societies, more of this is negotiated within online
spaces (Kurek et al., 2017). Shifting perspectives have seen adolescents afforded rights (United
Nations, 1989), which have recently extended to digital environments (Livingstone 2019). Social
media present adolescents with opportunities for new freedoms away from the confinements of the
family, providing an extension of peer sociality (Couldry & Hepp, 2017). Yet, parents perceive risks
(George & Odgers, 2015), and are concerned about the negative effects on mental health (Richards
et al., 2015); a relationship not as simple as it is ostensibly presented publicly (O’Reilly et al., 2021).
The impact of social media as related to psychosocial functioning is not well-researched (Barry
et al., 2017). There is evidence linking social media use to poor mental health, including low self-
esteem, anxiety, and depression (Ehrenreich & Underwood, 2016), and adolescents themselves
often view social media as detrimental for their wellbeing (O’Reilly et al., 2018a). However, a recent
meta-review suggests the relationship is not straightforward (Valekenburg et al., 2022), with re-
search indicating that ill effects are mediated by factors like sleep or bullying (Viner et al., 2019).
Concerns about the relationship between social media and mental health have tended to focus on
screen time, failing to consider the varying character of adolescents’ usage, their differing digital
literacy skills, and competence (Orben et al., 2020). Thus, literature on risk in this context, while still
relatively nascent, has rapidly had to become ever more nuanced and differentiated, with a growing
recognition of the need to account for the complexities involved in more adolescent-centric ways.
Adolescents use a broad gamut of social media for many purposes including communication,
extending social ties, creating networks, and creativity (Davies & Eynon, 2013). Indeed, social
media are plural — the term encompasses various platforms, technologies, and modes of online
engagement. Common to these is a social component which, particularly for adolescents attuned to
peer relations, can be beneficial (Uhls et al., 2017). It is precisely these potentially more positive,
prosocial uses — often neglected in the literature — that arguably can be protective of mental
health. Indeed, factors like self-esteem, social capital, social support, and self-disclosure are critical
to healthy development (Uhls et al., 2017). Moreover, the online lives of adolescents are funda-
mentally inter-related with their offline lives, with social media providing a means to co-construct a
narrated reality that simultaneously shapes and is shaped by the blurred lines between their online
and offline selves (Underwood & Ehrenreich, 2017).
Successive moral panics regarding social media use and mental health (see Waldron, 2014;
Jenkins et al., 2015) risk eclipsing the considerable complexity of existing research, over-
simplifying the harms, and almost entirely ignoring the potential benefits of social media in lay
discourse and related policy enactments. In this article, therefore, we aim to address this lack of
nuance by specifically exploring adolecents’ constructions of the positive aspects, contextualised by
a clear sense of their uses of social media and the understood significance for their wellbeing.
2 Clinical Child Psychology and Psychiatry 0(0)

Centrally, we seek to advance a better understanding of the complexities of how adolescents are
active in the construction and maintenance of their own identities, and, of how these young people
should not be constructed as the passive recipients of the ‘effects’ of social media. Following Sirkko
et al. (2019), we contend it is essential that adults listen to adolescents’ voices carefully to maximise
opportunities to support their emergent sense of agency. Therefore, adolescents are at the centre of
our research question, ‘What aspects of social media engagement do adolescents consider as
positive for their own and others’ mental health?
Method
The underpinning theoretical framework was macro-social constructionism as this reflects a view
that children and childhood are constructed and change over time (Grieg et al., 2007). This accounts
for how adolescents actively engage with, modify, and potentially transform the rhetoric of social
media and mental health through their own lived experiences.
Data collection
Six focus groups were audio-recorded with adolescents aged 11–18 years (N = 54) from London and
Leicester (UK). This included 30 males and 24 females from different ethnic groups (predominantly
White British and South Asian). Utilising a ‘stopping criterion’ of frequent repetition of meaning,
saturation was determined (Francis et al., 2010), which was consistent within and across groups
(Hancock et al., 2016). The focus group schedule was sufficiently broad to allow dialogue to be
participant-driven and person-centred. It reflected the three core issues of the main project: con-
ceptualisations of mental health and illness, opinions and experiences of social media, and the
potential of social media for mental health promotion and psychoeducation.
Analysis
A thematic design was utilised because of its meaning-making emphasis and participant-driven
character (Braun & Clarke, 2006). Specifically, template analysis was utilised as this provides a
hierarchical coding approach designed to provide a structural framework while allowing flexibility
to adapt to the priority of the study (King, 2004). In other words, this represents a blend of a priori
construction of a coding template grounded in the research agenda with data-driven interrogation of
the recordings reflecting the opinions and experiences of participants. The initial template was
shaped and refined through a coding and analytic process as themes were identified.
A close interrogation of the data demonstrated that adolescents talked about social media
predominantly in negative ways but did so with third party attributions (see O’Reilly et al., 2018a).
When speaking in a personal capacity they narrated more neutral or positive views. It is these data
that are analysed here; that is, the positive ascriptions, contextualised by a sense of their active use of
social media. Thus, our coding process extrapolated the positive narratives specifically to address
the research question outlined, and data not relevant were excluded as they are reported elsewhere
(see O’Reilly, 2020; O’Reilly et al., 2018a). We thematised the core understandings and experiences
of the potentially positive relationship between mental health and social media, generating four
themes from eight original conceptual categories. These together created the overall template of
relevant areas, see Figure 1. Adolescents differentiated us versus them, the real from the virtual, and
the safe from the dangerous in relatively sophisticated ways, implying social competencies in
recognising risk to their mental health and its mitigation.
O’Reilly et al. 3

Ethics
Ethical approval was provided by the University of Leicester Ethics Committee. Consent was
obtained from all participants, with parental consent acquired via school gatekeepers for those 15-
years and under. Parents and adolescents were provided with information sheets, distributed via
schools. All quotations are presented anonymously, with ‘Yr’ representing the English school year
group to which the participant belonged.
Findings
The template was built by engaging with the commonly cited concepts, broadly thematised into four
domains. First, was the value of social media for social connections, building relationships and peer
support; considered important for maintaining wellbeing. Second, was recognition that social media
could protect mental health. Third, was consideration of social media as a space for information-
seeking and psychoeducation about mental health and illness. Fourth, was that social media
provided a foundation for those with mental health conditions to support each other and share
information. Underpinning the template was a meta-narrative that media literacy and using the
internet in positive ways required a degree of control and sensible morally appropriate behaviour.
Theme one: Social connections, building relationships and peer support
A primary function of social media from users’ perspectives was to facilitate relationships and peer
networks. Adolescence is a period where social relationships become central and can play a role in
the development of identity (Blakemore, 2018; Erikson, 1968). Participants discussed the role social
media play in developing and maintaining relationships, as well as the utility of these platforms to
promote and create social spheres which contributed positively to their mental health. Indeed, some
Figure 1. Cross-cutting thematic template.
4 Clinical Child Psychology and Psychiatry 0(0)

argued that the function of social media was to ensure sociability, allowing social skills to improve
and develop.
It [social media] makes you more social
P8-Leicester-Yr13
Noteworthy here is P8’s use of language, presenting social media within a more deterministic and
causal framing. In other words, entrenched in this narrative is the notion that social media ‘makes’
adolescents more sociable; that these platforms have a direct relationship with socialising, and are in and
of themselves responsible for encouraging pro-social relationship building. Participants argued that social
media provide a mechanism for communication, which was viewed as central to their relationships.
It’s a way of communicating with people, maybe like really good friends you wouldn’t see very often
P4-Leicester-Yr11
Maybe it could be a way to connect with your old friends, so maybe people you lost touch with, maybe it’s a
way to find them again.
P6-London-Yr8
In describing the importance of social connectivity, participants positioned themselves as ac-
tively engaged in maintaining and promoting friendships. They included good friends that were not
part of their immediate geographic environment and friends they do not see face-to-face at all. They
also recognised the value in communicating with old friends, those who were no longer connected
since social media provided opportunities to reconnect.
It’s how I communicate with friends that I don’t see, and just friends in general, because it’s a quick way of
saying “oh, are you free or whatever”
P6-Leicester-Yr11
“So many good things come from having that instant contact with people”
P5-Leicester-Yr13
Important to these adolescents were friends in general. In their discussions, the boundary
between online and offline were merged and blurred, as social media afforded them a convenient
form of communication, that is, it was considered a quick and immediate way to communicate. In
such communicative environments, adolescents valued instant contact. While there may be a
temporal transience to these relationships, they were argued to serve a positive social function.
On Facebook you get to know more people, like you know more about them and these types of things, you
can talk to them as well, like you get to meet new people every now and then
P2-London-Yr11
O’Reilly et al. 5

It [social media] can also be a positive thing as you make friends, which is actually the purpose of it
P4-London-Yr9
I think it actually builds friends, cuz the first time you meet someone it’s a bit awkward, but if you talk to
them constantly on social media, then it becomes easier to talk to them in real life
P3-Leicester-Yr11
Participants saw social media as a way of connecting with new people, which some viewed as a
pathway to meeting new people face-to-face, differentiated as real life. Social media were typically
constructed as facilitators to building relationships and easing the way for regular communication,
as they took responsibility for forming, maintaining, and promoting relations with peers. Such
structuring of peer relationships was positioned in a positive way, as it was argued by participants
that communicating online was a basis for face-to-face interactions. Indeed, for some this was
argued to be the primary function of social media.
Theme two: Using social media to protect mental health
Through their discourses the adolescents in our study were clear that they had a degree of control
regarding their uses of social media. They recognised ‘excessive’ use could be detrimental, and
consequently their personal use of social media was often constructed as having a positive function
to protect their mental health. In this way, social media were viewed as helpful as using these
platforms relieved stress and promoted relaxation. In other words, they could recognise when their
positive mental state was under threat — from the pressure of revision or other aspects of their lives
— and actively attended to such concerns.
You can use social media as like an escape from it, if you’ve been revising for like hours then you can take
your mind off it or whatever by getting on your phone or listening to music
P3-Leicester-Yr10
I usually like go on YouTube, like it relaxes me
P2-London-Yr9
Like, you’re able to get away from things
P2-Leicester-Yr13
A central motif throughout these discussions was the notable resilience of adolescents; the
reported coping mechanisms developed to manage stress and other negative aspects of their lives.
Participants highlighted that they use certain types of social media, predominantly in the form of
YouTube videos and music on their phones, to escape from difficult situations or emotions, as well
as for entertainment which promoted relaxation. In these ways, participants discussed how they
made active decisions to attend to the stressors in positive ways to minimise any detriment to their
wellbeing. Specifically, they described such modalities as distractions.
6 Clinical Child Psychology and Psychiatry 0(0)

Um, it can be a distraction from the things around you and make you less stressed
P1-London-Yr8
Not only did they utilise social media to distract themselves from everyday pressures of exams
and schoolwork and to relax or escape, but also described utilising social media actively to find
techniques to promote their positive mental health and manage stress. Again, this demonstrates an
active decision-making role, and recognition that stress affects wellbeing. In using social media in
this positive way, they become informed health-management agents who exercise some degree of
control over their own stress, and some autonomy over their decisions.
Like, um, how to overcome stress, you type that in, there’s like a million, million ways of doing it and
different videos.
P3-London-Yr9
Clearly, the internet and social media (typically conflated to mean the same thing), provided
adolescents with information and support in ways they found valuable. The use of videos, via
YouTube, was presented as a convenient way to find techniques and information that was supportive
of their mental health by teaching them how to manage stress and how to relax when experiencing
the pressure of the real world. Users described a range of sources in this respect — some turning to
material from lay or self-appointed ‘experts’, others from content providers championing alternative
therapies and meditative techniques, and some from more official and traditional sources and
authorities. Notably, the trustworthiness of such sources may be questionable and although this was
acknowledged by some, they did not all point to this challenge. This was a pertinent issue when
seeking information about mental health, as theme three indicates.
Theme three: Information-seeking and psychoeducation
An area of questioning in the focus groups was on the potential of using social media for mental health
promotion (O’Reilly et al., 2018b). The use of social media for health educational purposes is only just
starting to emerge in the mental health promotion literature. However, participants reported using social
media (and the internet) to seek out information for a range of issues related to wellbeing, and fre-
quently recognised issues surrounding the trustworthiness and credibility of that information. Often
social media were reported to be their first choice for gathering information about mental health.
Participants noted that to find information about mental health using social media they needed to
specifically seek it out.
A lot of social media, if you want to look at that, you’d have to specifically sort of search for a page on it
[mental health]
P8-Leicester-Yr10
Participants reported that a single internet site or social media platform was unlikely to offer
sufficient information on a given mental health subject or area and, thus, they were sensible to seek
out multiple sources of information. Furthermore, they noted that it was this capacity of social media
that was particularly appealing, alongside their perception that social media allows for anonymity
(which is arguably more nuanced than they may believe).
O’Reilly et al. 7

You don’t just use one resource you have to use many to get an answer
P2-London-Yr9
I think some social media platforms are better than others, because, like, say on some you could have like an
anonymous question-answer sort of thing
P7-Leicester-Yr10
Recognised here was the array of sources that may be able to provide information on subjects
related to mental health and conditions. Participants constructed themselves in the position of
information researcher as they navigated a range of social media platforms and internet sites to gain
the knowledge required. Thus, their searches for information about mental health were con-
textualised with narratives of trustworthiness. They were cautious in interpreting information
offered about specific mental health conditions, but also about the offering of support and coping
strategies for maintaining positive mental health. Demonstrated in these discourses was the notion
that adolescents believe they are savvy about assessing information and its trustworthiness. Yet, this
needs to be treated with caution, as individuals may overestimate their digital literacy (Helsper et al.,
2020).
I feel like some people wouldn’t trust it because it, a lot of the stuff that is based on social media is probably
not true
P5-Leicester-Yr11
It’s not reliable so you don’t know if you, who you’re talking to if they’re qualified to give you advice
P8-Leicester-Yr10
Participants were nonetheless cognizant of inherent problems of inappropriate, untrustworthy, or
fake information spread via social media. Furthermore, they also recognised that some social media
involved multiple forms of social interaction, whether synchronous or asynchronous, and that some
of the advice or information offered through these platforms was drawn from lay viewpoints, from
those who ran sites or contributed to them, and as such they actively questioned the credibility and
qualifications of those providing it. Thus, they described being able to assess, to varying extents, the
value of the information being imparted from those sources.
While participants sometimes described being unsure how to differentiate the true from the
untrue, and the trustworthy from the untrustworthy, they did nonetheless express caution when
reading information on these platforms. They felt that when seeking information about positive
mental health or mental health conditions, it was essential to use sources that were known to have
credibility.
I prefer the way Childline is done, because it’s a well-known website where, it’s got adverts and stuff and
everyone knows what it is.
P4-Leicester-Yr 11
8 Clinical Child Psychology and Psychiatry 0(0)

Normally, there’s like on YouTube, there will be like factual videos and they’ll put their sources in the
description, so most of the time you could see like if they’re from a well-known site or if they’ve actually
conducted their own research
P2-London-Yr8
Undergirding these narratives was the notion of process. In other words, there was a recognition
that a process of checking, verifying, and understanding the information held by social media or on
internet sites, or transmitted via individuals through them, was important in the use and validity of
the material. Perhaps most significantly, participants felt it was their responsibility to check validity.
Again, they described their information and navigation processing skills (see Helsper et al., 2020) in
navigating through multiple and contradictory online information landscapes to seek out educa-
tional materials about a range of issues relating to mental health. They were able to recognise some
sources are more credible because of their organisational standing, such as Childline, or because the
website’s origin was well-known, and their own research corroborated the information. In so doing
there was some demonstrated social competence for managing a vast amount of information online,
although it is recognised that reported competency and demonstrated competency are not always
aligned in digital spaces (see Donoso, 2022).
Theme four: Using social media for peer-to-peer mental health support
Information-seeking was not simply a case of passively reading information and absorbing
knowledge. Indeed, some educational uses of social media were constructed as interactive, in the
sense that social media or internet forums were used by adolescents to learn about mental health
conditions, provide peer support, and to create communities of people with certain conditions. In
such a way they were positioned as active researchers of ‘symptoms’.
“but I’ve definitely researched certain mental illnesses and seen if I, and sort of looked at symptoms”
P5-Leicester-Yr13
For adolescents experiencing characteristics of mental health conditions, or those with a di-
agnosed condition, social media can be a useful source of information or peer support. Experiencing
mental health difficulties can feel isolating or challenging, and social media can be a helpful source
for coping.
“Zoella did her anxiety video, didn’t she? And I think that helped a few girls thinking, ‘oh, it’s not just me
that’s like that”
P1-Leicester-Yr13
“Like if, for example, someone like a young person suffers from whatever, whether it’s anxiety like simple
things, like you can go on this website and get self-help and you have like tips on how to overcome the
anxiety or panic attacks”
P5-London-Yr10
O’Reilly et al. 9

The spread of information, and the potential for celebrity endorsement, was positioned as helpful
in raising awareness of mental health conditions, like anxiety. Consequently, the benefit was argued
to be that they were supported by the notion that others also encountered the same symptoms. Not
only were they constructed as no longer isolated, but as actually having treatment options available
to manage the effects of the condition, as the internet has ‘tips’ for managing symptoms. The
availability of such information was argued to create a community of peers who produced a
supportive online environment.
“If that’s happened to people before and then hearing about it from them [via social media] that may help
you if you’re similar it could help you”
P4-London-Yr11
“Using forums is good because you know there are other people like you”
P2-London-Yr8
Some also recognised that their peers experienced mental health conditions, and that to be a
supportive friend sharing information and understanding that condition was important.
…because when my friend was going through an eating disorder, but I didn’t know, I could tell she was
acting different, so I was searching online like depression, you know, stuff like that
P5-Leicester-Yr13
A good example of this was P5, whose friend had been formally diagnosed with an eating
disorder, which initially was believed to be depression by P5. Her first source of support and
information was the internet. It was only later, after clinical consultation, that the condition was
found to be an eating disorder rather than depression. Although the accuracy of the research on
depression was positioned through a positive narrative, this suggests that access to information is
insufficient, as it is not simply a question of access, but being able to process and utilise the
information in ways that are helpful and reflect the true nature of the health condition, requiring
some expert input.
Discussion
Adolescence is characterised by tensions between developing independence, while maintaining
some dependence on adults (Livingstone and G}
orzig, 2014). As digital media have become more
embedded, so too has been a rise in prevalence of mental health conditions. Evidence suggests there
has been an increase in the number of adolescents with mental health conditions (NHS digital, 2018)
with a concern raised about the role social media plays in mental health. Many adults blame
technology for undesirable outcomes rather than acknowledging cultural, personal, or social factors
(boyd, 2014). However, as ever, correlation is not causation. It is important not to attribute single
factors as responsible for causing mental health conditions, as it is well known there is a multi-
factorial aetiology (Dogra et al., 2017). Indeed, mental health conditions result when several factors
come together in a set of circumstances, and they are also dependent on whether there are any
protective factors in place.
10 Clinical Child Psychology and Psychiatry 0(0)

Nonetheless, these concerns about adolescents’ relationships with and through digital tech-
nologies, and the potential impact of these on mental health and wellbeing remains to be a potent
source of controversy, both in the lay discourse and the scientific literature. Our research highlights
the need to move away from a one-dimensional focus on adolescents as the vulnerable, potential
victims of digital harms, and the need to consider the active, often agentic, array of approaches to,
understandings of, and uses of a wide range of different social media and related technologies.
While some adolescents are indeed especially vulnerable to developing an unhealthy relationship
with technology and are at risk from utilising it in ways that may lead to negative effects on their
mental wellbeing, this is not the case for all. Indeed, the term ‘vulnerable’ itself is both contested and
problematic – we might argue that all adolescents are ‘vulnerable’ to the risks inherent in social
media use, and that the true challenge they face is in learning to manage those risks as they age
towards adulthood. Such arguments have made social media an easy target for adults to blame,
rather than paying attention to other important factors in adolescents’ lives (boyd, 2014). This is
significant as through this study, we suggest that what is needed is an intersectional and multi-
systemic framework that enables balanced and nuanced perspectives.
Such a framework would, for example, explain that while exposure to online risk is increasing,
(e.g., cyberbullying, racial-hatred, self-harm websites and pro-anorexia content), self-reported
levels of harm directly associated with social media have only increased slightly as adolescents learn
to survive and thrive in their online activities (Livingstone & Grozig, 2014). Yet, it should also be
recognised that adolescents’ discourse may not always reflect agency or digital skills. Based on
these initial focus groups, such a framework might begin to evolve with different dimensions.
Adolescents and their technology use might operate within relational structures (including families,
communities, and educational or work contexts) that enable them to take appropriate risks in a
context of safety, fundamental to successful resilience (Theron et al., 2021). Furthermore, such a
framework should also account for wider systemic factors, such as the role of governments, policies,
and the responsibility that big technology companies should take. These are important discussions
that recognise the intersecting issues that scholars are currently grappling with (see Smahel et al.,
2020).
Through our discussion we have illustrated that highlighting the voices of adolescents and
interrogating their own personal experiences of social media present a different account of the
relationship between social media and mental health to the commonly held generic view. By
listening to adolescent perspectives, it is possible to gain insights into their social competencies and
consider the potential benefits of social media. In discussing positive influences of social media,
adolescents understood these platforms to be essential to developing and maintaining social re-
lationships, which indirectly had a positive effect on their wellbeing and emergent sense of identity.
Indeed, they contended that social media were protective of their mental health since they utilised
these platforms as a coping mechanism to manage stress, to learn about mental health or gain
support (albeit the case that for some this ‘support’ may ultimately be detrimental). There was
recognition of the viability of information and assessing its validity. Participants discriminated
between different sources of information, forging emergent senses of themselves as competent
‘researchers’ and experienced internet users — in itself a form of education as participants can be
observed as developing progressively sophisticated criteria for trustworthiness and informational
provenance. Nevertheless, it is important to acknowledge that such self-reports may be subject to
social desirability biases (Donoso, 2022) and, may overestimate actual digital skills (e.g., Helsper
et al., 2020). This highlightsthe essentialness of the role of schools in educating children, and in
helping them improve their media literacy and digital skills.
O’Reilly et al. 11

This study included a representative and diverse sample, with adequate numbers for qualitative
work but is nonetheless limited in the transferability of core messages yielded as further research on
a wider scale is warranted. Importantly, however, our study illuminates the need for the broader
inclusion and consideration of adolescent perspectives on these issues to prevent an adult-centric
rhetoric being too influential on such a global matter. Furthermore, this concern necessitates a
greater body of interdisciplinary work to help researchers identify the right kind of questions to be
asking in a more adolescent-centric research environment. Key concerns that follow from our study
include:
1. Social media are considered to have potential to facilitate adolescents in building their
relationships and extending peer support. This has implications for the social brain in
adolescence which may function as a protective factor (see Blakemore, 2018)
2. Adolescents argued that social media can be protective of their mental health. This raises
questions about the value of human-computer interaction, and questions regarding whether
the benefits truly outweigh the risks.
3. Social media were viewed essentially as a source of intelligence about mental health. This
raises crucial questions about the quality, range, and accessibility of online information, and
the potential inequalities resulting from the lack of access, as well as the possiiblities and the
digital skills of adolescents to access and assess it.
4. Peer support was valued by the adolescents. Accordingly, a consideration of how this is
facilitated digitally (as well as the conditions under which it can become dysfunctional) are
areas worth pursuing.
Clearly, without adequate explanations for the different ways that adolescents use social media it
will not be possible to understand how they develop their own spans of agency in recognising and
mitigating online risks and opportunities; how agendas regarding mental wellbeing might be set for
social media use; nor how it is possible to address a tendency towards technological determinism in
prevailing accounts of these concerns (Selwyn, 2011). Arguably, a person-specific media approach
on a large scale may help promote an understanding of when, why, and for whom social media lead
to positive or negative effects on mental health (Valekenburg et al., 2022). We argue that it is crucial
that society treats adolescents as active, reflexive navigators of their complex social and digital
words, and not simply as passive recipients of the ‘effects’ of social media.
In conclusion, adolescents are not a homogenous group. Their engagement, usage and un-
derstanding of social media, as well as the risks they take and the possible outcomes and con-
sequences of their uses of social media have great diversity. To treat all young people as
‘vulnerable’, lacking in agency and any degree of self-determination online is entirely inappropriate.
This underestimates the digital competences adolescents acquire, the resilience they develop and
their ability to navigate and blend their online and offline worlds. This does not mean adults can
become complacent; indeed, the complexities of our study suggest digital literacy and online safety
should remain high on the political agenda. However, our findings suggest that adults, like parents,
teachers, policymakers, and the industry should work more closely with adolescents to ensure that
they are sufficiently supported and empowered to navigate the online world knowledgably, safely,
creatively in ways that are positive and rewarding to them. It is arguably more appropriate to address
and mitigate the risks of online participation whilst potentially bolstering the benefits to the
wellbeing of adolescents.
Clinical Child Psychology and Psychiatry
12 Clinical Child Psychology and Psychiatry 0(0)

Acknowledgements
We are very grateful to all the participants who gave their views so openly and without whom the study would
not have been possible. We are also grateful to Paul Reilly (University of Sheffield) and Natasha Whiteman
(University of Westminster) for their involvement in the project.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or
publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or pub-
lication of this article: This work was supported by the Wellcome Trust (Grant number: 109393/Z/15/Z)
ORCID iDs
Michelle O’Reilly  https://orcid.org/0000-0003-1978-6405
Diane Levine  https://orcid.org/0000-0002-0790-4518
References
Barry, C. T., Sidoti, C. L., Reiter, S., ReiterBriggs, S. R., & Lindsey, R. A. (2017). Adolescent social media use
and mental health from adolescent and parent perspectives. Journal of Adolescence, 61, 1–11. https://doi.
org/10.1016/j.adolescence.2017.08.005
Blakemore, S. J. (2018). Avoiding social risk in adolescence. Current Directions in Psychological Science,
27(2), 116–122. https://doi.org/10.1177/0963721417738144
boyd, D (2014). It’s complicated: The social lives of networked teens. Yale University press.
boyd, d., & Ellison, N. (2007). Social network sites: Definition, history, and scholarship. Journal of Computer-
Mediated Communication, 13(1), 210-230.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology,
3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Couldry, N., & Hepp, A. (2017). The mediated construction of reality. Polity Press.
Davies, C., & Eynon, R. (2013). Teenagers and technology. Routledge. https://doi.org/10.4324/
9780203079270
Dogra, N., Parkin, A., Gale, F., & Frake, C. (2017). A multidisciplinary handbook of child and adolescent
mental health for front-line professionals (3rd ed.). Jessica Kingsley Publishers.
Donoso, V. (2022) Youth’s digital skills: Insights from the ySKILLS project. (CO:RE Short Report Series on
Key Topics). Hamburg: Leibniz-Institut für Medienforschung | Hans-Bredow-Institut (HBI); CO:RE –
Children Online: Research and Evidence. https://doi.org/10.21241/ssoar.78951
Ehrenreich, S. E., & Underwood, M. K. (2016). Adolescents’ internalizing symptoms as predictors of the
content of their Facebook communication and responses received from peers. Translational Issues in
Psychological Science, 2(3), 227–237. https://doi.org/10.1037/tps0000077
Erikson, E. (1968). Identity: Youth and crisis. Norton.
Francis, J., Johnston, M., Robertson, C., Glidewell, L., Entwistle, V., Eccles, M., & Grimshaw, J. (2010). What
is adequate sample size? Operationalising data saturation for theory-based interview studies. Psychology
and Health, 25(10), 1229–1245.
O’Reilly et al. 13

George, M. J., & Odgers, C. L. (2015). Seven fears and the science of how mobile technologies may be
influencing adolescents in the digital age. Perspectives on Psychological Science, 10(6), 832–851. https://
doi.org/10.1177/1745691615596788
Greig, A., Taylor, J., & MacKay, T. (2007). Doing research with children (2nd ed.). Sage. https://doi.org/10.
4135/9781849209045
Hancock, M., Amankwaa, L., Revell, M., & Mueller, D. (2016). Focus group data saturation: A new approach
to data analysis. The Qualitative Report, 21(11), 2121–2130. https://doi.org/10.46743/2160-3715/2016.
2330
Helsper, E., Schneider, L., van Deursen, A., & van Laar, E. (2020). The youth Digital Skills Indicator: Report
on the conceptualisation and development of the ySKILLS digital skills measure. KU Leuveny SKILLS.
Jenkins, H., Ito, M., & boyd, D. (2015). Participatory culture in a networked era. Polity Press.
King, N. (2004). Using templates in the thematic analysis of text. In C. Cassell & G. Symon (Eds.), Essential
guide to qualitative methods in organisational research (pp. 256–270). Sage Publications. https://doi.org/
10.4135/9781446280119.n21
Kurek, A., Jose, P., & Stuart, J. (2017). Discovering unique profiles of adolescent information and com-
munication technology use: Are ICT use preferences associated with identity and behaviour development?
Cyberpsychology: Journal of psychosocial Research on cyberspace, 11(4), 1–18. https://doi.org/10.5817/
CP2017-4-3
Livingstone, S. (2019). Claiming rights and righting wrongs: children’s rights in the digital environment. In C.
Donohue (Ed.), Exploring key issues in early childhood and technology: Evolving perspectives and
innovative approaches (pp. 42–48). Routledge.
Livingstone, S., & Görzig, A. (2014). When adolescents receive sexual messages on the internet: Explaining
experiences of risk and harm. Computers in Human Behavior, 33, 8–15. https://doi.org/10.1016/j.chb.
2013.12.021
NHS digital. (2018). Mental health of children and young people in England 2017: Emotional disorders.
Health and Social Care Information Centre.
Orben, A. (2020). Teenagers, screens and social media: A narrative review of reviews and key studies. Social
Psychiatry and Psychiatric Epidemiology, 55(4), 407–414. https://doi.org/10.1007/s00127-019-01825-4
O’Reilly, M. (2020). Social media and adolescent mental health: The good, the bad and the ugly. Journal of
Mental Health, 29(2), 200–206.
O’Reilly, M., Dogra, N., Hughes, J., Reilly, P., George, R., & Whiteman, N. (2018b). Potential of social media
in promoting mental health in adolescents. Health Promotion International, 34(5), 981–991.
O’Reilly, M., Dogra, N., Levine, D., & Donoso, V. (2021). Digital media and child and adolescent mental
health: A practical guide to understanding the evidence. London: Sage.
O’Reilly, M., Dogra, N., Whiteman, N., Hughes, J., Eruyar, S., & Reilly, P. (2018a). Is social media bad for
mental health and wellbeing? Exploring the perspectives of adolescents. Clinical Child Psychology and
Psychiatry, 23(4), 601–613.
Richards, D., Caldwell, P. H., & Go, H. (2015). Impact of social media on the health of children and young
people. Journal of Paediatrics and Child Health, 51(12), 1152–1157. https://doi.org/10.1111/jpc.13023
Selwyn, N. (2011). Making sense of young people, education and digital technology: The role of sociological
theory. Oxford Review of Education, 38(1), 81–96. https://doi.org/10.1080/03054985.2011.577949
Sirkko, R., Kyrönlampi, T., & Puroila, A. M. (2019). Children’s agency: Opportunities and constraints. In-
ternational Journal of Early Childhood, 51(3), 282–300. https://doi.org/10.1007/s13158-019-00252-5
Smahel, D., Machackova, H., Mascheroni, G., Dedkova, L., Staksrud, E., Ólafsson, K., Livingstone, S., &
Hasebrink, U. (2020). EU Kids Online 2020: Survey results from 19 countries. EU Kids Online. https://
doi.org/10.21953/lse.47fdeqj01ofo
14 Clinical Child Psychology and Psychiatry 0(0)

Theron, L., Murphy, K., & Ungar, M. (2021). Multisystemic resilience: Learning from youth in stressed
environments (p. 0044118X2110173). Youth and Society. https://doi.org/10.1177/0044118x211017335
Uhls Y Ellison, N., Subrahmanyam, K., Underwood, M., & Ehrenreich, S. (2017). Benefits and costs of social
media in adolescence the power and pain of adolescents’ digital communication: Cyber victimization and
the perils of lurking. Pediatrics, 140American Psychologist, 2(S2), 144–158. https://doi.org/10.1542/
peds.2016-1758e
Underwood, M., & Ehrenreich, S. (2017). The power and pain of adolescents’ digital communication: Cyber
victimization and the perils of lurking. American Psychologist, 2, 144–158.
United Nations (1989). Conventions on the Rights of the Child. New York: UN.
Valekenburg, P., Meier, A., & Beyens, I. (2022). Social media use and its impact on adolescent mental health:
An umbrella review of the evidence. Current Opinion in Psychology, 44(6), 48–58. https://orcid.org/10.
1016/j.copsyc.2021.08.017
Viner, R., Aswathikutty-Gireesh, A., Stiglic, N., Hudson, L., Goddings, A., Ward, J., et al. (2019). Roles of
cyberbullying, sleep, and physical activity in mediating the effects of social media use on mental health
and wellbeing among young people in England. A secondary analysis of longitudinal data. The lancet:
Child and adolescent health, 3(10), 685–696, https://doi.org/10.1016/s2352-4642(19)30186-5
Waldron, L. M. (2014). Cyberbullying: The social construction of a moral panic. Communication and in-
formation technologies annual, 197–230 (pp. 197–230). Emerald Group Publishing Limited. https://doi.
org/10.1108/s2050-206020140000008023
O’Reilly et al. 15