The Lived Experience of Social Media by Young People who Self Harm Dr Rob Flynn Teesside University & Tees, Esk, & Wear Valley NHS Foundation Trust
Contents Defining Social Media Rationale & Aim of Study Existing Literature Method Results Discussion Implications for Practice Recommendations
Defining Social Media Social media is commonly regarded as the social interaction among people, in which people create, share or exchange information and ideas, in virtual communities and networks. Kaplan and Haenlein (2010) define social media as "a group of Internet-based applications that build on the technological foundations of web, and allow the creation and exchange of user-generated content.
Defining Social Media It s just a really really powerful thing like there s no point in trying to stop it because the whole world has social media everywhere is connected, everywhere and trying to prevent it is stupid. You ve got to embrace the change. Emma (Participant 2)
Rationale A need to understand young people s experiences of social media and its impact on their mental health This is the first generation to grow up with social media being around their entire lives; with young people more than any other age groups, accessing the internet to connect with others (Van den Eijnden, Spijkerman, Vermulst, van Rooij, & Engels, 2010) Existing literature shows a lack of research, focusing on this population
Existing Literature Richards, Caldwell, & Go (2016) identified that the health impact of social media on children and young people was greatest on their mental health and specifically in the areas of self-esteem and well-being. Muller et al (2016) explored if the use of social networking sites is related to psychosocial distress (N = 9173 adolescents, 12 19 years). Adolescents using social networking sites intensely displayed higher psychosocial distress. Sampasa-Kanyinga & Lewis (2015) found that the daily use of Social Networking Sites for more than 2 hours was independently associated with poor self-rating of mental health and experiences of high levels of psychological distress.
Existing Literature Research has also found that teens with mental health conditions use the Internet to find ways to cope or deal with their worries, unhappiness or problems (Stallard, Velleman, & Richardson, 2010). Almost half of young people reporting self-harm also report high Internet use (Mitchell and Ybarra, 2007). Identified online risks included exposure to unsolicited pornography or violent content, sexual predation, cyber-bullying, and social isolation (Rosenblum, 2007; Ybarra & Mitchell, 2008).
Aim of the study To gain an understanding of how young people in mental health services (who self-harm) use, view, and experience social media. This aim was to be achieved through interviewing and then interpreting the selfreported experiences of young people who were attending mental health services, about their social media use.
Method Qualitative approach Interpretative Phenomenological Analysis (IPA) Semi-structured interviews (average 35 minutes) Sample 10 young people currently in services (9F 1M) 5 CAMHS tier 3 services Age range 13-17 (average age 15) One episode of self-harm in patient history
Tees, Esk, & Wear Valley Trust (TEWV) TEWV provides a range of mental health, learning disability and eating disorders services around County Durham, the Tees Valley, Scarborough, Whitby, Ryedale, Harrogate, Hambleton, Richmondshire and the Vale of York
Results Superordinate Theme/s
Results Everyday Use Superordinate Theme/s Erm.Just something like it gives you like the opportunity to like con- like contact people and share like information with people who like you don t really, well, I usually use it, like share information with people who like I don t really see that often um it s... it s something that you can use to like talk to other people that you wouldn t be able to talk to like without it
Results Everyday use Superordinate Theme KEY POINTS: Maintaining existing friendships Meet new people and make online friends Influence on social hierarchy and popularity Important to keep in touch with family (Support) Social Media often used out of boredom
Results Real Life Consequences Superordinate Theme/s Erm, yeah. Yeah. Erm cause I wouldn t be, I don t think I d be in contact with the people who I am now if, if that, like if social media didn t exist Erm but then there s been, there s been incidents where I ve fallen out with people on Facebook, had big arguments and then never spoke to them again Well there s like, obviously you can get abuse from it easily like very easily and you can do it anonymously as well
Results Real Life Consequences Superordinate Theme KEY POINTS: Manage their arguments and disagreements on social media as well as in real life Social media has become an environment for young people to dispense online abuse, offensive language, and create labels that remain with people in their real life Participants described experiences of exposure to sexism and racism were common during their social media use The negative effect amplified by online anonymity
Results (Mental Health - Unhelpful Aspects) Superordinate Theme/s Images of like self-harming and like body images are really triggering, eating wise, stuff like that knowing that they would make me feel worse If I m just, just a bit sad or something I d go and see what was going on and that, that might make me even more sad so then I just come off it anyway
Results (Mental Health - Helpful Aspects) Superordinate Theme/s Um well it s helped to find other people, that like have gone through the same things and have got better or are like currently getting better I mean it encourages you I guess Um and at the same time it s also helped me not do bad things cos there s you know people encouraging you not to do things and like telling you like that it s not going to get better through that Yeah I mean, not always, like they might just be using it as an escape to get out their own emotions
Results Mental Health Superordinate Theme KEY POINTS: Social media as an environment for support Help with their emotions and current life difficulties Make connections with others experiencing similar distress Withdrawing from social media at times when they felt their mental health was negatively affected Seeing people harming themselves, or discussing selfharm on social media could start or trigger self-harm
Results Superordinate Theme/s I mean you can express your feelings more easily on social media for me anyway and like I don t know like a picture can speak louder than a word could for me anyway so if I have something to say and I don t know how to say it, I d put it on social media and for other people to like have their view on it and for them to say what they think about that a great way I think of meeting new people and telling them how you feel and knowing that they feel the same way too
Results Developmental Processes Superordinate Theme KEY POINTS: Participants were aware of changes they had made through their lives, such as; Changing their social media use Gaining a sense of social media maturity A realisation of how they wanted to use social media Social media behaviour changed as they got older, both in what they accessed, and their knowledge of how to respond to the situations social media provides. Through social media participants learnt how to manage their emotions online, that may include therapeutic selfdisclosures.
Results Developmental Processes Superordinate Theme KEY POINTS: Specifically participants found using pictures, on sites such as Instagram or Snapchat, as an important way to express their current emotion or mood. Online quotes, and online pages dedicated to displaying numerous quotes about various feelings, were also an important way for young people to reflect on their current feeling/emotion when using social media. Is there an online developmental stage that young people go through during their adolescence?
Discussion Social media can provide the development of meaningful and supportive relationships, and can help maintain family links, both of which can be used to offer support to these young people. Social media is also a tool for young people to discuss and express their emotions, share experiences, and make a connection with others experiencing similar distress. However, the findings also suggests that the use of this technology can risk a number of distressing, harmful online and offline consequences.
Discussion The issue of social media may arise during the therapeutic process, however we should be asking about it right from initial contact with services, and throughout their time within therapy as social media is an ever changing factor in the young peoples lives This is not a static factor; it is a continuum, and responses/interaction with social media will change throughout time, especially as children mature through their adolescent years. As a profession we should embrace this new cultural direction in which society is heading, and discuss with young people something (social media) that is as important and integrated in their lives as much as sleep and food is.
Implications for Practice Current CAMHS services offer in-depth assessments covering a wide range of issues, however social media is not currently standard practice to be discussed in an initial assessment. Mental health professionals working with young people, should inquire about their social media use, in order to better understand the role it may play in affecting their mental health (Lewis, Heath, St Denis, and Noble 2010, Swannell et al., 2010). Clinicians could try to get a sense of where the young person is in terms of developmental use of social media as part of assessment. Currently, there are no clinical guidelines that can be used to inform clinicians as to the most helpful role of social media in child mental health services.
Future Recommendations Focus on the particular social media being used by young service users, and the types of activities that are taking place online Focus on the younger end of the adolescent age group; as the younger participants would be at the beginning of their social media experience Look at how the young people learned to develop and change their social media behaviour
Appyness A mental health app (available to Wokingham teenagers) has been developed to help teenagers record their mood, and tackle mental health issues. This app allows young people to scale their mood daily and plot it on a graph so they can track their progress over time, it gives top tips for coping with stress, depression and anxiety, and it provides links to local and national organisations. It is hoped that the app can spark conversations between young people and health professionals over mental wellbeing. The information recorded on the free app is confidential and secure, but can be shared with mental health professionals if the user chooses. http://healthwatchwokingham.co.uk/appyness-app/
Conclusion The current research findings highlight the importance of the communication factor, the value of finding likeminded others, and takes into consideration the developmental process of becoming a more mature user of social media. More research is needed in this area to further understand the impact of social media on young service users. For now we must take social media into consideration when carrying out assessments and formulations of children and adolescents mental health.
Any Questions
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