Professor Umar Toseeb Hello, welcome to the Podcast series for the Association for Child and Adolescent Mental Health, or ACAMH for short. I'm Umar Toseeb, Professor of Psychology. My research focuses on special educational needs and mental health in childhood and adolescence. All listeners to this, and indeed any of ACAMH's podcasts, are eligible for a free CPD certificate. Do please visit acamhlearn.org for details of this, together with information on how you can access hundreds of hours of free talks, lectures, interviews, all of which you can also get free CPD certificates for. The web address is acamhlearn.org. That's a-c-a-m-h-l-e-a-r-n.org. Today, I'll be speaking to Professor Pete Etchells, Professor of Psychology and Science Communication at Bath Spa University in England. Professor Etchells is the Author of the book, "Unlocked The Real Science of Screen Time (and How to Spend it Better)." this will be the focus of today's podcast. Pete, thank you so much for joining me. Professor Pete Etchells No, thank you for having me. Professor Umar Toseeb Do you want to start by just telling us a bit about who you are and what you do? Professor Pete Etchells As you say, I'm a Professor of Psychology and Science Communication. I guess I'm a bit of a non-traditional Professor in many ways, in that I think if you look at most Professors' CVs, there's bazillions of pounds worth of grants and papers and things like that. I'm a Psychologist by background, but really, my interest is in practical, on the ground, science communication, so that's where I've focused my work over the past ten years or so. So, for about five years, I u - I ran The Guardian science blog network. That was really cool. I miss doing that. That was, basically, about 20 or 30 Scientists and Science Writers had the keys to The Guardian's website. We could literally write about whatever we wanted to, whenever we wanted to, with, basically, no editorial oversight. It was a terrifying thing to do, but, you know, it worked and we got to write, you know, write about really cool science stuff. So, that was fun, and then, I - once that closed down, I, sort of, moved into more longer-form writing, really. So, I wrote a book in 2019 called "Lost in a Good Game," which is all about why we play videogames and what they can do for us. I've always been interested in digital technologies and their impacts, their psychological impacts. Things like, you know, what their effects on mental wellbeing are, mental health, behaviours, as well. So, that's where my research has been focussed over the past ten years, as well. So, I try and do both side-by-side really, so a bit of research, but thinking about how do we talk with people about really complicated topics in science, in psychology in particular, things that people care about, but the science is really not unidirectional? It's not saying, you know, very much the case that this thing is true. How do you navigate those very difficult conversations in such a way that people can take something useful from it and apply that to their daily lives? Professor Umar Toseeb Excellent, and you've already touched upon this a bit and why is there a need for this book now? Professor Pete Etchells And it's a great question. There's been growing concerns around screen time, for well over ten years, but increasingly so since just before the pandemic. So, this is something that I've always taken an interest in, both from a research perspective, but also in terms of, you know, talking about it and talking with people about it in the mainstream media. And what I've noticed is that there's always been murmurings around screen time as a broad concept feeling a little bit unwholesome and a little bit unnatural and not great for us. And then, about six or seven years ago, those concerns really exploded and there was this real concern. So, there was - I often go back to an article that was published in The Atlantic magazine, I think it was 2017, and the reason that I go back to that so often is because it was one of the most widely shared science opinion pieces across the entire internet that year. Like, it's hard to overstate how impactful that article was, that was talking about how smartphones have destroyed a generation. And this really gels with how we feel about screens and social media and smartphones, that they're not good for us and they're really not good for kids. And then we have this weird blip, which was the pandemic, where everybody was forced onto screens to connect with each other. So, I wrote an opinion piece just at the start of the pandemic for The New York Times, which was, basically, like, don't freak out about quarantine screen time. My quiet hope was that because we're, sort of, being forced to engage with this, you know, you can't - you know, for work or for connecting with family members, you're going to have to use WhatsApp or FaceTime or something like that, and we're going to have to come face-to-face with this, that maybe what that would generate is more nuanced understandings of how we use screens and what their impacts are. And that might lead to a more rational, more sensible, discussion and debate about how do we regulate these technologies and how do we make them work for us? And then 2024 happened and that didn't come about, right? So, what's happened over the past, well, nine months/year or so, is that there has been a real explosion in concerns, particularly focused at children and young people, around their use of smartphones and social media, in particular, but it also bleeds out into, you know, videogames and anything digital tech, really. We've got these panicked worries now that things are really bad and they've got really bad really quickly, and we need to do something about it now, and we need to fix it now. And what we're reaching for in that panic state is very heavy-handed regulations around the nature of things like bans. It's funny, because over the past ten years or so, these issues, these worries, have been bubbling under the surface and for whatever reason, this year, and I'm not sure what the particular reason is, that they've just, kind of, exploded. Professor Umar Toseeb I think I'm guilty of this, and I imagine lots of people are in the general popugation - population are guilty of this, and also, Researchers, so I think we should start by just thinking about some of the terms that you will be using, and we will be using, in this conversation. So, in your book I think you make a distinction and you explain that 'screen time' is one term, 'social media' is another term, 'digital technology', and there's lots... Professor Pete Etchells Hmmm. Professor Umar Toseeb ...of different terms that are used to probably describe social media, I think is probably what people are getting at. But actually, there's lots of different words that people use. What are the terms that we're going to use in this conversation and what is the distinction between them? Professor Pete Etchells Probably all of them and probably interchangeably. So, I, kind of, I'm a massive hypocrite, right? So, I talk about this in the book, about how "Screen time is essentially a meaningless concept because it means so many different things." And I spend quite a long time making this argument and then I finish it off by saying, "But I'm going to use screen time anyway to mean all of these things." That's part of the problem, right, because we need a shorthand way of talking about all of these sorts of digital technologies. And one of the major issues I think we have with having sensible conversations about the positive or the negative, the intricate impacts of digital tech, is that we don't really have a good language, a good set of terms, to talk about these things. I've often wondered, since "Unlocked" was published, actually, that maybe it was published about a year too late, or six months too late, because, you know, the focus in that book is very much on screen time. I don't think people care that much about screen time as a concept anymore. You know, when you have somebody like me come along and say, you know, "We're going to measure, like, an hour of screen time." "Well, that's meaningless, because one hour for me is different from one hour for you. An hour on Instagram is different to an hour playing Minecraft" and yadda, yadda, yadda. Everybody goes, "Well, yeah, obviously, yeah, we all know that, right? That's a complete strawman argument to make." And I get that. At the same time, we're having lots of worries at the minute about social media and I would say that 'social media' is a similar useless term, because so many different things are social media. And again, I go into this in the book that, you know, if you're trying to tackle this from an evidence-based scientific perspective, you need to be specific about what it is that you're measuring, what it is that you're worried about, and we're not in these conversations. Facebook is very different to Instagram, purely in terms of, like, how you interact with it. One is a very, kind of, audio-visual medium, one is more, well, a mix, Facebook's more of a mix nowadays. But, you know, if you compare that with something like WhatsApp, which is more text-based. Some of these are platforms where you primarily talk to and with people that you know, close family and friend members, whereas others are more parasocial in nature. You know, you're talking with people you don't know and you're talking with celebrities, people that you look up to, things like that. Some of them, the message disappears really quickly, you know, it's not permanent. Others, they really are, and you think about all the different ways in which you can, kind of, curate those sorts of feeds. Some of them, you know, Twitter, Instagram, we're very much concerned about the way that information is algorithmically presented to us. Something like Bluesky is much more individualistic in that there isn't an algorithm managing what you're shown. It's up to you to decide what you see. All of those different factors and different ways in which we might conceptualise a social media platform you would imagine have very different impacts on people in terms of voice, their psychology, but we're not having that conversation. We're saying, "Social media is bad," or "Social media has this effect." And yeah, I have some really great conversations with parents about this and my deep sense is that, you know, people get all of this sort of stuff, but they're just really worried, primarily by a lot of stuff that you see in the news. And, you know, the fair criticism there is, "So what? Why are we having this very nerdy, boring conversation about how we define something? Why do we care?" Yeah, that's a - you know, it's the classic, like, academic ivory tower, "This is very wonderful and interesting that you're saying that we need to be defining these things more properly, but I don't care." And my response to that is that you just need to look at what happened in Australia. There's been rushed legislation pushed through in Australia to ban all under 16-year-olds from social media. And there was a news story that it, kind of, got lost in the noise a little bit, where you actually look at what the legislation says and it doesn't really define what social media is. So, the next thing that happened was that you had companies like Snapchat, actual social media companies like Snapchat, coming out and saying, "We're not social media, because by these definitions, we're a messaging service. Therefore, we would be exempt from these rules." Snapchat's one of the things that people are worried about, right? And we're talking about putting in legislation where the - it doesn't apply to that particular platform, and I'm sorry, but that is why having these very boring, niche, nerdy conversations about what you mean and what you're worried about in terms of impact, are really important. Because if you don't take care and pay attention to the details, you end up banning the wrong thing, or focusing on the wrong thing, or missing the things that you're actually caring about. And it's part of the reason why we have such a mixed evidence base. All of this work started using screen time as a concept generally, right, because it makes sense. Doesn't tell you anything useful, doesn't mean anything. Like, it's a complete red herring measure, but we're still stuck on it. And, you know, I see papers every week coming out that is just the same study over and over again. It's a bunch of Researchers asking lots and lots of people, "How much time have you spent on TikTok? What's your wellbeing like? I'm doing a correlation," as though that is useful. And we're at a point now where that sort of research is just - it's just pointless now. Professor Umar Toseeb My follow-up question was going to be this. So, there's a group of Researchers who suggest that social media, screen time, digital technology, is bad for young people's mental health, and you've highlighted one potential flaw with that argument, which is that, how are we defining the exposure here? Is it screen time, is it what are they doing on social media, all of those things, what the platform is? What are some of the, in your view, some of the other flaws or problems with the argument that social media, screen time, digital technology, is bad for young people's mental health? Professor Pete Etchells I would say that the major problem that really is the, kind of, foundation for all of the other issues, I think is that we're asking the wrong question. The questions that we ask, or the statements that we make, are "Social media is bad for mental health." And then, the nitty gritty of that, when you, kind of, get into debates with people, then drills into "What aspects of social media, what types of social media?" one side of the equation, and "What do you mean by mental health?" bad outcomes, generally, on the other side. And this is why it's, sort of, made it very difficult to have nuanced conversations about this over the past year or so. You know, I've had a lot of conversations with Journalists about - in this very same way, right? You know, trying to understand and unpack, what is it that's a problem? What are we worried about? What are we concerned about? And you'll start off by saying, "Well, you know, people are worried about social media impacting adolescents in terms of suicide rates or suicidal ideation," or something like that, and then you'll go into the details of that research. And, you know, you can, kind of, make - you know, there's evidence that rates are going up, there's some evidence that rates are going down or are staying stable in some populations. It then, sort of, goes into an even nicher, nerdier conversation about, "How do you interpret data? What are the most appropriate data to select?" But then the goalposts shift, and you say, "Okay, well, that's the conversation about suicide, but what about depression or what about body imagine, or" - as all of these things are the same. You end up, kind of, constantly running around, somebody shifting the goalposts and, you know, and it'll veer out of mental health. It will start talking about educational attainment or cyberbullying, and then you start getting into a conversation around "It's not social media necessarily, but it's smartphones as a proxy measure for social media. And it's not about smartphones generally, it's about smartphones in schools." And it becomes really difficult to navigate that space because all of these things are really different, right? These are all very different ways to think about this relationship, that require different forms of data, different types of evidence, different types of methodologies and things like that. But you get stuck, because it's all about digital tech on one side and bad stuff on the other side. And my feeling is that if you look at the broad research in this area, it all largely takes the same, sort of, format, right? Which is that it's either - you see, it's really - I should caveat this by saying, you know, it's really hard to do research on digital tech in terms of its psychological impacts, right? I can't overstate that enough, like, how hard it is to do a good study in this area that actually gets at the questions and the measures that you want it to, for reasons that I'll explain in a minute. What that means is that we often fall back on less appropriate measures, and I should say, you know, I do this in my own research, as well. We tend to ask them questions like, "How much time have you spent on screens?" Or if you're being more nuanced about it, "How much time have you spent on TikTok in the past day?" And we'll ask them about their mental health or whatever it is that we're interested in. You get the very basic stuff where you ask, like, 60 undergrad students to report those, all the way up to thousands, or tens of thousands of people, being surveyed over long periods of time, as a part of, you know, bigger longitudinal studies. So, there are vast datasets at play in this sort of space, but they all, essentially, do the same thing, right, which is they ask those questions. And we know from various lines of research that if you ask somebody how much time they spend on a screen or on social media, they will give you a number, of course they will. Whether that has any bearing on reality or not is a different question entirely, and the answer is probably not. So, if you get more objective measures of screen time - so, if you ask somebody, "How much time have you spent on your phone yesterday?" they'll give you a number. If you ask them to go into the screen time app on their phone, which logs how much time they've literally spent on their phone, you'll get a different number. And we know from some lines of research that the subjective measure, the self-report measure, tends to be much more strongly correlated with various measures of mental health than that objective measure, right? Four times as strong in some cases. What that means is that when you ask somebody about how much time they're spending on their phone or whatever, you're not actually asking them that. What you're asking them is what do they feel about their screen use, really, how do they feel about it? So, what you find, across most areas of research here, is that people, if they feel as though they have a bad relationship with their phones, or social media or whatever, you will get really strong correlations between how much time they say they spend on their phones and your bad outcome. And you see that in the, kind of, mental health, mental wellbeing space, you see it in the attention span space, as well, you see it in the sleep space. You know, we are constantly told phones are bad for us, and so, this is very deeply ingrained in our psyche now. So, when somebody comes along and says, "Do you spend a lot of time?" And they say, "Yes." "Do you feel good about that?" "No." Of course you get that. So, 95% of the research literature is based on research that, sort of, takes that approach, and I realise this has been a very long, rambly answer to your question, which has not answered it yet, which is, you know, the main problem here is that we're asking the wrong questions, right? So, that's what happens if you get stuck in that frame of is social media, or is digital technology X or Y good or bad for you? 'Cause the answer will always be a little bit yes and a little bit no, right? I don't think anybody in this space is saying actually, digital tech is fine for us. We don't need to worry about this, it's not a problem. I don't think anybody is saying that because it's silly. It's like of course it will have an impact on us, but that's not a useful answer, right? The answer is, yeah, it has some positives and it has some negatives, but, you know, depends. What we need to be asking more in the research space, and in our day-to-day lives, in these conversations we have every day, is why? Why is that some people really thrive online and really thrive on social media and other people, who might seemingly be in similar situations, really struggle? How do we identify what those vulnerabilities are, what those at risk profiles are? And what we can then do, if we did that properly, is go, well, this is how you develop platforms that give people those positive experiences, they don't impact on those, but they provide buffers, they support people with vulnerabilities. They support everybody's psychological vulnerabilities in this space, rather than playing into them. And I think if we could have those sorts of conversations, those more nuanced conversations, and get that more nuanced understanding. You know, I have this conversation a lot and people who don't necessarily agree with this line of thinking go, "Oh, you know, you're just an apologist for Big Tech. You're letting Big Tech off the hook here by saying we need to do more research, we need to do more individually." I actually think it's the opposite, because I think Big Tech is being let off the hook at the minute, because we're having these very silly conversations, sorry. You know, saying things like "Smartphones are rewiring kids' brains" is such a demonstrably false thing to say from a research perspective, that as a tech company, you can go, "Well, this is silly, 'cause I can point to this research evidence that shows that this is a silly thing to say. I'm not interested in this conversation anymore, we're out, I'm going to disengage." And that doesn't help anybody. Whereas if you can go, "Actually, nobody's saying that. What we're saying is that in these situations, these sorts of mechanisms, these sorts of factors that are obvious and they're evidenced and demonstrable in a social media platform, are not good for people. They're particularly not good for people in this situation. You need to do more about fixing that." That's a much harder thing to ignore, because we're not saying all social media is bad, because it's not. We all get positives out of social media. Professor Umar Toseeb Thank you, and I think what I got from your book was it's not that the research says, and you're supporting that, social media is or isn't bad for you. It's that we just don't have the evidence base to come to a conclusion about this because of lots of the things that you've described so far around measurement issues, around the kinds of research questions that people are asking. And one of the things that you touch upon in your book is the inferences that then people make from the evidence that's out there. And there was some conversation around causation and correlation. Do you just want to touch on that a bit? Professor Pete Etchells Well, I think that goes back to what I was talking about earlier in terms of, you know, the vast majority of the research in this area is what we call cross-sectional and longitudinal. So, it's essentially either you get a bunch of people at a single point in time and ask them, "How much time are you spending on screens and what's your mental health like? I mean, I sim - that's an oversimplification, but that's, basically, what you do. Or you do a similar sort of thing, but over time, you track people over time. Now, those studies are great as a starting point, but I think we've never moved past that. The whole, kind of, "Correlation isn't causation" argument, I'm sure everybody's tired of that, but it's this idea that, you know, if you report high levels of screen time and you report poor mental health, which is causing which? And we default to, well, it must be the high levels of screen time causing poorer mental health, because that fits with our lived experience, in a way, right? We have all got stories to say of spending too much time on Instagram or whatever. That this idea that it's the screens causing bad thing to happen really fits with all of our experiences of not having a good time on social media. It could be the other way, though, and there is evidence to support this, right, that actually, it's more of, like, a reciprocal relationship. You know, there is a paper that if you're feeling low, you're more likely to go online and almost, like, seek out negative content that then makes you feel worse and you get stuck in that cycle. So, the argument that I make in the book is that trying to frame this as "Is X causing Y or is Y causing X?" is, again, it's the wrong way of thinking about it, because it's a litt - again, it's a little bit of both. It's thinking about this in terms of digital tech, or whatever you want the definition to be, social media, it's very individual for different people, has the power, the potential, to amplify, in some cases, or dampen, in other cases, our mood, depending on all sorts of factors. If you think of mental health, mental health's a super complicated thing, you know. It's never the case that there's one massive overriding global factor that will singularly and uniquely impact everybody's mental health in the same way. That's just not how mental health works. There are lots of things that impact mental health, positively and negatively, and they all sit together in this, like, ecosystem of factors that interact with each other, that will overall, produce a net positive or a net negative, and screen time's one of those things. Whether it's a major one or not, we're not quite clear yet. There's some evidence to point that, you know, it has an impact, but it's not a massive impact. And again, this is one of the worries that I have, that the focus is so much on screens that we miss some of the more obvious stuff, particularly around, kind of like, adolescent mental health and things like that. We know that there are really strong consistent factors that lead to poorer mental health in adolescence, right? Things like early childhood trauma, adverse childhood experiences, things like that have a huge impact. We don't really seem to be having a conversation about how do we support and mitigate those sorts of factors, because it's easier to focus on the screens. So, you need to go, "Well, you know, you see everybody, like, on their phones. It's a really salient thing that you see all the time, that must be the thing. Let's focus on that." Yeah, it does have an impact. It's very nuanced and complicated what sort of impact it has. If you take that away, it's not clear to me that you fix the problems that you want to fix. Professor Umar Toseeb It's a very interesting point, 'cause I hadn't really thought of it like that, but when you say it, it does make sense that by focusing on social media so much, it might even detract attention from the things that we know are having a negative impact on young people's mental health, because you're focusing on something that may or may not have a negative impact, and if it does, we don't know the extent of it. One of the other things that I wanted to pick up on is, earlier, you talked about 'vulnerabilities' and one thing that I was thinking, when I was reading the book was, could it just be that young people who are vulnerable in the offline space, so in the world outside of screens, are also vulnerable in the online space? And actually, it's - if there is a negative impact, it's not the social media or the screen time, it's just those kids are vulnerable and whether they are vulnerable offline or online, it's just where they are vulnerable, but there's a similar profile, or similar type, or similar vulnerability of child who's going to be vulnerable in multiple different spaces. Professor Pete Etchells Yeah, we know that the specific types of vulnerabilities that children express go a long way to predicting what sorts of online risks they encounter. There's some great work by people like Aiman El Asam at Kingston University on this. The example that I use in the book from Aiman's work is, if you look at children with caring responsibilities, as an example group, these are children who spend a lot of their day at home, because they've got caring responsibilities, so that they're not in a, kind of, typical educational environment. They may be dealing with their own vulnerabilities or their own disabilities as well. Because they're at home quite a lot, they're more likely to be online for a greater proportion of the day. So, the more time you're online, the more chances there are to come across something negative. Because they're in that sort of situation, there are maybe fewer chances for them to get the, sort of, educational scaffolding around how to stay safe online. Plus, maybe a relative lack of curation and scaffolding that comes from parents or their guardians, because of that, kind of, relationship that they've got. And you put all of those things together and what you find is that kids who've got those sorts of caring responsibilities are more at risk of cyber scams and identity fraud and identity theft and things like that. And you can, kind of, see what the pathway to that is. It lends itself to this idea that our offline lives mirror our online lives in quite important ways, sometimes in ways that we don't necessarily notice. And to me, that suggests quite strongly that you can extrapolate out to everybody in a sense, and go, you know, when we feel - you know, regardless of, you know, what our background is in terms of physical or mental health vulnerabilities, when we feel as though we've not had a good time on our phone, or on social media or whatever, are there echoes of something that's happened that day or that's going on in the background in our lives, that maybe, kind of, precipitate that? You see this in other realms as well, right? So, you know, if you take cyberbullying, for instance, cyberbullying is awful. It is - it's really insidious. It happens in places that should be safe spaces for kids. It happens at home, it happens anywhere, right? That's the point of it, because you can be targeted anywhere where you've got your phone. But we also know that there's a lot of overlap between online and offline bullying. So, 90% of kids who report that they are bullied online also report that they're bullied offline, as well. 90% of kids who report being bullies say that they bully offline as well as online. You know, there's a huge overlap there. You know, it makes sense, right, in terms of, like, the social relationships that develop leading up to bullying occurring, you know, they don't happen in isolation. They are intricate and they're interacting, so, you know, it makes sense to me that you get that massive, sort of, overlap. And that's why I go back to this idea of, you know, thinking about why is it that some people come across these negative experiences and aren't able to weather them online, and other people aren't? And that's part of it, you know, if you look - there's a, sort of, growing line of research around this idea of the digital divide. There are massive inequalities across the board everywhere, right? But in terms of digital accessibility and digital education, you see big disparities, you know, even in terms of basic work, looking at this in terms of socioeconomic status, right? So, we know that household income is a predictor of mental health. We also know that household income is a predictor of how accessible digital tech is, as well. And we know that the experiences that you can have with digital tech can impact mental health. Even there, there's quite an intricate web you can weave, a diagram you can draw connecting all of those things, with feedback connections and things like that. But we know from some studies that kids from lower socio and economic status backgrounds have less access. But it's something like - in the US, it's kids from lower SES backgrounds have, like - 70% of them have access to a phone or a laptop in the home. It's upwards of 90% for higher income household kids. Despite that, kids from lower income households are more likely to spend more long - more time online, so about an hour and a half more per day using digital tech, but about 50% less time using digital tech for homework. So, you see these, kind of, disconnects between access, ability to use, type of use, amount of use, all of those sorts of things that are, you know, really important factors to consider in all of this. Because what's happening underneath that is that there's - so, this is research by Candice Odgers, who's amazing in this space, in the US, that, basically, this is argument that people in higher resource homes have the time, the space, the resources, to curate their kids' experiences online. Whether that's in terms of education, around online safety, providing the space to talk, providing a support network. Kids from lower resource income homes, for various reasons, they just don't have the access to. And that lack of resourcing and scaffolding both means that you're at increased likelihood of coming across something negative or potentially harmful, or problematic, online. Just because you come across something like that online doesn't mean you are going to be harmed by it, but you are also - you know, you need other things. You need support networks in place to weather those sorts of events, and those are less available, as well. So, it's all of these things together that lead to, ultimately, do you get a harmful outcome or not? And again, like, even in this conversation, we're moving - we've just moved into - we're talking about harm, we're talking about this entirely in terms of negatives. What we've got relatively little research evidence for in this space, but we know that it's there if you talk to kids, if you talk to them about what they use their tech for and what they get out of it, they have really important insights in this space. They know that there are horrors out there and they are worried about them. They are worried about the relationships that they're developing with their technology. They're - the - you know, and they're worried about those being unhealthy, but they also see the benefits that they get from these forms of tech, as well. But it's also a way for them to be creative, as well. You know, they ex - a lot of kids express their creativity through social media and through, kind of, the sorts of things that they post on there and the artwork and things like that. Digital technology is not going away, so, you know, they need to learn how to navigate this effectively, better than we did, basically. Social media, iPhones, Android phones, whatever, they didn't come with a manual on how to use them in a healthy way. We just tried to figure it out as we went along, and I don't think we did a particularly good job of that. I don't think we're equipping younger generations with that sort of manual, in the same way. We're saying you shouldn't use this stuff because it's too bad, and I totally get where that comes from. It's way more complicated than that when you talk to them about what they use their tech for. There's so much interesting stuff there and so much good that comes out of it, as well. Professor Umar Toseeb Yeah, I think that's really important, there, 'cause I think one of the things that I was going to ask you, and you've answered this already, is the value in talking to young people via qualitative research around their experiences of using social media and the positives and the negatives that they get from that and what they feel about that. Because I think a lot of the research that I've read, in your book and other books and research papers, is quite quantitative and looking at the relationships between X and Y, whilst controlling for Z, or whatever it might be. But actually, if we talk to people and young people and ask them of their experiences, it might get to the point of us asking the right questions, 'cause - just what you touched upon earlier on, as in, like, we intuitively and automatically, go to, what are the negatives of this? And then... Professor Pete Etchells Hmmm. Professor Umar Toseeb ...measure those things. But actually, if we speak to young people, we might get to a point where we realise there are lots of positives with this, potentially, and then we investigate those positives. 'Cause, you know, like, even in the quantitative space, I'm not that familiar with the topic, but I imagine there probably isn't a lot - as much on the positive associations of social media use, digital tech, what you do online, with positive aspects of psychological functioning, as there is the negative. And that might be driven by the fact that we intuitively go to what's wrong with this? I just want to move on, just to wrap up. If we think about your take home message, what is your take home message for our listeners, but also if there are people who are policymakers, practitioners, even parents? Professor Pete Etchells And I tend to default here to saying first and foremost, "Don't panic." And I know that we're in a space at the minute where it feels like we're at a tipping point and everybody is worried and we need to do something right here, right now. But I think it is possible just to take a step back for a second, breathe and try and look at this, and what I mean by 'this' is either the whole debate or your own individual use, or your use in - you're across family members, friends and things like that. Just, sort of, take a step back and take a breather at the minute and think about how do we turn this conversation around a bit so that it's not all doom and gloom, but we can think about how do we maximise the positives of our tech use and minimise the negatives? And again, this is not me being an apologist for Big Tech or anything like that. I do think they have some very, very serious questions to answer about the way that they develop these platforms. How we turn that ship around, I think is going to take quite a lot time, and I think at the same time, there are immediate things that we can do in our own lives that help with this. Part of it is around thinking about the language that we use and the way that we communicate with each other about digital tech. There's a, sort of, great irony here that these are fundamentally communication media and we are really bad at communicating about them. Being open and transparent about what we get, you know, bad and good, out of our own tech use, I think can be really revealing. It's really hard and those sorts of conversations often come with a sense of guilt or shame, because we're so used to thinking about we're doing this thing too much or it's bad for us. But I think being more open and transparent about our tech use can really, kind of, break some of those boundaries down. Part of it for me is shifting our frame of thinking around - I've lost track of the number of stories that I've seen about how we're addicted to phones and social media and we're not. Like, the - it's - formally, clinically, it is not a thing. The only dig - the only formalised digital addiction is gaming disorder and even there, there is a massive disagreement in the research literature about what it is, how you define it or diagnose it, whether it's a unique disorder or better represented by something else. WHO formalised that in the International Classification of Diseases, like, six years ago, but we're still having debates and disagreements and arguments about what that actually is. On the WHO's own website, they link to a 2020 systematic review of, like, 160 studies on this, 35 different ways of measuring gaming disorder. Not one, 35, and if you look at a prevalence rate, it's anywhere from about .2% to something like 57 % of the gaming population. So, you're saying that either, basically, nobody has it or two out of every three gamers has gaming addiction, basically. That says to me that you don't know what you're measuring and that's for the one formalised digital addiction. We're not even at that point yet for social media or smartphone addiction, whatever. But everybody talks about being addicted to their tech, and not only being addicted to it, but that it's addictive by design. And the social media companies really don't help themselves in this space, because they also talk about it in these ways. You know, I think there's some, sort of, story that got leaked out of TikTok a while ago that made the news, because it was saying that TikTok, you know, say that "It only takes," like, "36 minutes to get addicted to the platform," and that's a horrifying thing to say, right? How terrifying is that? But that's because of the framing that we're using. It's not because these things are actually necessarily addictive. And I appreciate that's a really hard sell for people and I appreciate that probably at this point in the podcast, there are a lot of people going, "I don't like this guy anymore." Like, "This is just ridiculous." I know it's a hard sell, and because I know it's so ingrained in the way that we talk about this. I spend a lot of time unpacking that in the book, and my feeling is that the evidence base just doesn't support these things being addictive. What it does support is that they are habit forming. Habits are a different thing. There are, kind of, overlaps between habits and addictions, but what we're fundamentally talking about here is things that start off as neutral habits, like checking your phone is a neutral habit. Whether it becomes a bad or a good habit depends on other things that are going on, other factors. So, if you are checking your phone in the evening when you're feeling lonely and you want to connect with friends, good habit. Checking your phone because you're bored and you just want to see if there's a funny cat video on Instagram when you're driving down the road, really bad habit to get into, disastrously bad habit. It's not the thing itself, it's the situational factors around it. The thing about habits is that you can change 'em. They're really hard to change, but you have power over that. If you'd frame your thinking around digital tech as I am addicted my phone and it's because of the way that it's designed that this has happened to me, that is such a disempowering message. Because the only solution there, realistically, if that's what you seriously think, is to get rid of it and for the government to be involved in that in terms of top-down regulation, which are very, very hard things to do successfully. And we know from the digital detox literature, that they don't work. You know, just abstinence doesn't work, not in the long-term, anyway. If you think about this in terms of habits, then we can still have conversations about what government regulations should look like to improve these platforms, absolutely, and we should do that. At the same time, you can do something about it yourself. You can think about well, what are the positives that I get about - when I'm engaging in this habit, when am I having a good experience? How do I keep those? When am I getting a bad experience and why? And that takes effort and it takes reflection and it takes being open and talking and having conversation about it, but I think it leads to more sustainable outcomes. Because what you do then is not get rid of the technology, which is actually quite useful for us all. I know it's, sort of, a bit of a weird thing to say, but we actually like using this tech, you know, there are positives that we get out of it. You can have fun on your phone, or on your computer, or on your videogame console, right? You know, these things are designed, fundamentally, to be technologies of pleasure or convenience or entertainment. And use and goals that don't align with those ideas, how do we pull them out of our lives, basically, out of our use? And like I say, again, it's really hard to do. I'm not saying that things are going to get magically fixed overnight if you take that approach, but hopefully, over time, what you see is having better conversations with the people around you, better, more reflective self-use, and you feel happier using this sort of tech. Professor Umar Toseeb Thank you so much. A really wide-ranging conversation there, and I think that really, what I'm taking away from this is that there are lots and lots of unanswered questions in this space. We are a long way, in terms of research, from figuring out whether social media is good or bad for young people's mental health, and we just need to be asking the right questions, different questions, and have an open mind and an ongoing conversation. Professor Pete Etchells Thanks for having me. Professor Umar Toseeb Thank you so much. Don't forget to follow us on your preferred streaming platform, let us know if you enjoy the podcast, with a rating or review, and do share with your friends and colleagues. Please visit the ACAMH website, www.acamh.org. ACAMH is spelt A-C-A-M-H.