Comment

Smartphone use and mental health: going beyond school

Smartphone and social media use are plausibly associ- activity or educational attainment. As expected, partici- The Lancet Regional
ated with poorer mental health outcomes among ado- pants in schools with restrictive policies reported less Health - Europe
lescents, with likely mechanisms including: increased phone use during the school day (by about 30 min), but 2025;51: 101237
access to cyberbullying and views supportive of eating compensated for this when outside of school, so overall Published Online xxx
disorders, suicide, and self-harm1; impaired cognitive there was no evidence of a difference in screen time or [Link]
functions2; unhealthy social comparisons3; and social media time on weekdays or weekends. The study 1016/[Link].2025.
displacement of healthy behaviours (sleep, exercise, in- had a rigorous design and sampling strategy but was 101237
person social interactions).4 However, the epidemiolog- limited by a poor school response rate (10%), and the
ical evidence for a causal association is weak,5,6 as most cross-sectional non-randomised design, which limits
studies are ecological and/or cross-sectional, showing conclusions about causal effects of the restricted policy.
correlation rather than causation and not adjusting for The study did confirm findings from other cross-
potential confounders.6 The associations between social sectional studies, that students with longer duration of
media use and mental health are likely complex and smartphone use or social media time had poorer well-
bidirectional,7 and there is little causal evidence to date being, mental health scores, sleep and educational
that reducing the time spent on social media will attainment.3
improve mental health and wellbeing.6 The lack of impact of the restrictive phone policy on
Despite the evidence-gap on the benefits of reduced mental wellbeing may partly be because there was no
social media time, governments are implementing or reduction in screentime or social media use overall, only
considering bans on smartphones in schools to improve during school hours. Despite this lack of effects, phone
adolescent wellbeing, mental health and educational bans in school might be an appropriate intervention to
outcomes. In February 2024, the UK Government is- benefit school functioning and educational engagement.
sued non-statutory guidance that schools prohibit use of Future studies could look at outcomes such as school
mobile phones throughout the school day (including climate, bullying and social connectedness, and on
breaks).8 In this issue of the Lancet Regional Health - improved memory, concentration and learning.
Europe, Goodyear and colleagues report findings from More generally, a focus on total screentime and so-
the first study (“SMART Schools”) to rigorously evaluate cial media use is likely to fail to address the diverse and
the impact of the UK restrictive school phone policies complex mechanisms via which social media use might
on key health and educational outcomes.9 In this multi- impact on mental health. Studies suggest that social
method study, the authors used an observational study comparison, passive versus active use of social media
to compare mental wellbeing, sleep and educational and various motives for social media use may have more
outcomes among 1227 adolescents aged 12–15 years in influence on depression, anxiety and psychological
30 schools in the UK. Of these, 20 schools had imple- distress than merely the duration of use.6,10
mented restrictive policies (recreational phone use not One lesson from this research is that to reduce social
permitted, usually requiring phones to be kept switched media use among adolescents, comprehensive mea-
off in school bags) and 10 schools had permissive pol- sures are needed to address use at home as well as at
icies (recreational phone use permitted at any time or at school. The UK Government guidance on phone use in
certain times and/or in certain places). schools is unlikely to be sufficient to have an impact on
The study found no evidence that school phone poor mental health, wellbeing and education. However,
policies were associated with improved mental well- improving smartphone habits at home is challenging,
being, anxiety, depression, problematic social media especially given the cognitive predilection of adolescents
use, sleep health (duration, efficiency, timing), physical towards peer interactions and influence. We need
improved parental education and guidance on how to
DOI of original article: [Link] reduce and improve their children’s phone use,
*Corresponding author. including use of parental control mechanisms, guidance
E-mail address: [Link]@[Link] (H.A. Weiss).
on online safety, and understanding the importance of
© 2025 The Author(s). Published by Elsevier Ltd. This is an open access
article under the CC BY license ([Link] sleep and physical activity, and in-person socialising.
4.0/). Unfortunately, such interventions are likely to be least

[Link] Vol 51 April, 2025 1

effective for those most in need or socially disadvan- 4 Khalaf AM, Alubied AA, Khalaf AM, Rifaey AA. The impact of
social media on the mental health of adolescents and young adults:
taged. We also need a regulatory approach to the tech- a systematic review. Cureus. 2023;15:e42990.
nology industry that is flexible and evidence-based, 5 Stiglic N, Viner RM. Effects of screentime on the health and well-
focussing on preventing the forms of social media use being of children and adolescents: a systematic review of reviews.
BMJ Open. 2019;9:e023191.
that are most harmful, rather than merely focused on 6 Mansfield KL, Ghai S, Hakman T, Ballou N, Vuorre M,
screentime limits. This is essential to optimise use of Przybylski AK. From social media to artificial intelligence:
social media among adolescents in this time of rapid improving research on digital harms in youth. Lancet Child
Adolesc Health. 2025. [Link]
technological change. 00332-8.
This commentary was conceptualised and written by 7 Hartanto A, Quek FYX, Tng GYQ, Yong JC. Does social media use
increase depressive symptoms? A reverse causation perspective.
HAW and CB. Front Psychiatry. 2021;12:641934.
8 Mobile phones in schools. Guidance for schools on prohibiting
Declaration of interests
the use of mobile phones throughout the school day. [Link]
We declare no competing interests. [Link]/media/65cf5f2a4239310011b7b916/
Mobile_phones_in_schools_guidance.pdf. Accessed January 13,
References 2025.
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