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An interdisciplinary team from Imperial College London has developed a new framework that addresses how primary healthcare can play a key role in solving social media-related anxiety.
In 2023, the attorneys general of 33 different US states took legal action against Meta, alleging that use of the company’s Instagram platform was associated with depression and anxiety among young people. The lawsuit highlighted growing awareness of the link between social media use and anxiety, which the World Health Organisation identifies as the most common type of mental disorder worldwide.
Anxiety tends to be managed in primary care settings, which in the UK means that general practitioners (GPs) have a key role to play in addressing it. However, 40 per cent of GPs in the NHS are aged over 50, making them much less likely to be regular users of social media or have an awareness of its relationship with anxiety, particularly for young people. The vast majority of Instagram and TikTok users, for example, are aged under 34.
In order to analyse this further, our research – the first study to use empirical data for this purpose – explores GP perceptions of social media’s impact on anxiety, and looks at how primary care can change to better address it. This is particularly important given that National Institute for Health and Care Excellence guidelines do not currently even identify social media as a potential cause of anxiety.
Improving patient outcomes
Our study (conducted jointly by Imperial medical students and the Business School) aimed to identify barriers and facilitators to addressing the impact of social media in primary care, in order to improve the ability of GPs to support and understand patients and, ultimately, to improve patient outcomes. We spoke to GPs about areas including their views on social media and wellbeing, how comfortable they were discussing social media with patients, and what techniques and knowledge they would find useful in supporting patients.
GPs also highlighted that they need appropriate referral options
One of the main barriers identified by GPs was a general lack of awareness of social media’s impact on anxiety. Respondents primarily put this down to the aforementioned age gap between GPs and young adults, which also makes it difficult for them to understand the context of social media-related anxiety issues. Others noted that they received no education on the topic as part of their continuing professional development (CPD).
GPs also acknowledged that many of them have a cautious attitude towards asking young adults about their social media habits, and were concerned that doing so might be seen by patients as intrusive or judgemental. On top of this, respondents highlighted that they simply lacked time to address social media during mental health consultations, due to existing pressures related to both capacity and funding.
Providing effective care pathways
Alongside identifying these barriers, GPs also expressed a willingness to better address social media’s impact on anxiety. They felt that informal strategies such as discussion frameworks, alongside mandatory training from a trusted organisation (e.g. as part of their CPD requirements), would be useful – particularly if this was extended to other primary care professionals too.
One of the main barriers identified by GPs was a general lack of awareness of social media’s impact on anxiety
GPs also highlighted that they need appropriate referral options – solutions for young people experiencing anxiety related to social media. Community support groups could play an important role here, helping to provide alternative care pathways while also reducing the burden on existing services. This could fit in as part of the wider social prescribing trend that sees primary care link with community and local authority provision.
In order to encourage young adults to seek support from their GPs, respondents proposed having dedicated resources, such as leaflets and self-assessment questionnaires available online and at practices. This could help empower young people to bring up social media-related anxiety in consultations, giving them the language they need and the confidence that their GP will understand the issue.
Building understanding between doctors and patients
With these findings in mind, we developed a framework to help address anxiety related to social media. This is based on four questions for primary care practitioners to explore with patients:
- Do you feel as though your social media usage needs to change?
- Does social media ever make you feel anxious?
- How do you feel when you look at content posted by others?
- What makes you use social media?
This can serve as a first step towards building understanding among GPs and normalising discussions in primary care settings for patients – key starting points for the facilitators discussed above. Progress on these is important, as solutions to addressing anxiety caused by social media could also make a difference in preventing other issues, including depression, self-harm and suicide, which are similarly linked to use of social media.
With this in mind, GPs have a vital role to play as a first port of call in addressing mental health issues related to social media. Learning from more informed interactions between GPs and young adults in this space could also be valuable for psychiatrists, university mental health teams, social media companies and policymakers. Ultimately, this can move us closer to a future where safe, aware social media use is the norm, with problems identified and supported at an early stage.
This article draws on findings from "Exploring the facilitators and barriers to addressing social media’s impact on anxiety within primary care: a qualitative study", by Imperial College London's Ailin Anto, Rafey Omar Asif, Arunima Basu, Dylan Kanapathipillai, Haadi Salam, Rania Selim, Jahed Zaman and Andreas Eisingerich.