Need2Know - Online Experiences and Young People's Wellbeing
Most adolescents and young adults now grow up partly online. Friendships, learning, identity, play and help-seeking increasingly happen there - and so do bullying, harassment, harmful content and relentless comparison. The evidence reflects both sides: online life carries measurable benefits for young people's mental health, including connection, peer support and access to help, and measurable harms, including cyberbullying, online sexual harassment, body image pressure and problematic patterns of use - often on the same platforms, sometimes for the same person.
This matters for mental health advocacy now. Governments across the world are legislating on online safety, platforms are making public commitments, and advocates are being asked to take positions on regulation, age limits and platform design. Doing this well requires a good understanding of the evidence that moves beyond the familiar question of "screen time" towards a more holistic view of online living: what young people actually experience online.
Here is what you “need to know” from the evidence base.
The evidence at a glance
Problematic use is rising
In a large WHO-supported survey of nearly 280,000 adolescents across 44 countries, 11% showed signs of problematic social media use in 2022 (up from 7% in 2018), and 12% were at risk of problematic gaming.
“Time spent online” is a weak measure
In one analysis of over 350,000 adolescents, digital technology use explained at most 0.4% of the variation in wellbeing. Reviews consistently conclude that the effects are not uniform: benefits accrue to some young people, while risks cluster among others.
Specific online harms show stronger, more consistent links to mental health
Cyberbullying victimisation is associated with worse mental wellbeing, higher psychological distress, depression, anxiety and suicidal ideation across countries and study designs.
The benefits are real too
A global analysis of 2.4 million people in 168 countries found that internet access and use were, on average, associated with higher wellbeing. Online communication with existing friends is linked to better mental wellbeing in adolescents, and online social support can buffer against stress.
Risk and benefit are unequally distributed
Marginalised young people - including LGBTQI+ youth - face higher exposure to online harms, but can also gain the most from online connection and community.
1. From screen time to online experiences
The best-known body of research on young people and technology measures time: hours per day on screens or social media, set against measures of wellbeing. Some large datasets show that heavier digital media use is associated with lower psychological wellbeing, with stronger associations for girls. These findings have shaped much of the policy conversation.
Looked at across the whole evidence base, however, the associations are small and inconsistent. Part of the reason is that "screen time" bundles together qualitatively different activities (e.g. video-calling a grandparent, doomscrolling, gaming with friends, being bullied in a group chat) into a single number of hours. When studies separate these out, the type of online interaction changes the direction of the effect: frequent online communication with "real" (existing) friends is associated with better wellbeing, while communication limited to virtual-only networks is associated with worse. Recognised methodological problems add to the picture: heavy reliance on self-reported use, mostly cross-sectional designs, and too little attention to who is vulnerable and in what context. Hours online are an imprecise proxy for risk. The evidence becomes clearer when it measures specific experiences and patterns instead.
The debate over what to measure also looks different outside High-Income Countries (where most of the world's young people live). In many settings the more consequential question is not how many hours a young person spends online, but whether they get to be online at all, and on what terms. Access is patterned by wealth and by gender: in some countries girls are markedly less likely than boys to own a smartphone, and poorer young people less likely than wealthier ones. Where norms or religious expectations restrict girls' access in particular, the harm may lie as much in exclusion (e.g. from information, education, help-seeking and peer support) as in exposure.
One construct that does show clearer links to mental health is problematic use: a pattern resembling behavioural addiction, marked by loss of control, withdrawal, and negative consequences in daily life. Problematic social media use and internet gaming disorder are associated with depression, anxiety, stress, poor sleep and lower life satisfaction, and problematic internet use is a recognised clinical concern in adolescent psychiatric populations. The WHO/HBSC data show problematic social media use affects around 1 in 10 adolescents and is rising, with girls affected more than boys (13% vs 9%). This is a minority of young people - most use social media without meeting the threshold for problematic use - but it is a substantial and growing minority.
Highlight: The Inspired Internet Pledge
Launched in 2023 by the Digital Wellness Lab at Boston Children's Hospital, the Inspired Internet Pledge is a call to action for technology companies and advertisers to make the internet a safer and healthier place, especially for young people, through public and annually reviewed commitments. Pinterest, the founding signatory, has made accounts of teens under 16 private by default, avoided beauty filters that reinforce unrealistic standards, retrained its recommendation algorithms to optimise for positive content rather than engagement alone, and - with the National Association for Media Literacy Education - built (Me)dia Mindfulness, a free media literacy and digital wellbeing resource hub for teens, parents and educators. Pinterest's CEO has publicly argued that Big Tech must reject "Big Tobacco's model" (profiting from addictive design while denying harm), a framing that places online platforms squarely within the commercial determinants of mental health (see our Need2Know on the Commercial Determinants of Health). Industry pledges are not a substitute for regulation, but they demonstrate that engagement-at-any-cost is a design choice, not an inevitability.
2. Online harms: where the evidence is strongest
The evidence on specific online harms is considerably stronger than time-based research, in construct validity, consistency, and interpretability.
Cyberbullying is the best-studied harm. Victimisation is associated with worse mental wellbeing and higher stress in adolescents, with some studies reporting substantial effect sizes. Reviews of the global evidence describe consistent impacts on mental health across countries and contexts. Studies during COVID-19 lockdowns found higher psychological distress - including sadness, loneliness and suicidal ideation - among young people who experienced cyberbullying. Online bullying victimisation has been linked to suicidal thoughts in adolescent research samples.
Online sexual harassment adds a distinct layer of risk. In a nationally representative US sample of teenagers, both online sexual harassment and cyberbullying contributed to heightened risk of mental health and behavioural problems.
Body image pressure is a harm that cuts across platforms. Appearance-focused content, filters and image-editing apps that let users reshape their face and body are linked to appearance comparison, body dissatisfaction and poorer mental health, particularly among young women, and body image concerns are themselves associated with depression, anxiety and disordered eating. Image-editing apps are an industry growing largely unchecked, and there have been calls for app stores to include mental health among the harms their developer guidelines cover and for age-restrict body- and face-editing apps.
Harmful online communities are a distinct and severe risk. Some spaces actively promote suicide and self-harm, spread hate, or draw young people into extremist or misogynistic content. Perhaps the clearest example in policy is a suicide forum, linked to more than 130 UK deaths and cited in multiple coroners' reports, which hosted instructional method "guides", which was fined for £950,000 in May 2026 by the UK regulator Ofcom. Two features make these communities dangerous: (i) they aggressively absorb people who are isolated, vulnerable, or higher risk, and (ii) they can normalise harm as identity or belonging. This is also where regulation has the firmest ground: the content is often already illegal, and the harm is direct rather than inferred.
Online Gambling has been studied through a commercial determinants lens: the harm is not an accident of the technology but a product of an industry designed to maximise engagement and spend. More than 80% of countries now permit gambling legally, yet a global review of legislation found that policy remains focused on individual responsibility rather than population-level prevention or the wider social and economic harms. The exposure is heavily gendered: marketing normalises betting and successfully reaches young adult males in particular, and problem gambling is consistently more prevalent among males. For advocates, gambling is a reminder that "online harm" is not only about content or contact, but about business models - and that the same commercial-determinants framing developed for tobacco and alcohol applies here (see our Need2Know on the Commercial Determinants of Health).
Mediating pathways matter. Research on gaming shows that harm often travels through identifiable mechanisms - sleep disruption and exposure to toxic online environments (including cyberbullying) mediate the relationship between heavier gaming and more severe psychological outcomes. This points to modifiable targets - sleep, platform design, moderation - rather than blanket restriction.
Vulnerability is not evenly distributed. Marginalised young people experience more online victimisation, and its effects can shape developmental trajectories. LGBTQI+ youth face distinct online risk exposures and associated mental health outcomes compared with heterosexual peers. Among sexual and gender minority Latinx youth, online safety and parental acceptance act as protective factors against distress linked to cyberbullying.
There are two important notes on the evidence base: First, most of this evidence remains observational, and the relationship between distress and online risk is likely bidirectional - young people already struggling are more likely to encounter online harm, which then compounds the struggle. Second, intervention evidence is still developing: trials of support for cyberbullying-exposed adolescents are underway, but effective intervention remains under-researched.
Highlight: A note on social media bans; and what young people want
Age-based bans are the fastest-moving policy response to online harms. In December 2025, Australia became the first country to bar under-16s from major social media platforms; governments including Denmark, France, Greece, Indonesia, Malaysia and the UK have since enacted or announced similar restrictions, most relying on age verification (see BBC Newsround's global overview). The appeal is clear but the evidence fit is not as much: bans regulate access and aggregate exposure and risk cutting off the connection and support that matter most to vulnerable young people, while leaving addictive design untouched for everyone above the age limit. Early enforcement data point the same way: polling by the Molly Rose Foundation four months into Australia's ban found that 61% of 12–15-year-olds who previously had accounts on restricted platforms could still access at least one.
Young people themselves are asking for something more precise. At The Table, a youth-led hackathon convened by FlippGen with Beyond, Pinterest and the Molly Rose Foundation, participants called for regulation that prioritises wellbeing over profit; prohibits addictive design (infinite scroll, autoplay, gamification) which they named as a structural problem and not a personal failure; requires transparent algorithms and age-appropriate design standards; and makes digital and media literacy statutory, from early years, for all. FlippGen's Youth Town Hall report - written by young people after an event bringing together 60 participants aged 9–21, held with the 5Rights Foundation and the UK Department for Science, Innovation and Technology - goes further: participants wanted to keep access to social media, not lose it, and recommended, explicitly in place of a unilateral ban, age-appropriate design for under-16s that disables addictive features by default (autoplay, infinite scroll, push notifications, hidden clocks); meaningful autonomy over algorithms; age assurance framed positively, as protection rather than punishment; limits on anthropomorphic AI chatbots for under-16s; and digital literacy that is empathetic, current and taught peer to peer. Notably, participants reported feeling less in control of their use as they got older, not more. Their shared conclusion: design reform and education must run alongside regulation, bans alone will not solve the problem.
3. The benefits of online living
Online life carries measurable benefits, and research is increasingly designed to capture them.
At the broadest level, a study of 2.4 million people aged 15 and over across 168 countries - one of the few analyses to include Latin America, Asia and Africa rather than only high-income Anglophone samples - found that internet access and use were consistently associated with higher wellbeing, including life satisfaction, purpose and social wellbeing. This is an association, not proof of causation, but it is a useful corrective to a debate often conducted as if the internet were only a risk factor.
For young people specifically:
Online social support is associated with better adolescent mental health, consistent with stress-buffering models: support matters most when people are under strain.
Connection with existing friends online is associated with better wellbeing. In the WHO/HBSC study, adolescents who were heavy but non-problematic users reported stronger peer support and social connection.
Gaming can support wellbeing when played intentionally. It has been shown that simply reflecting on play habits (e.g. through a gaming log) helps gamers get more benefit from gaming.
Digital tools can deliver mental health support. Apps, online communities and virtual therapy can lower barriers to help-seeking, particularly where services are scarce, although quality and evidence vary widely. See our separate Need2Know on Digital Mental Health.
Skills-based approaches show promise. Evaluation of a middle-school digital citizenship curriculum found young people can gain positive peer support online while learning to manage risk. Reviews of internet safety education recommend integrating online safety into established, evidence-based prevention programmes rather than running fear-based standalone campaigns. The wider research direction is a shift from fear and restriction towards resilience and intentional technology use, co-designed with young people themselves.
For marginalised youth, the benefit side of the ledger can be especially significant: online spaces may offer community, identity affirmation and information that is unavailable or unsafe to seek offline. The same groups facing the highest online risks often have the most to lose from blunt, restriction-only responses. But the balance of risk and benefit is not the same everywhere. For LGBTQI+ young people in particular, the online community that is a lifeline in one country can be a source of acute danger in another: in contexts where same-sex relationships are criminalised or socially policed, the same platforms can expose young people to surveillance, outing, blackmail or state action.
Highlight: How GMHAN members are responding to this area
Across our Network, members are already doing this work - and much of the most practical activity is happening in Low- and Middle-Income Countries. In Uganda, the Online Safety Foundation Uganda safeguards and empowers children online through its SPRAT framework (safeguarding, protection, resilience, awareness, and training), including AI-powered content moderation tools for schools, while youth-led conversations in Kampala help young people take back control of their online habits rather than escape digital spaces altogether. In Nairobi, the Digital Education Wellness Symposium has convened youth, educators and policymakers around online gender-based violence, cyberbullying and digital burnout, placing mental wellbeing at the centre of the digital-safety agenda. Our members from LMICs are also shaping strategic initiatives: co-hosting shared spaces with the DTH-Lab on youth, art and digital wellbeing (exploring what it means to grow up online and how digital life shapes emotions, identity and relationships) and advising the AI Health Literacy Hub on digital literacy, community lived experience and wellbeing. Around the world the focus is consistent: building safer, more equitable digital spaces where young people can thrive.
4. What this means for advocates and policymakers
The evidence supports a shift in framing, and advocates are well placed to lead it.
Do not focus on "screen time" as the headline metric. Advocate for policy, guidance and research that distinguish between types of online activity and target specific harms and specific patterns of problematic use.
Focus regulation on harms and design, not on young people's access. Cyberbullying, online harassment, body image pressures, and design features that drive compulsive use have the clearest evidence of harm. The US Surgeon General's advisory reached a similar conclusion: the priority is safer platform design, data transparency and safety standards, alongside honest acknowledgement that social media carries both benefits and risks.
Push for enforcement of existing laws against the most harmful communities. Spaces that promote suicide, self-harm or hate often host content that is already illegal. The priority here is not new rules but effective, timely enforcement and cross-border cooperation, since the most dangerous sites are frequently hosted outside the jurisdictions of the young people they harm.
Treat gambling as a commercial-determinants issue. Regulate the industry, not just the individual: restrict marketing that reaches children and young people, close the gap between gaming and gambling (loot boxes, "skins" betting), and shift policy from "responsible gambling" messaging towards population-level prevention.
Protect the benefits while reducing the risks. Blanket restriction risks cutting off the support that matters most to vulnerable groups. Interventions should build digital skills and resilience, and be co-designed with young people.
Demand better research. Push for longitudinal and experimental designs, objective measures of use, platform data access for independent researchers, and studies from low- and middle-income countries; where most of the world's young people live, and where most of the evidence does not.
Focus on inequality. Both online harms and the consequences of exclusion from online life fall hardest on marginalised young people. Online safety is an equity issue.
Highlight: GMHAN at the first Health Nexus Forum
At the inaugural Health Nexus Forum (in Leuven, June 2026, hosted by the Nanopoulos Foundation), GMHAN convened a panel on young people, wellbeing and the online world, bringing youth campaigners together with an audience of academics, policymakers, donors and practitioners. The framing question was deliberately provocative: what problem are we trying to solve, and is AI the solution? Mental health has a long history of reaching for “silver bullets” from the asylum to the lobotomy to the pill; each a way of avoiding the slow, relational, structural work that recovery actually requires. AI arrives in a world where mental health systems are already struggling: around a billion people live with a mental health condition, government spending sits at a median of 2% of health budgets, and there are just 13 mental health workers per 100,000 people globally. We argued that, in this context, AI should be presented as a systems-strengthening tool, not a single cure, as is supported by the evidence so far. The risk for young people is specific and immediate: roughly one in five now use AI chatbots for mental health advice, and the same anthropomorphic design that makes a chatbot feel like a confidant can pull a young person away from trusted human support (a concern echoed directly by young people in the Youth Town Hall). The Forum's own framing put it well: the question is not whether AI will change health, but deciding, as a community, who that change is for.
Conclusion
For adolescents and young adults, online life is neither a hazard to be eliminated nor a neutral backdrop. The evidence identifies specific harms (cyberbullying, harassment, body image pressure, problematic patterns of use) with consistent links to mental ill-health, and specific benefits (connection, support, access to help) with consistent links to wellbeing. Policy and practice should target both: reducing the harms without sacrificing the benefits, and paying particular attention to the young people for whom the stakes on both sides are highest.
GMHAN’s work on youth mental health and online wellbeing is generously supported by:
