By Nur Rhyhan Mohamed Astha
In a survey by McCann World Group involving 32,000 people identified as Generation Z, 66% of respondents globally say they feel lonely, even when surrounded by friends and family[1]. In Singapore, one in three youth reported mental health symptoms such as sadness, anxiety, and loneliness, in a national study of 3,336 young people aged 11 to 18[2]. As ‘digital natives’, the catch-all term for under-35s who first embraced smartphones and have higher usage of such technology compared to other age groups, it is easy to associate our declining mental health state with our use of technology[3]. However, doing so uncritically and unfairly demonises technology. Today, the internet has provided myriad mental health solutions that cannot be overlooked. Having said that, it is important to assess the potential harm and good that technology poses to the mental health of youth.
CREATING A FEAR (OF MISSING OUT)
FOMO or fear of missing out is a well-documented effect of social media usage, especially amongst youths. FOMO is a feeling of anxiety when one believes that others have a better life than them, especially after seeing a social media post that might suggest that[4]. Such a social media post might depict someone hanging out with other groups of friends and having fun, making one wonder about their own group of friends. The feeling of FOMO is especially pertinent amongst vulnerable groups like younger youths aged between 15 and 25, for whom feeling left out of social situations is already a significant worry associated with being a teenager[5]. At its core, FOMO arises from focusing on what one lacks compared to someone else, rather than what one already has[6].
Older youths, between the ages of 26 and 35 experience significant feelings of FOMO as well. For example, middle-aged adults 30 years and above often take stock of their accomplishments and compare themselves with their peers, which can lower self-worth and mental well-being[7]. Social media sites like Instagram and LinkedIn, where one can compare lifestyles and professional growth, are some of the main culprits for inciting FOMO. Older youths on LinkedIn might find themselves feeling inadequate, as other users within their network share their ‘career victories’ and other job-related accomplishments that make people question the worth of their accomplishments[8].
THE INTERNET IN THE COVID ERA
In the COVID era, social media has become an additional source of stress, as social media became saturated with updates on rising cases and death tolls. Due to lockdowns, more people turned to their mobile phones as a source of news. This led to the phenomenon of ‘doomscrolling’, where a social media user devotes most of their time viewing and absorbing negative news. The doomscroll causes a skewed perception of the world and fosters pessimism. For youth with existing mental health conditions, the social media doomscroll day after day has been associated with higher instances of depression and post-traumatic stress disorder symptoms[9].
At the same time, the COVID era has also unlocked the internet’s significant potential for improving mental health outcomes. Crucially, the pandemic has brought essential mental health services into cyberspace. The rise of telehealth, which brings professional healthcare services to one’s computer and smartphone, provides the guidance of a doctor without the hassle of going down to a physical location for consultation[10]. In Singapore, there has been a steady rise in the amount of psychological health providers pivoting towards virtual therapy services. Online services often improve access to mental healthcare for youths. By meeting virtually with healthcare professionals, youths report feeling less intimidated as opposed to meeting a therapist physically[11]. However, access to online mental health services is hindered by the significant financial cost of telehealth services, as shown in Figure 1.
The above graph shows how the price of online counselling services can vary quite widely depending on the service provider, with the lowest price of $60 costing almost one-third of the most expensive service at $185. For younger youths without a disposable income, the task of asking for money to attend online therapy services might be stressful or even impossible, considering that most Singapore youth believe their parents will trivialise their mental health issues and are unwilling to offer the support needed[13].
For older youths, telehealth services might be more within reach financially, since most already have incomes from full-time jobs. However, such access to mental healthcare can vary significantly between youths of different income groups, with those of higher incomes feeling less financial strain when getting help for mental health. Accordingly, those of lower income report lower levels of mental health than those of higher income[14].
NEW MENTAL HEALTH RESOURCES
On the bright side, affordable solutions are increasingly popping up online for those who need mental health care but cannot afford current prices. For example, free smartphone apps provide remote personalised guidance through in-app messaging and questionnaires that allow clinicians to monitor a patient’s mental health at rates cheaper than talk therapy[15]. Apps like 29k promise “science-backed tools” to improve mental health “without the fear of additional financial costs”[16]. Nevertheless, more studies are still needed to assess the effectiveness of mobile apps in improving mental wellness[17]. These apps continue to face teething problems that curtail their full therapeutic potential[18]. However, existing studies show that in the short-term, these apps do decrease symptoms of depression and anxiety, which shows the great potential the internet has to host therapeutic tools to improve youth mental health[19].
There is also increasing awareness of the need to moderate internet use, especially on social media platforms. Significant advances have been made in mental healthcare, where there are now specific programmes that seek to deal with emotions like FOMO resulting from social media usage. For example, social media hygiene programmes are being rolled out by mental health providers, where younger youths are guided to turn off smartphone notifications, unfollow accounts that create negative feelings, and spend time on non-smartphone activities, which were seen to reduce the incidence of depression amongst younger youths[20].
INTERNET AS SOLACE
The content and social interactions users have on the internet can in and of itself be a source of happiness. For both older and younger youths, the internet has become a place to seek solace and find communities of belonging that are not available in person. Younger youths, especially those in their teens, are in a process of understanding basic aspects of their identities, such as who they are, what they believe in, and how they wish to live[21]. Through online communities, younger youths can find individuals or groups with whom they feel a sense of belonging. Such feelings of belonging might supplement connections youths find in person or make up for a lack of such communities of belonging in person[22].
Importantly, youths who have social anxiety might find communicating within online communities safer and more comfortable[23]. For younger youths between the ages of 20 and 25, who are considered ‘young adults’, the internet has a practical element of ensuring continued interaction with an already established social network, despite conflicting schedules that have arisen due to greater responsibilities at work or in the family. Online, young adults can regularly catch up with each other through short updates about their everyday life and check-ins to see how friends are doing[24]. Hence, the internet ensures that those who struggle with socialising in person can feel less isolated.
For older youths, the internet has also similarly been helpful by creating a forum to discuss the pertinent issues that their generation faces but have for a long time been stigmatised. Most of these youths who are between the ages of 26 and 35, and especially those in their older years, were likely introduced to the internet without a smartphone. Online, heated discussions about values like parenting, filial piety, and the rising cost of living are held openly. As these are issues that the newly independent older youths immediately face, the internet can be a useful resource to seek guidance, or even refuge, from others who are in the same shoes. Like younger youths, older youths also foster a sense of belonging by being on the internet, as they can find communities where they can talk about important issues that matter to them.
Ultimately, the internet has proven itself to be a place that can be a positive force for improving youth mental health. Presented with both the positives and negatives of the internet, I suggest that we look at the great potential the internet has, to be as a force for good. With the power that the internet holds in connecting people across borders and its ability to offer mental health services that would have previously been inaccessible, there have never been more opportunities for people to find solidarity and form meaningful connections. I further suggest that if anything, the internet has just made more tangible issues that we have faced for generations, such as low self-esteem in youths and financial inequality. I suggest that this clarity the internet offers us of pre-existing issues, along with the internet’s ability to connect individuals across borders, reveals how internet technologies have the potential to be a force for good by allowing us to clearly identify our problems and tap on global humanity’s knowledge to come up with solutions.
1 McCann World Group. The Truth About Gen Z. n. d. Accessed on 2022, August 16 at: http://view.ceros.com/mccann/truthaboutgenz
2 Ang, Q. About 1 in 3 Young People in Singapore Has Mental Health Symptoms: Study. The Straits Times. 2022, May 20. Retrieved from: https://www.straitstimes.com/singapore/about-1-in-3-youths-in-singapore-has-mental-health-symptoms-study
3 Prensky, M. Digital Natives, Digital Immigrants Part 1. On the Horizon, 9 (5). 2001, September 1. pp. 1–6. Retrieved from: https://doi.org/10.1108/10748120110424816
4 Vernon, L., Modecki, K. L., and Barber, B. L. Mobile Phones in the Bedroom: Trajectories of Sleep Habits and Subsequent Adolescent Psychosocial Development. Child Development, 89 (1). 2017, May 29. pp. 66–77. Retrieved from: https://doi.org/10.1111/cdev.12836
5 Twenge, J. M. Have Smartphones Destroyed a Generation? The Atlantic. September 2017. Retrieved from: https://www.theatlantic.com/magazine/archive/2017/09/has-the-smartphone-destroyed-a-generation/534198/
6 Scott, E. Do You Have FOMO? Here Is How to Cope. Verywell Mind. 2022, July 19. Retrieved from: https://www.verywellmind.com/how-to-cope-with-fomo-4174664
7 Hardy, B. W., and Castonguay, J. The Moderating Role of Age in the Relationship between Social Media Use and Mental Well-Being: An Analysis of the 2016 General Social Survey. Computers in Human Behavior, Vol. 85. August 2018. pp. 282–90. Retrieved from: https://doi.org/10.1016/j.chb.2018.04.005
8 Tan, A. Commentary: LinkedIn’s Toxic Positivity and Hustle Culture Create Unrealistic Work Expectations. CNA. 2022, February 3. Accessed on 2022, August 23 at: https://www.channelnewsasia.com/commentary/linkedin-social-media-employment-opportunity-toxicity-mental-health-2465171
9 Price, M., et. al. Doomscrolling during COVID-19: The Negative Association between Daily Social and Traditional Media Consumption and Mental Health Symptoms during the COVID-19 Pandemic. PsyArXiv. 2021, March 30. Retrieved from: https://doi.org/10.31234/osf.io/s2nfg
10 Pierce, B. S., et. al. The COVID-19 Telepsychology Revolution: A National Study of Pandemic-Based Changes in U.S. Mental Health Care Delivery. American Psychologist, Vol. 76 (1). 2021. pp.14–25. Retrieved from: https://doi.org/10.1037/amp0000722
11 Storer, H. L., et. al. Technology ‘Feels Less Threatening’: The Processes by Which Digital Technologies Facilitate Youths’ Access to Services at Intimate Partner Violence Organizations. Children and Youth Services Review, Vol. 139. August 2022. Retrieved from: https://doi.org/10.1016/j.childyouth.2022.106573
12 See: 7 Cups. Accessed on 2022, September 22 at: https://www.7cups.com/; BetterHelp. BetterHelp | Professional Therapy With A Licensed Therapist. Accessed on 2022, September 22 at: http://www.betterhelp.com; SACAC Counselling. SACAC Counselling – Singapore’s Comprehensive Mental Health Practice Since 1973. Accessed on 2022, September 22 at: https://www.sacac.sg/; Safe SpaceTM. Accessed on 2022, September 22 at: https://safespace.sg/; ShareTM. ShareTM – Always Care, Always There. Accessed on 2022, September 22 at: https://www.theshareco.org/faq/; Singapore Counselling Centre. Online Counselling (Video Counselling) – Counselling Services by Singapore Counselling Centre (blog). Accessed on 2022, September 22 at: https://scc.sg/e/online-counselling-video-counselling/; Talk Your Heart Out. Accessed on 2022, September 22 at: https://app.talkyourheartout.com/; The Counselling Paradigm. Accessed on 2022, September 22 at: https://www.thecounsellingparadigm.sg/fees; WINGS Counselling Centre. Fees – WINGS Counselling Centre | Singapore. Accessed on 2022, September 22 at: https://wingscounselling.org.sg/fees/
13 Neo, C. C., Goh, C. T., Yip, C., and Tan, R. More Youths Seeking Help with Mental Health – but Finding It Isn’t Always Easy. CNA. 2022, May 1. Retrieved from: https://www.channelnewsasia.com/cna-insider/youth-mental-health-illness-singapore-help-treatment-2649296
14 Thomson, R. M., et. al. How Do Income Changes Impact on Mental Health and Wellbeing for Working-Age Adults? A Systematic Review and Meta-Analysis. The Lancet Public Health, Vol. 7, (6). June 2022. pp. e515–28. Retrieved from: https://doi.org/10.1016/S2468-2667(22)00058-5
15 Aravinthan, Y., et. al. Internet-Delivered Mental Health Treatment Systems in Scandinavia – A Usability Evaluation. Internet Interventions, Vol. 20. April 2020. Retrieved from: https://doi.org/10.1016/j.invent.2020.100314
16 29k is a mental health app on the App Store. Available at: https://apps.apple.com/us/app/29k-mental-health-app/id1434100083
17 Williams, J. E., and Pykett, J. Mental Health Monitoring Apps for Depression and Anxiety in Children and Young People: A Scoping Review and Critical Ecological Analysis. Social Science & Medicine, Vol. 297. March 2022. Retrieved from: https://doi.org/10.1016/j.socscimed.2022.114802
18 Yogarajah, A., et. al. Internet-Delivered Mental Health Treatment Systems in Scandinavia – A Usability Evaluation. Internet Interventions, Vol. 20. April 2020. Retrieved from: https://doi.org/10.1016/j.invent.2020.100314
19 Hur, J.,et. al. A Scenario-Based Cognitive Behavioral Therapy Mobile App to Reduce Dysfunctional Beliefs in Individuals with Depression: A Randomized Controlled Trial. Telemedicine and E-Health, Vol. 24 (9). 2018, September 14. pp. 710–16. Retrieved from: https://doi.org/10.1089/tmj.2017.0214
20 Kassondra, A., et. al. Problematic Internet Use in Adolescents and Implementation of a Social Media Hygiene Protocol. Journal of Pediatric Nursing, Vol. 63. 2022, March 1. pp. 84–89. Retrieved from: https://doi.org/10.1016/j.pedn.2021.10.011
21 To, S., et. al. Sense of Meaningfulness, Sources of Meaning, and Self-Evaluation of Economically Disadvantaged Youth in Hong Kong: Implications for Youth Development Programs. Children and Youth Services Review, Vol. 47. December 2014. pp. 352–61. Retrieved from: https://doi.org/10.1016/j.childyouth.2014.10.010
22 Chassiakos, Y. L. R., and Stager, M. Current Trends in Digital Media: How and Why Teens Use Technology. In: Technology and Adolescent Health. (eds) Moreno, M. A., and Hoopes, A. J. Academic Press. 2020, March 20. pp. 25–56
23 Nesi, J., Choukas-Bradley, S., and Prinstein, M. J. Transformation of Adolescent Peer Relations in the Social Media Context: Part 1—A Theoretical Framework and Application to Dyadic Peer Relationships. Clinical Child and Family Psychology Review, 21 (3). 2018, April 7. pp. 267–94. Retrieved from: https://doi.org/10.1007/s10567-018-0261-x
24 Scott, R. A., Stuart, J., and Barber, B. L. Connecting with Close Friends Online: A Qualitative Analysis of Young Adults’ Perceptions of Online and Offline Social Interactions with Friends. Computers in Human Behavior Reports, Vol. 7. August 2022. Retrieved from: https://doi.org/10.1016/j.chbr.2022.100217
Nur Rhyhan Mohamed Astha is a Research Analyst at the Centre for Research on Islamic and Malay Affairs (RIMA). He is a graduate of Yale-NUS College, where he majored in Urban Studies. He has an avid interest in the arts, with a liking for music.
This commentary was also published in The Karyawan, October 2022, Volume 17, Issue 4.
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