Cyberbullying and websites advocating anorexia and self-harm are also posing a danger to the mental wellbeing of children and young people, the Commons health select committee says in its report.
Sarah Wollaston, chair of the committee, who was a GP for 24 years before becoming a Tory MP in 2010, said: “In the past if you were being bullied it might just be in the classroom. Now it follows [you] way beyond the walk home from school. It is there all the time. Voluntary bodies have not suggested stopping young people using the internet. But for some young people it’s clearly a new source of stress.”
However, the MPs said they had found no evidence that the emerging digital culture was behind the worrying rise, of up to 25% to 30% a year, in numbers of children and young people seeking treatment for mental health problems.
The cross-party group acknowledges that forms of online and social communication are now central to the lives of under-18s, but says that a government inquiry into the effects is needed because of the potential for harm.
“For today’s children and young people, digital culture and social media are an integral part of life … this has the potential to significantly increase stress and to amplify the effects of bullying,” the committee’s report says.
Some young people experience “bullying, harassment and threats of violence” when online, the MPs say. While they did not look into internet regulation in depth during their six-month inquiry, they concluded: “In our view sufficient concern has been raised to warrant a more detailed consideration of the impact of the internet on children’s and young people’s mental health, and in particular the use of social media and impact of pro-anorexia, self-harm and other inappropriate websites.”
It calls on the Department of Health and NHS England’s joint taskforce, now investigating, alongside bodies such as the UK Council for Child Internet Safety, the mental health of under-18s, to assess the impact of social media.
The MPs appreciate the move for e-safety to be taught at all four education key-stages in England. But they also want the Department for Education, as part of a review of mental health education in schools, to “ensure that links between online safety, cyberbullying, and maintaining and protecting emotional wellbeing and mental health are fully articulated”.
Wollaston voiced concern that “sexting” (sharing indecent photographs) could be traumatic for vulnerable young women persuaded to pose for intimate pictures then finding the shots shared widely. Some would end up being harassed, she said. Sexting had “become normalised in some school environments”, she said. “We need much better education about the dangers of sexting.” She also expressed unease about the impact of violent video games played by young people. Parents, she said, should do more to check what their offspring were doing online in their free time and talk to them because “if they are spending two hours a night doing that, is that harming their child?”
Lucie Russell, director of campaigns and media at the charity Young Minds, said: “The 24/7 online world has the potential to massively increase young people’s stress levels and multiplies the opportunities for them to connect with others in similar distress. Websites like Tumblr, where there has been recent media focus on self-harm blogs, must do all they can to limit triggering content and that which encourages self-harming behaviour.”
Russell backed the committee’s view that the internet could also be “a valuable source of support for children and young people with mental health problems”. But, she added that “many professionals feel completely out of touch with, even intimidated by, social media and the net”.
The report paints a grim picture of the growing number of under-18s needing care, often struggling to access it, or becoming an inpatient hundreds of miles from home, as children’s and adolescents’ mental health services tried to cope with budget cuts, lack of staff and too few beds.
“Major problems” in accessing services ends with “children and young people’s safety being compromised while they wait for a bed to become available”, say the MPs.
Services are under such pressure that in some parts of England children only get seen by a psychiatrist if they have already tried to take their own lives at least once.
Despite growing need, criteria for being referred for NHS treatment have been tightened in most of England, the MPs say.
Liz Myers, a consultant psychiatrist with the Cornwall Partnership NHS foundation trust, told the inquiry that its services for the young were receiving 4,000 referrals a year, though were only commissioned by the NHS to do 2,000.
“This has meant that we are necessarily having to prioritise those who have the most urgent and pressing need, and we have no capacity for earlier intervention and very little capacity for seeing those perhaps with the less life-threatening or urgent risky presentations.
“There are increasing waits. It is not okay. We do not want that for our children and young people, but we have to just keep prioritising.”
Hilary Cass, president of the Royal College of Paediatrics and Child Health, said failure to tackle emerging problems with young people’s mental health meant the issue was now “a hidden epidemic”.
Self-harm sites and cyberbullying: the threat to children from web’s dark side
“Some of the images do scare me, especially if it’s my friends. Once my friend cut lines down the side of his face as a ‘Chelsea Smile’, he put it online and it was the worst thing I had ever seen. He’s my friend, I don’t want to see him that upset. He got so much hate for it and ended up going into hibernation, nobody heard from him for over a week and we honestly thought he had killed himself.”
Frankie* is 15 and lives in the Midlands. For the past year or so she has updated her Tumblr blog most days. On other social networks she uses her real name, but on Tumblr – a blogging platform – she shares her darkest thoughts about depression, anxiety and self-harm anonymously. “The other day I put up a self-harm picture,” she says. “I was alone and in a dark place. […] Of course, nobody would help, but posting it boosted my confidence a little; finding it buried in amongst all the other self-harm posts reminded me I’m not alone.”
Fears about self-harm sites have been growing since the suicides of two teenagers who, it emerged, were obsessed with self-harm and depression blogs, with mental health campaigners and experts warning that the UK’s teens are at risk of becoming a lost generation if parents and adults cannot reach out to them across the digital divide.
Tallulah Wilson, a 15-year-old who killed herself in 2012, was caught up in a “toxic digital world”, according to her mother, while the parents ofSasha Steadman, a 16-year-old who died from a suspected drug overdose in January after looking at self-harm sites, said her “impressionable mind” had been filled “with their damning gospel of darkness”.
For the uninitiated, self-harm blogs present a surreal world of fantasy and pain. Countless sites dedicated to self-harm and depression are filled with images of bleeding wounds juxtaposed with pixelated gifs, flickering eerily with snippets of Hollywood angst. Helen, who is now 18, visited them regularly, before stopping to help herself move on from self-harming. “You have people asking you how to cut yourself deep enough because their therapist said it wasn’t bad enough,” she says. “I have had people tell me to kill myself. I think the most traumatic is when you find someone’s suicide note online and there is no way to actually get in contact with the person.”
Isolated and lonely, she used the blogs because they gave her a sense of belonging. “You want to find people who are similar to you. That is what humans do,” she says. “It starts off as trying to help, but then it becomes competitive and dangerous. You get sucked into this world of who can cut the deepest/be the skinniest and avoid notice by the outside world. You end up spending hours a day searching these sites for reassurance, but it just makes it harder.”
Keeping children safe online is the “child protection challenge of this generation”, according to Peter Wanless, head of the NSPCC. ChildLine, part of the organisation, registered an 87% rise in calls about cyberbullying last year, a 41% increase in calls about self-harm, and a 33% increase in calls about suicide, with the biggest increase among 12- to 15-year-olds.
While the internet provides unprecedented opportunities for young people to communicate and learn, it can be a dangerous place for vulnerable teenagers, says Sue Minto, the head of ChildLine. “Children are communicating in a way we have never seen before – all the time and instantly,” she says. “Personally, I think this kind of relentless exposure is the biggest challenge we have ever faced.”
Minto notes that while peer pressure and bullying have been around for a long time, the ability to be contacted at all times is new. The cloak of anonymity can lead children to make comments they would shy away from in “real” life, she says. “The pressure on children is immense and very worrying – there is no break for these young people, it is quite relentless. Children who are being bullied tell us there is no point in turning off their phone, because the messages will just be there waiting for them.”
A recent survey carried out by youth charities ChildLine, Selfharm.co.uk,YouthNet and YoungMinds revealed that 61% of the 4,000 young people who responded said they self harmed because they felt alone, while 25% cited bullying. Almost 40% said they had never spoken to anyone in the “real world” about it.
Rachel Welch, director of Selfharm.co.uk, which supports young people affected by self-harm, says there is a huge gap between what adults see of the online world and their children’s experience. “So many young people are drifting into a world where they are completely disconnected,” she says.
But how dangerous are self-harm sites? Do they simply show teenage angst and creative expression, or highlight a worrying deterioration of teenage mental health?
Mary Hassell, the coroner presiding over the inquest of Tallulah Wilson, was concerned enough to write to Jeremy Hunt, the health secretary, to warn him of a risk of future deaths without a greater understanding of children’s online worlds. Although Tallulah was treated by healthcare professionals, they didn’t have “a good enough understanding of the evolving way that the internet is used by young people, most particularly in terms of the online life that is quite separate from the rest of life”, she wrote.
A study into possible links between suicide and the internet has just been commissioned by the Department of Health and will report in two and a half years: a department spokeswoman said children’s mental health was a priority for the government and pointed to the introduction of “family-friendly filters” and internet safety into the national curriculum.
But for Sarah Brennan, chief executive of the youth mental health charity Young Minds, the real issue is ignorance of the scale of the problem, or even denial that the problem exists. The current NHS commissioning of youth mental health services is based on data collected in 2004 – the year Facebook launched.
“It is shocking that the government is allowing NHS commissioners to plan services based on out of date and inaccurate data,” Brennan says, adding that a Young Minds freedom of information request recently revealed that 34 out of 51 local authorities in England have reduced the budget for their children and adolescent mental health services since 2010, while a Community Care/BBC investigation this week showed that a growing number of seriously ill children are being admitted to adult psychiatric wards or sent hundreds of miles from home for hospital care.
“We are sitting on a ticking time bomb here,” says Brennan. “At the same time that we are seeing an increase in need, youth mental health services are being cut. There is an explosion of bullying online and young people struggling to cope with mental health issues, anxiety, eating disorders. If we don’t do something about it we could have a lost generation.”
What can be done? Since Tallulah Wilson’s suicide, Tumblr has introduced a warning that pops up when users search for terms related to self-harm, directing them towards sites offering support and calling on users to report blogs with “inappropriate content” so they can be taken down. A Tumblr spokeswoman said the site was “deeply committed to protecting our users’ freedom of expression”, but that it draws lines “around a few categories of content we consider damaging to our community, including blogs that encourage self-harm”.
And while there have been calls to shut down certain sites, such as Ask.fm – which allows users to ask anonymous questions and has beenlinked to teen suicides – teenagers and professionals spoken to by the Guardian agreed that simply banning sites or “dangerous” search terms was futile. Regulation can also backfire – recent efforts to impose opt-out “objectionable content filters”, backed by the prime minister, have resulted in sites such as ChildLine and Refuge also being blocked.
“We cannot put our head in the sand, simply blame these sites or hope to regulate our way out of this,” says Minto. “We are playing catch-up, but we need to take responsibility. You wouldn’t let your child cross the road without talking to them about road safety and the same goes for the risks of the internet – if we don’t tackle this it’s like opening the door and letting them walk through this cyberworld completely unequipped.”
Welch at Selfharm.co.uk agrees: “Calling for any type of ban is just missing the point. What we have to do is make sure our young people are emotionally resilient, emotionally aware and they know where to go to get help if they need it.”
Others say that while parts of the internet can be dangerous for vulnerable children, it can also provide the means to keep others safe and let them talk about their problems. As many young people contact ChildLine online as call its helpline. Online friends can be a force for good.
Samantha, a 17-year-old who started self-harming when she was 14, says her Tumblr site helped her recover from depression. “I felt like I belonged somewhere, they understood me in a way I felt I had never been understood before,” she says. At one point, she was off school with depression and spent all day online, answering 10-15 messages from other troubled teenagers every day. Now she “has a life” again and is online less frequently. “I’ve been told that I’ve saved lives and it made me feel good about myself that I was helping other people,” she says. “It’s really odd – but it works for me.”
Frankie, who is still working towards recovery, has mixed emotions. While she recognises that some blogs might encourage self-harmers, or make them feel worse, she still believes they can help. “I think for [people] like myself it can be reassuring just to know there are others out there that do it too [but] what scares me is thinking how many there are, how they are all posting it online, are they all cries for help? If that many people are crying for help then something needs to be done, and fast.”
*Names of young people have been changed. If you face any of theissues in this piece, you can call ChildLine on 0800 1111