The Good, the Bad, & the Ugly: What Adolescents are Really Saying About Social Media & Mental Health

Introduction

O’Reilly (2020) addresses a central tension in youth mental health practice: social media is nearly universal among adolescents, yet its mental health impact remains debated. While research often emphasizes harms (e.g., anxiety, depression), adolescents also report benefits such as stress relief and connection. O’Reilly (2020) argues that practitioners must understand both adolescent perspectives and clinician assumptions to assess risk and promote well-being without defaulting to moral panic or blanket restrictions.

Methods

Eight focus groups were conducted in two UK cities: six with adolescents aged 11–18 (N = 54) recruited through schools, and two with CAMHS practitioners (N = 8). Discussions explored experiences of social media and its perceived links to mental health. Data were analyzed using thematic analysis across four coders, producing 122 conceptual categories consolidated into three overarching themes. Ethical approval and consent procedures were followed.

Results

Participants constructed social media as “good,” “bad,” and “ugly.” The good included connection, reduced isolation, improved social skills, and stress distraction (e.g., YouTube for relaxation). The bad involved overuse, fear of missing out, social comparison, body image pressure, and disrupted sleep. The ugly centered on cyberbullying, trolling, self-harm content, and suicidal encouragement—often discussed as risks affecting “other” adolescents rather than oneself. Clinicians echoed strong concern, especially about sleep and crisis escalation through online content.

Discussion

The author highlights a mismatch: adolescents often describe personal benefits while attributing major harms to peers, whereas practitioners tend to generalize risks across youth. She argues that social media should be incorporated into clinical risk assessments, guided by adolescent narratives rather than clinician presumption. Additionally, she cautions against unsupported policy restrictions, emphasizing that evidence remains mixed and context-specific. The paper calls for balanced practice frameworks that recognize vulnerability differences and emerging opportunities for digital mental health engagement.

Implications for Mentoring Programs

Mentoring programs should:

• Normalize conversations about online experiences
• Teach critical media literacy (comparison, “likes,” misinformation)
• Build coping strategies for cyberbullying and distressing content
• Encourage healthy sleep and boundary-setting—without framing social media as inherently harmful. Mentors can model balanced use and help youth identify supportive online communities while recognizing warning signs of risk escalation.

Read the full paper here.