For teens' mental health, strong friendships matter more than social media use, NIH study finds

Teens who report strong, high-quality friendships tend to have better mental health—an influence that appears nearly three times stronger than the link between social media use and mental health challenges, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health. 

Today’s teens spend a lot of time online. This has raised concerns about how digital interactions affect teens’ well-being. As social media use has grown, some wonder if it’s playing a role in the rise of teen mental health challenges. Such concerns prompted the U.S. Surgeon General to issue a warning in 2023 about the potential impact of social media on youth mental health.

“Social media use does not occur in a vacuum—it’s one piece of a much larger picture,” said Courtney K. Blackwell, PhD, of Northwestern University’s Feinberg School of Medicine. “Our study found that peer relationships seem to matter a lot more than social media when it comes to teen mental health outcomes.”

In the study, researchers found that a teen with strong, supportive friendships is likely to experience positive mental health, regardless of how much time they spend on social media. By contrast, teens who report poor-quality friendships and nearly the same level of social media use are more likely to report poor mental health. In comparison, the amount of time spent using social media had a much smaller influence on teen mental health outcomes.

Teens ages 13 to 18 reported how much time they spend on social media and whether they use it actively (like posting and commenting) or passively (like scrolling and browsing). Researchers used the PROMIS® assessment tools and the Strengths and Difficulties Questionnaire to measure their mental well-being, including life satisfaction, sense of purpose, symptoms of depression, and the quality of their friendships.

A 2021 national survey of 8th and 10th graders, cited in the U.S. Surgeon General’s report on social media and youth mental health, found that teens spent an average of 3.5 hours daily on social media. More recently, a 2023 Gallup survey of 13- to 19-year-olds reported that the average had increased to 4.8 hours per day.

The study included 963 teens aged 13 to 18 from across the United States. Teens completed surveys on social media habits, peer relationship quality, and mental health outcomes. The results provide insight into how social media use and mental health influence each other during the teenage years, extending beyond negative outcomes like anxiety and depression to also include positive mental health indicators.

“Instead of just focusing on limiting adolescents’ social media use, perhaps emphasizing ways to bolster the quality of their social relationships would help address the current youth mental health crisis in the U.S.,” said Dr. Blackwell.

Looking ahead, the research team plans to use data collected over time to understand better how social media use and mental health influence each other during this sensitive development period. Future studies could focus on improving peer relationship quality as a pathway to better teen mental health outcomes.

This collaborative research was published in the Journal of Adolescent Health.

About ECHO
The ECHO Cohort Consortium is a research program supported by the National Institutes of Health (NIH) with the mission to enhance the health of children for generations to come. ECHO Cohort investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.