INTEGRATIVE SUMMARY OF ROUNDTABLE DISCUSSION GROUPS AND SUMMARY OF INFORMATION GATHERING METHODOLOGY

The Task Force consulted with a wide array of experts and stakeholders³⁵⁵ to inform the development of best practices for parents and caregivers; best practices for industry on safety-, health-, and privacy-by-design, a research agenda, and next steps for policymakers. Information from key stakeholders was primarily gathered through the following methods:

Roundtable Discussion Groups

SAMHSA hosted six 90-minute virtual roundtable discussions with representatives from mental health professional associations, researchers, youth agencies, parents, teachers, educational organizations, and young adults between August 31, 2023, and March 6, 2024. Participants responded to a public announcement of the roundtable events and were invited based on their expertise on youth and social media. Each roundtable session addressed the following:

1. current and emerging risks of harm and potential health benefits to minors associated with online platforms;
2. measures and methods for assessing, preventing, and mitigating such harms;
3. research needs regarding online harms and health benefits to minors; and
4. best practices and technical standards for transparent reports and audits related to online harms to the health, safety, and privacy of youth.

On January 18, 2024, NTIA hosted a public listening session focused on the concrete and actionable steps that industry is taking—or can consider in the future—to improve the environment for all minors online.

Requests for Public Comments

The Department of Commerce’s NTIA received over 500 written comments in response to its Kids Online Health and Safety Request for Comment (RFC), which was issued in September 2023.³⁵⁶ The RFC was designed to gather information about social media and online platforms’ impacts on minors, current industry practices, and ways in which current and future industry efforts could be used to mitigate harms and promote the health, safety, and well-being of minors online.³⁵⁷

Principal Listening Sessions

White House | Washington, DC, February 2, 2024

• Convened a discussion with co-chairs and representatives from the Task Force and 13 representatives from youth advocacy, civil society, academia, and industry to understand the risks posed by social media and other online platforms and identify solutions to mitigate those risks.³⁵⁸

Stanford University | Palo Alto, CA, March 13, 2024

• Convened an event, hosted by the Stanford Cyber Policy Center and attended by nearly 100 participants, that included high school and college-age students describing their experiences and what they and their peers would like to see changed with online platforms and services.³⁵⁹ The event featured co-chairs and representatives from the Task Force, industry experts, and child safety and civil liberties advocates.³⁶⁰

Emanuel Preparatory School for Math and Science | Fortson, GA, March 25, 2024

• Convened a hybrid discussion, facilitated by the Morehouse School of Medicine and attended by co-chairs and representatives from the Task Force, with nearly 60 parents and elementary and middle school students from the Columbus, GA area to discuss their experiences with youth online safety and mental health.

SAMHSA hosted a series of six roundtable discussions with key stakeholders who have technical and experiential knowledge of youth and social media. They reported on “the status of existing industry efforts and technologies to promote the health and safety of children and teenagers vis-à-vis their online activities, particularly with respect to their engagement in social media and other online platforms.”³⁶¹

SAMHSA organized six 90-minute virtual roundtable discussions between August 31, 2023, and March 6, 2024. Participants responded to a public announcement of the roundtable events and were invited based on their expertise on youth and social media. Each roundtable session addressed the following areas: (1) current and emerging risks of harm and potential health benefits to minors associated with online platforms; (2) measures and methods for assessing, preventing, and mitigating such harms; (3) research agenda regarding online harms and health benefits to minors; and (4) best practices and technical standards for transparent reports and audits related to online harms to health, safety, and privacy of youth.

Participants responded to each focal area on Mural, a virtual whiteboard platform for each topic area, followed by a 15–20-minute group discussion, during which they elaborated on their entries and answered additional discussion questions.

Integrative Key Findings

1. Current and emerging risks of harm and potential health benefits to minors
   • Framing the potential harms and benefits of social media use should consider developmental (age, brain maturation, “windows of vulnerability”—early childhood and early adolescence), individual (vulnerabilities and resilience, history of mental health concerns—most notably depressive, anxiety, and trauma/stressor-related disorders; minority status based, but not exclusively on race, physical/ cognitive ability, and sexual/ gender identities), social (peer comparison, isolation), family (guardian supervision), and regional (urban, suburban, rural) factors, and how these factors interact with each other to affect youth engagement with online content. “Blanket, broad categories” that contribute to broad sweeping “polarized discourse” are not helpful. (Sessions 1, 2)
   • Potential harms of social media broadly include (but are not limited to): (a) offline vulnerabilities of youth (“…address the issues young people have outside of their lives online because technology just makes the struggle they experience in real life more visible”) (Session 2); (b) nefarious online adult actors who intend harm on youth (sextortion); and (c) social media platform designs that are not necessarily intended to harm youth (Session 2, 3, 5).
   • Potential benefits of social media broadly provide: (a) safe alternatives to offline support and access to otherwise unavailable or less available offline information and programming; (b) opportunities to promote youth agency, activism, and self-expression; and (c) supplemental skills building (e.g., social skills for neurodivergent youth) (Session 4, 5).
2. Assessing, preventing, and mitigating such harms
   • Different stakeholders have described efforts they say are intended to contribute to mitigating harm and amplifying benefits of social media use. However, these efforts have been siloed and are not always equitably distributed:
     1. Industry: Prioritizing the development of accessible and simplified resources to improve digital literacy for parents and youth, transparency of how “back-end” algorithmic and user data are used (e.g., monetizing private information);
     2. Schools: Promote social-emotional learning, digital citizenship, and civics; encourage reporting of cyberbullying; consider burden placed on educators to integrate social media with pedagogical practices; address how social media has affected student attention capacities; and
     3. Families: Consistently engage children in conversations about social media use, especially when they receive their first smartphone, increase parental monitoring and supervision without being overly punitive (Sessions 1, 2, 3, 4).
3. Research agenda regarding online harms and health benefits to minors
   • Challenges to advancing research are:
     1. methodological (access to hard-to-reach, vulnerable populations; access to industry-held data; definitive determination of whether, how, and the degree to which specific forms of social media use harm or benefit sub-groups of youth); and
     2. resource constraints (inadequate funding for larger scale studies; multi-sector collaborations) (Sessions 2, 3).
   • Research focused on establishing a causal link to a certain extent between social media, harm, and benefits may be less important than understanding what makes social media platforms safer for youth. This is especially important to consider given the rapid advances in generative artificial intelligence and how this technology will likely reshape the curation of social media content for youth (e.g., altering on-line photos with exploitative intent) (Sessions 2, 3, 4).
   • Broaden research across a wider developmental span – with attention on onset and prevention of vulnerabilities that place young children <10-years-old at higher risk of harm when using specific social media platforms (Sessions 1, 2, 3).
   • Further clarify the relationship between on-line and off-line behavior. Consider examining, for example, how patterns of social media use and its effects “can provide valuable insights into students’ lives that would otherwise remain concealed” (Sessions 2, 4).
   • Address potential harms and benefits of social media use for: (a) specific groups based on primary language, social-economic class, region, sex, age, and sexual identity (Session 1); and (b) users of platforms with specific design features (Session 1, 2, 3, 5).
4. Best practices and technical standards for transparent reports and audits related to online harms to the privacy, health, and safety of children and teenagers
   • Participants highlighted that recommendations to date for best practices have been polarized and siloed – underscoring the need to identify a balanced common ground that is youth-led and centered and supported by tech companies (Session 1). Different approaches to date have included:
     1. policy and legislation (Kids Online Safety Act; California Age Appropriate Design Code);
     2. banning or restricting minors’ access to social media platforms at home and school;
     3. government (federal and state) and third party (research centers) regulatory oversight – with particular attention on preventing extreme and explicit harms of online sexual exploitation;
     4. social media platform design which permits more user control and promotes agency of online use;
     5. prevention of early stages of “grooming” youth for victimization;
     6. online and local community resources that guide parents and youth seeking to minimize harmful use of social media; and
     7. exemplar global legislation and reform, most notably in the EU (Digital Services Act) and UK (Age-Appropriate Design Code Digital Services Act (Sessions 1, 2, 3, 4).

Findings from each roundtable discussion are summarized below:

In response to the United States Surgeon General’s Advisory on Social Media and Youth Mental Health, the Substance Abuse and Mental Health Services Administration (SAMHSA) conducted a series of six roundtable discussions to gather insights from different stakeholder groups on the impact of social media on youth mental health and safety.

SAMHSA conducted 90-minute virtual listening sessions with six stakeholder groups:

The roundtable sessions were organized to support an open dialogue between facilitators and stakeholders through the use of guiding questions, thought exercises, and a real-time mural board tool to visually capture and organize ideas. Each roundtable session was transcribed to ensure that discussions were accurately documented for analysis. SAMHSA conducted a thematic analysis of the transcripts and mural boards to identify five broad topic areas within each stakeholder group. The five topic areas include:

Topic Area 1: Managing Social Media for Maximized Benefits

What are the ways that youth manage social media and online behavior to maximize the possible benefits and minimize potential harms?

Topic Area 2: Measuring, Assessing, and Preventing Harms

What are your observations with methods for measuring, assessing, and preventing potential harms of online platforms and social media?

Topic Area 3: Effective Practices for Minimizing Harms

What are useful or effective practices and/or resources aimed to prevent/ minimize the harms of online use among youth?

Topic Area 4: Further Research for Safety & Wellbeing

What research exists on this topic and what further research is needed to inform strategies for ensuring the safety and well-being of youth in online environments?

Topic Area 5: Role of the Federal Government

What role could the Federal Government play in enhancing the safety of minors who use online platforms?

Roundtable 1: Behavioral Health Providers & Groups | August 31, 2023

Roundtable Takeaways

The issue of social media and its effect on youth mental health is highly complex; addressing it necessitates bringing a diverse group of stakeholders to the table – with youth group involvement as a priority.

There is no “one size fits all” solution. An approach should not be overly broad but rather youth-focused, developmentally-centered, and sensitive to the needs of youth groups that are especially vulnerable to harm, such as LGBTQIA+ and BIPOC youth, youth with disabilities, and adolescents.

Benefits & Harms of Social Media for Youth

1. Bullying, screentime, and the potential for misinformation were the most common harms cited by participants.
2. Blanket generalizations that “all screens are bad” are common among adults. Adults do not fully appreciate how nuanced and sophisticated youth are in their understanding of social media’s harms and benefits; the approach to preventing harms should be just as nuanced.
3. Social media can promote a sense of community among youth, offering a space for them to find otherwise unavailable information, acceptance, and support.
4. Certain youth groups are more vulnerable to the negative impact of social media than others.

Measuring, Assessing & Minimizing Harms

• Participants suggested social media companies should be more proactive in preventing harms by enforcing their current policies and harm monitoring as well as including digital literacy tools in their platforms.
• Groups more vulnerable to the negative impact of social media may need targeted support and interventions to mitigate these risks and ensure equitable access to the benefits of social media.
• Educational resources and digital literacy training for youth, parents, and caregivers were endorsed as a strategy to prevent harm.

Suggested Actions & Policy Implications

The federal government has a role to play in helping regulate the digital ecosystem, fund research, and hold industry accountable. Engaging the youth voice and involving diverse community groups with wide representation will bring balanced perspectives and ensure cultural alignment.

Passage of the Kids Online Safety Act (KOSA) was suggested as a positive step forward.

Participants suggested requiring social media companies to make investments in research and training for those who interact with youth regarding social media use.

Roundtable 2: Research Groups | September 13, 2023

Roundtable Takeaways

Despite what most adults believe, a direct link between social media use and youth mental health has not been sufficiently proven by current research. Research on this issue remains challenging due to inadequate funding, lack of transparency and access to algorithmic and user data from tech companies, and a lack of diversity in sample groups.

Youth mental health is more complicated and nuanced, with root causes involving offline behaviors and environmental factors. Technology is an amplifier of issuesthat exist offline, not necessarily a cause.

Focus should shift from blaming technology to improving platforms for youth using a balanced, evidence-based approach.

Benefits & Harms of Social Media for Youth

1. Prevailing thought leadership making causal claims from correlative studies are flawed, misinforming, and divert attention from a substantive examination of real root causes.
2. Youth mental health is a complex and multifaceted issue. Focus on online safety should not be to the exclusion of addressing the bigger ecosystem and issues youth are facing holistically.
3. Rather than centering the tech, center the child. Youth who are more vulnerable online are more vulnerable in other contexts as well. Technology makes their vulnerability visible or augments existing issues.
4. Potential harms are not about the technology per se, but about the dynamics with peers, strangers, or content that is upsetting to them.

Measuring, Assessing & Minimizing Harms

• Youth are often better than adults at navigating social media and tailoring it for their needs. In contrast to the stereotype, youth curate their online presence and do employ measures to protect privacy and minimize harm.
• Social Emotional Learning (SEL) educational focus can help youth develop essential skills, cultivate empathy, teach digital literacy and citizenship, and build resiliency.
• A paradigm shift is needed - away from blaming technology for harm to improving platforms to enable youth to achieve their goals.

Suggested Actions & Policy Implications

Participants suggested that legislation be mindful of the balance between protecting children from harm and enabling them to find necessary supports through social media.

Algorithmic and user data transparency, data sharing rights, and regulating data protection were suggested as a policy priority to allow researchers to have access to better data and users to control how their data is used.

Funding for the development and dissemination of social media education and digital literacy training is needed.

Roundtable 3: Youth & Parent Organizations | September 20, 2023

Roundtable Takeaways

A sense of helplessness that tech companies are solely responsible and “hold all of the cards” has led to frustration that there is only so much adults can do to keep youth safe from harms online. Proactive conversations with youth lead to positive outcomes, but the burden cannot lie solely on parents to protect children online.

Commercial interests preclude child safety online. Unless social media companies are compelled to be transparent and make changes to platform design, they cannot be counted on to do so. Whether through punishment or incentive, social media companies must be involved and accountable for change.

Benefits & Harms of Social Media for Youth

1. The “Wild West” nature of the social media ecosystem has allowed companies to prioritize profit over user safety. Commercial interests supersede child welfare and safety online.
2. The complexity of online challenges faced by youth today is not fully understood. Negative experiences are inconsistently reported, either because victims are reluctant to come forward or are not aware of how to.
3. Youth have a level of awareness about the harms and have become savvy at self-regulating and detecting misinformation. However, rather than relying on their ad hoc strategies, youth should have better access to tools and resources.
4. Proactive not reactive measures are needed. Parents feel ill-equipped to take proactive measures, but if not addressed, the consequences of social media’s harms can be severe.

Measuring, Assessing & Minimizing Harms

• Youth who have open, proactive conversations with adults about social media tend to have more positive experiences and are more open about negative experiences.
• Parent-oriented, youth-focused digital literacy education, social media best practices, and training about how to have age-appropriate conversations at every developmental stage is needed.
• Social media companies, schools, peers, parents, trusted mentors, and even youth ambassadors and influencers all need to be involved in promoting online safety as a community-wide effort.

Suggested Actions & Policy Implications

Federal government is an important “convener” to bring all voices together and level the playing feld - academia, parents, schools, youth, public health, tech companies and even influencers all need to have a seat at the table.

Government can play a proactive role in sharing resources, toolkits and information about existing policies or new legislation when it is passed.

Government could provide necessary funding for more research and digital literacy education programs.

Roundtable 4: Education Organizations | September 27, 2023

Roundtable Takeaways

While online tools can be problematic for educators, students benefit from use of online platforms as an educational tool.

Digital literacy, online responsibility, and digital citizenship can be incorporated into the core curriculum, and inappropriate behavior online can be turned into “teachable moments.”

The aim should be to equip students with essential skills that will equip them for a digital future. Partnerships between schools and tech companies can help build career development pathways to meet demand for digital skills in the workforce - particularly around data protection.

Benefits & Harms of Social Media for Youth

1. Online platforms can be educationally positive as a tool for research, collaboration, real-time feedback, for students with disabilities due to its flexibility, and for career networking.
2. Students struggle to manage platforms that are designed to continuously feed them content and retain their engagement. Social media impacts mental health of students and educators alike, and these concerns appear to be worsening over time.
3. Educators feel pressured to integrate online platforms into instruction, but the field lacks a clear definition of what makes a technology tool “social.”
4. Concerns around data privacy, addictive algorithms, and a lack of guardrails around Artificial Intelligence (AI) and generative AI are troubling for educators who are equipping students with essential skills for a digital future.

Measuring, Assessing & Minimizing Harms

• Schools need good vetting mechanisms to evaluate platforms, digital content for bias, learning progressions, and use of AI in the classroom.
• Online responsibility and digital literacy can be incorporated into the core curriculum, but online safety should not be up to schools alone.
• Strong school board policies developed jointly with educators are needed to establish consistent standards and safety measures. Schools, parents, and government need to be aligned and working together with the same mission.

Suggested Actions & Policy Implications

Minimum safety standards to mandate safe storage practices as a preventative measure against cyber attacks. Regular audits for data privacy protections, safety practices, and access to data.

Convene a task force focused on AI to establish standards and guardrails with regular audits of algorithms for bias.

Recent European legislation could serve as a model for legislation that provides researchers with access needed for deeper-dive research, and for government holding social media companies accountable for safety.

Roundtable 5: Parents of Minors | February 27, 2024

Roundtable Takeaways

Minors benefit from the opportunity to connect with family and peers outside of their local community and develop cricial thinking skills from online platforms, but time spent online, bullying, sexting and the sharing of personal information are significant concerns for parents.

Parents have developed ad hoc strategies to limit harms, but they would like access to tools and resources to support proactive measures and alert them when inappropriate or harmful activity occurs.

Benefits & Harms of Social Media for Youth

1. Social media offers youth opportunities for increased social connection to family, friends, and peers who live far away, the development of problem solving and critical thinking skills, and a sense of independence.
2. Harms such as excessive time spent on online platforms, addictive behavior patterns, sexting, and bullying are significant concerns for parents.
3. Setting boundaries around time limits for devices, online applications, and wifi access, frequent device checks, and establishing rules for using devices in shared spaces are helpful as parental controls. These strategies are most effective when paired with open conversation about why they are needed.
4. Access to tools and digital literacy resources would be beneficial for parents to inform and guide proactive safety measures and conversations.

Measuring, Assessing & Minimizing Harms

• A list of red flags, warning signs to look out for, and commonly used terminology or “slang” language would be helpful to enable parents to be more proactive in preventing harm.
• “Push” notifications from social media platforms alerting parents of their children’s concerning or inappropriate behavior online and offering support resources could advise parents when harmful situations are developing.
• Schools could provide parent education programs and student courses around use of devices/social media/gaming, the potential harms, and short- and long-term effects of online platforms.

Suggested Actions & Policy Implications

Public service announcements and public safety messaging were suggested as a strategy to make social media safer and a more positive experience for parents and youth alike.

Algorithms or SMS messaging could be leveraged to push relevant safety information to parents when concerning events happen in their local geographic areas.

Improving regulations around phone controls and settings so that they are more user friendly to parents and easier to use for restricting access to inappropriate content for youth.

Roundtable 6: Young Adults Ages 18 - 25 | March 6, 2024

Roundtable Takeaways

There is a generational divide between young adults who use social media as a tool for connection, democratized information, and self-expression and older generations who focus exclusively on the negatives of social media.

While young adults understand the potential harms of social media, the benefits outweigh the risks. Instead of imposing restrictions, parents should create a healthy environment for their child to feel safe discussing anything they experience online.

Regulation and content censoring or filtering is not the answer; instead, more resources should be available to self-check online behavior, to familiarize adults with platforms they don’t trust, and to support youth in crisis using social media as a cry for help.

Benefits & Harms of Social Media for Youth

1. Young adults use social media as a tool for connection, democratized information, and entertainment, but also for self-expression - it is a key part of developing their authentic identity.
2. Adults assume that social media is solely a threat, making youth susceptible to misinformation and political bias. Young adults, however, think the abundance and immediacy of real-time decentralized information online makes them more informed and can empower broader perspectives - although algorithms can create echo-chambers by feeding content designed for engagement.
3. Parental controls and content filtering are intrusive and ineffective, denying youth information, risking free speech rights, and often resulting in youth hiding activity from parents.
4. Third party tools, self-timers, and turning off notification settings are effective tools to self-check online activity. Regulation of content is not the answer.

Measuring, Assessing & Minimizing Harms

• Clear user warnings and explicit community guidelines around the use of offensive language or content is preferable to content censoring or restrictions.
• Educational resources for parents to familiarize themselves with online platforms and normalize conversations about social media would ease discomfort, uncertainty, and distrust.
• Schools and healthcare providers who are in a position of trust should play a role in developing and disseminating youth-oriented education materials and mental health support resources.

Suggested Actions & Policy Implications

Hesitancy around potential regulations and policies for social media among youth stem from concerns about free speech thwarted, silencing of minority voices, and uncertainty that the internet can be regulated at all.

Government warning labels and information campaigns like there are for other potentially dangerous products like cigarettes, alcohol, vaping, etc. could be helpful in simplifying messages around potential harms.

Regulation of privacy protections may be an appropriate area for government action.