Abstract
<p>Background: The impact of smartphones and social media on adolescent mental health and wellbeing are key concerns for families and policy makers. Much previous research has focussed on screentime, which does not capture the multi-functional nature of these technologies, and the mechanisms of influence. This study aimed to explore adolescent, parent and teacher perspectives on how different types of smartphone and social media use influence mental health and wellbeing outcomes.Methods: Adolescents (aged 12-15, N=82), school staff (N=46), and parents (N=49), recruited from 7 English Secondary Schools, participated in focus groups exploring adolescent uses of smartphones and social media, and associated mental health and wellbeing outcomes. Findings: Thematic analysis revealed six mechanisms of influence of adolescent smartphone and social media use on their mental health and wellbeing; displacement; sustained engagement; algorithmic content exposure; emotional and behavioural regulation; knowledge acquisition; and constant connectivity. There was broad agreement across participant groups on most themes, with each group providing a more nuanced perspective. Conclusions: This study provides a new taxonomy of mechanisms that explain how adolescents’ uses of smartphones and social media influence mental health and wellbeing outcomes. It highlights the benefits and harms associated with a wide variety of smartphone and social media use behaviours, across physical, cognitive, social, and emotional wellbeing domains. These findings can be used as a decision-support tool to inform clinical practice, intervention development and guidance on adolescent smartphone and social media use for families, clinicians and researchers.</p>