Determinants that impact the use of social media for mental health promotion amongst young people: A scoping review protocol

Abbreviations

CFIR: Consolidated Framework for Implementation Research

JBI: Joanna Briggs Institute

LGBTQ+ community: lesbian, gay, bisexual, trans and queer community. The plus sign includes people with other minority sexual orientations and gender identities.

MMAT: Mixed Methods Appraisal Tool

OSF: Open Science Framework

PPI: Patient and Public Involvement

PRISMA-ScR: the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews

SM: Social Media

SMU: Social Media Use

Background

Adolescence, defined in a seminal paper by Sawyer et al. (2018) as the period from 10 to 24 years, is a key period of physical, psychological, and social transition. Notably, the WHO also broadly defines adolescents and young people as those aged 10–24 years (World Health Organization, 2024). As a life-stage, this period can be a difficult time when young people grapple with these changes and increased societal pressures. While most young people will navigate successfully through this period experiencing only ‘normal emotional turmoil’ (Freake et al., 2007: 639), a significant minority will experience more serious emotional and mental health difficulties. The presence of even a relatively mild mental health difficulty in adolescence can result in a disruptive transition into adulthood and adverse long-term outcomes including impacts on mental and physical health, social functioning, quality of life, and the establishments of adult roles (Copeland et al., 2015).

Most mental health difficulties manifest before the age of 24 (Blakemore, 2019) with variations reported in prevalence rates due largely to heterogeneity in study samples and methodologies. Silva et al. (2020) in a systematic review of cross-sectional and longitudinal studies report the prevalence of Common Mental Disorders at 31% of the adolescent population (Silva et al., 2020), while the World Health Organization estimate that one in seven adolescents globally experience mental health difficulties (World Health Organization, 2024). In Ireland, a recent systematic review of the prevalence of mental health difficulties in children and adolescents nationally reported a range between 4.4% to 27.4% (Lynch et al., 2023). In addition, suicide is the third leading cause of death among young people aged 15–29 years old (World Health Organization, 2024), while self-harm, a major predictor of later death by suicide (Moran et al., 2024), also peaks in the adolescent age group (Joyce et al., 2025). The mental health of adolescents and young people aged 10–24 years therefore constitutes an important public health issue, both in Ireland and beyond.

Help-seeking for adolescents experiencing mental health difficulties is reported to be low (Sheppard et al., 2018). In Ireland, the National Youth Mental Health Task Force Report (Department of Health & National Youth Mental Health Task Force, 2017), identifies how many young people do not access mental health services and supports when they are required. Pressures on existing services (Lynch et al., 2023), and young peoples’ identified barriers to help-seeking (e.g. feeling stigmatised, perceiving mental health service provision as overly formal, and not trusting care providers) (Doyle et al., 2017; Huff et al., 2024) mean that many young people who need mental health service provision do not receive it. In addition, minority groups such as refugees or members of the LGBTQ+ community may have specific vulnerabilities or difficulties, such as disclosure to parents, beliefs around mental health issue and fears of discrimination, that can make access to mental health services additionally challenging, (Department of Health, 2020; Higgins et al., 2021; Huff et al., 2024). In the absence of access to formal service provision, young people often turn to social media to understand more about their mental health difficulties and share their experiences (Naslund et al., 2019).

Social media use has been defined by Valkenburg, Meier, & Beyens (2022: 59) as “the active (e.g. posting) or passive (e.g. browsing), private (e.g. one-to-one) or public (e.g. one-to-many) usage of social media platforms, such as Instagram, Snapchat, Facebook, WeChat, TikTok and WhatsApp”. Other definitions of social media use include “an online space that allows for community interaction and the exchange of user-generated content (e.g. online discussion boards, forums)” (Kruzan et al., 2022: 2) and “online platforms that enable interactions through the sharing of pictures, comments and reactions to content” (Carr & Hayes, 2015; Popat & Tarrant, 2023: 323). The concept of ‘virtual social interaction’ is one shared across most definitions of social media use. The use of social media is prolific amongst young people with reports identifying that up to 95% of adolescents use social media, with one in five of those saying that they use it “almost constantly” (Anderson et al., 2023). It serves a variety of functions for young people including self-expression, social engagement, peer support, and wellbeing (Kruzan et al., 2022; Popat & Tarrant, 2023). According to the Health Service Executive, Irish people were more reliant on social media than any other country in Europe (Health Service Executive, 2017). The penetration rate of both internet and smart phone usage in Ireland is very high, with almost all persons aged under 60 years of age having access to the internet on their mobile phone or smartphone in 2023 (Central Statistics Office, 2025).

Over the past number of years there has been a large increase in the number of studies focusing on adolescent mental health and social media use. In a recent scoping review of social media use and mental health and well-being in adolescence, Schønning et al. (2020) reported that three-quarters of the 79 papers included in their review were related to social media use and mental health difficulties, with only a minority of papers exploring the positive potential of social media. The studies and reviews focusing on how social media impacts the mental health of young people often present conflicting results. For example, an umbrella review of adolescent social media use concluded that social media could have a powerful positive influence in the lives of young people but also can be potentially harmful (Valkenburg et al., 2022). A qualitative literature review of the views of adolescents on social media and mental health also highlighted both positive and negative impacts of social media on adolescent emotional wellbeing (Popat & Tarrant, 2023). Findings suggest higher incidences of depression, suicidal ideation, self-harm, poor self-esteem, poor sleep and poor body image associated with adolescent social media use (Barthorpe et al., 2020; Kelly et al., 2018; O’Reilly et al., 2018). Reported also are pressures related to validation-seeking, fear of judgement, cyberbullying, and the “addictive” nature of social media use (Kelly et al., 2018; O’Reilly et al., 2018; Popat & Tarrant, 2023). Greater periods spent on social media were also associated with poorer mental health outcomes (Barthorpe et al., 2020; Kelly et al., 2018). The negative findings around social media use culminated in the recent issuing of an advisory by the US Surgeon General warning about the potential risks of social media use amongst young people with suggestions of a “warning label” being applied to its use (Office of the Surgeon General, 2023).

Despite the potential risks around social media use in young people, positive impacts and mechanisms have also been identified in the literature, although there is a paucity of published high-quality research on how social media can be used for improving mental health (Naslund et al., 2020; Popat & Tarrant, 2023; Valkenburg et al., 2022). Positive impacts centre on their being a sense of community and belonging, and the development of support and discussion forums for people with similar mental health issues with a youth-orientated focus (La Sala et al., 2023; Popat & Tarrant, 2023). An integrative review of the potential of social media in health promotion highlighted that engaging social media users in health awareness campaigns can increase the rate of reach and exposure, and impact health behaviours and outcomes (Ghahramani et al., 2022). A scoping review of social media-based interventions for adolescent and youth mental health, ranging from clinical to non-clinical support, provided preliminary evidence that social media interventions can improve mental health outcomes (Kruzan et al., 2022). The authors outlined areas for future research as the use of existing peer support networks, just-in-time or ad hoc interventions, and predesigned individually tailored social media interventions for the purposes of alleviation of distress, mental health promotion, mental health education or mental health literacy. A recent study on the use of social media by teenagers and their mental health, published by the WHO Regional Office for Europe, highlighted the need for developing digital literacy skills among teenagers and providing support for those at risk of problematic use so that adolescents could control their social media use rather than have social media controlling them (Boniel-Nissim et al., 2024).

Recognising the potential for social media as a mental health promotion tool, one of the recommendations of the Irish Mental Health Policy Sharing the Vision (Department of Health, 2020) focuses on harnessing the positive role evidence-based social media channels can play in the promotion of mental health of adolescents and young people and signposting to support and services. However, an implementation gap exists as to how this policy recommendation can be translated into practice (Health Service Executive and the Department of Health, 2022).

The reality is that young people use social media often (Anderson et al., 2023) and very few seek professional mental help on time, which can lead to exacerbation of mental health difficulties in the future (Huff et al., 2024). Exploration of determinants of the use of social media as a tool for youth mental health promotion, prevention and early intervention constitutes an important public issue which requires thorough investigation. The success of policy implementation may depend on willingness or readiness of both providers and beneficiaries of recommended policies, among other personal, professional, social and/or contextual factors (Emmons & Chambers, 2021; Labbe et al., 2024). Understanding factors which could either enable or impede implementation, is therefore vital for ensuring that evidence-based practice and policy recommendations are adopted in a particular setting. Implementation science can provide theoretical framework for investigating such factors (Labbe et al., 2024).

The Consolidated Framework for Implementation Research (CFIR) (Damschroder et al., 2022a; Damschroder et al., 2022b) is an integration of multiple theories of implementation from various disciplines which can be applied to multiple contexts to support the implementation of evidence-based practice, policies or innovations (Higgins et al., 2020; Labbe et al., 2024). The most recently updated CFIR (Damschroder et al., 2022a) comprises 48 constructs and 19 subconstructs grouped under five broad domains: inner setting (e.g., culture, IT or work infrastructure, communication), outer setting (e.g., legislation, local attitudes), intervention/innovation characteristics (relative advantage, evidence base, cost, complexity etc), characteristics of the individuals (e.g., leaders, providers and recipients of innovation) and implementation processes (e.g., activities or strategies to deliver the innovation) (Damschroder et al., 2022a; Damschroder et al., 2022b). Implementation science and the CFIR framework will help to identify and map various facilitators and barriers to the implementation of the recommendation of the Irish national mental health policy Sharing the Vision (Department of Health, 2020) regarding the potential of social media to be used as a tool for youth mental health promotion.

This scoping review is the first step of a wider study focused on the use of SOCial MEDia (SOCMED) as a mental health promotion tool in young people. The findings of the scoping review will be used to develop an interview schedule for the qualitative phase of the project involving interviews with young people and key stakeholders (e.g., parents, teachers) and will also inform analysis of interview data. SOCMED study is part of a broader VISTA research programme (VISion To Action for Promoting Mental Health and Recovery – An Implementation Science Approach to ‘Sharing the Vision’). The aim of VISTA programme is to develop implementation blueprints for the Irish Department of Health following recommendations of ‘Sharing the Vision’ the Irish National mental health policy (Department of Health, 2020; Gallant et al., 2025; McEvoy et al., 2025).

Protocol

Conclusion

This is an innovative scoping review which is guided at all stages by Implementation Science principles and PPI team involvement through consultation and engagement. The review extends the work of previous reviews by focusing explicitly on the identification of barriers and enablers to the use of social media as a mental health promotion tool in young people, and synthesising findings both deductively and inductively. Identifying the barriers and enablers to the use of social media for youth mental health promotion will inform Irish mental health policy, contribute to the design and development of youth-tailored social media campaigns, and improve our knowledge base both nationally and internationally.

Ethics and consent

Ethical approval and consent were not required for this scoping review.