671 Are clinicians assessing the impact of social media and/or time spent online on the physical and mental health of adolescents in paediatric admissions?

Abstract

<h3>Aims</h3> There is significant evidence that prolonged periods of screen time are associated with a variety of negative impacts on adolescent mental and physical wellbeing; namely adiposity, unhealthy diet, depressive symptoms and quality of life (1). However, the evidence-base to support a direct link between ‘toxic’ screen time causing obesity, mental health problems and educational failure has always been contested (2 3). Current RCPCH guidance on the health impacts of screen time highlights the link between higher screen time and less healthy diets, higher energy intake and obesity. There is a complex relationship between mental health and digital use with positive impacts e.g. maintain social friendships/groups, support for health conditions, online education and negative impacts e.g. cyber-bullying, body dysmorphia, exploitation/grooming. The aim of this audit was to ascertain whether social media/time spent online is discussed and documented in the admission clerking or the first detailed history. If possible, we wanted to establish any associations between indicators of poor mental and physical health with social media/time spent online The majority of evidence in the current RCPCH guidance is based on television time, but recommendations now need to focus on newer uses of digital media, such as social media. A recommendation to include social media as an important factor in assessing adolescent health and wellbeing was advocated in 2018 (4). <h3>Methods</h3> We undertook a retrospective review of 40 paediatric admissions in a medium district general hospital. Patients were eligible if they were admitted, for any reason, from 1st January 2021 - 31^st May 2021, aged 11 years old and above. <h3>Results</h3> Of the 38 admissions included, three had documentation regarding social media/time spent online (figure 1); one of these had a HEADSSSS assessment (figure 2). A further two had HEADSSSS assessments without clarifying social media/time spent online. Of these five patients: • Two admission documentations specified time spent online platform (XBOX), of which, one patient had a BMI of 30 • Three HEADSSSS assessments were carried out in patients with a presentation and/or history of mental health problems • Of these, one HEADSSSS assessment specified which social media platform the patient was using, and if they experienced cyber bullying <h3>Conclusion</h3> Our audit highlights a gap in use of social media screening in paediatric medical histories amongst health care professionals. Good practice was demonstrated for young people presenting with emotional health problems. This was a broad cohort, therefore questions relating to impact of social media may not be appropriate for every patient. The updated HEADSSSS assessment includes a fourth ‘S’ for social media use (4). Updating the clerking proforma to include this and raising awareness through training will support professionals to appropriately assess for new and evolving factors such as social media use, which are impacting on adolescent physical and mental health. (1) BMJ Open, Stiglic N, Viner RN (2) Guardian, Etchells P on behalf of all signatories (3) The Health Impacts of screen time: a guide for clinicians and parents, RCPCH (4) Paediatrics perspectives, Clark DL, Raphael JL, McGuire AL