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Guest article by Dr Line Farah, Director of the national digital programs on “digital and aging well” and “digital in mental health”, French Ministry of labour, health and solidarity 

In recent years, the growing exposure of children and adolescents to digital screens has raised significant concerns about their physical and mental health. Reports and action plans, such as the French children and screens report (1) and the national action plan about digital medical devices for mental health (2), provide valuable insights and actionable recommendations to address these issues across Europe. As we reflect on these reports, collective action is important to protect the well-being of the younger generation. 

A growing concern in France and worldwide: children and screens addiction 

The 2024 French children and screens report emphasizes the complex relationship between young people and digital screens (1). Screen exposure, particularly in young children, has been associated with risks such as impaired cognitive development, decreased attention span, and the risk of developing compulsive behaviours due to the over activation of the brain’s reward system. The report highlights how prolonged screen time can lead to addictive behaviours, negatively affecting sleep, learning, and social interactions. 

A particular concern is the growing digitalisation of children’s free time, which is being filled with activities that often lack educational or social value. The findings indicate that, despite the varied nature of screen activities, whether passive (like watching videos) or active (such as gaming), excessive usage during crucial developmental phases may hinder their cognitive and emotional growth. Importantly, the report also addresses the need for differentiated guidelines based on age and context, advocating for moderated screen use, and promoting non-digital alternatives such as reading, physical activities, and creative play. 

Epidemiological data on screen addiction among youth 

Recent data from France and global studies indicate an alarming increase in screen addiction among youth. In France, a 2021 study revealed that 20.8% of young adults aged 18-24 suffered from depression, a significant increase from 11.7% in 2017, with 9.5% of adolescents aged 17 showing severe anxiety-depressive symptoms​ (3). 

In the United States, the National Institutes of Health (NIH) reported that up to 23% of adolescents show signs of problematic screen use, with negative impacts on their academic performance, social behaviour, and mental health​ (3). 

These data underscore the urgent need for countries to implement stronger policies and prevention strategies to combat screen addiction. 

Global insights: literature reviews and mental health policies on digital usage 

Internationally, various literature reviews and mental health policies have examined the impact of digital technology on adolescents’ mental health (4) (5 (6) (7) (8) (9). These studies emphasize several key points: 

1. The importance of digital balance: achieving a balance between online and offline time is critical. While technology provides benefits for learning and socialization, these studies caution against its risks, particularly when usage becomes excessive. 
2. Digital health initiatives: mental health platforms and apps have been developed to offer psychological support, counselling, and preventative interventions to young people. These digital tools are designed to be accessible, interactive, and tailored to the specific needs of adolescents. 
3. Regulation and public policy: some countries have implemented regulations to limit children’s and adolescents’ screen exposure. This includes restrictions on advertisements targeting young people and official recommendations on screen time. 
4. Cross-sector collaboration: a collaborative approach involving governments, the healthcare sector, educators, parents, and technology companies is necessary to develop effective strategies for preventing screen addiction. 

These initiatives reflect the growing awareness of the impact of digital media on youth mental health and underscore the importance of adopting a holistic, multidimensional approach to fostering healthy technology use. 

Mental health and the role of digital medical devices 

The national action plan on digital medical devices for mental health represents a forward-thinking initiative aimed at leveraging technology to improve mental health outcomes (2). It highlights the potential of digital medical devices in supporting mental health care, from telemonitoring systems to cognitive-behavioural therapy apps. These devices can play a pivotal role in identifying early symptoms, enhancing diagnosis, and offering continuous support to patients with psychiatric conditions. One of the core aims of this initiative is to foster innovation and collaboration among healthcare professionals, patients, and developers. The plan stresses the importance of evidence-based development and clinical trials to validate the efficacy and safety of digital tools. It advocates for robust privacy measures and the need to ensure that technology complements—rather than replaces—human interactions in mental health care, especially regarding preventive and healthcare children’s pathways. 

Toward a collective European effort 

To effectively tackle screen addiction and protect the mental health of children and adolescents, European nations must unite in establishing guidelines and sharing best practices. Both the children and screens report and the action plan underscore that the solution requires a collective approach—governments, healthcare systems, educational institutions, and families need to work together. A pan-European framework can help establish unified recommendations, such as limiting screen time based on age, integrating technology into mental health care responsibly, and educating both parents and children on the risks and benefits of digital consumption. 

Recommendations of preventive actions to tackle screen addiction 

Preventing screen addiction among adolescents typically involves several levels of intervention detailed in the French report on children and adolescents’ exposure to screens published in April 2024. It proposes the following interventions (1): 

1. Education and awareness: raising awareness among adolescents, parents, and educators about the risks of excessive screen use and promoting responsible use. This can include workshops, awareness campaigns, and integrating these topics into school curricula. 
2. Screen time management strategies: encouraging families to establish clear rules around screen time, promote screen-free periods, and encourage alternative activities to reduce reliance on digital devices. 
3. Targeted interventions: offering prevention programs and targeted interventions for adolescents at risk of screen addiction, including behavioural therapies and support groups. 
4. Social and emotional skills development: helping adolescents build social, emotional, and resilience skills to better manage stress, anxiety, and other factors that may drive excessive screen use. 

Conclusion 

The digital mental health era presents undeniable benefits, but it also brings unprecedented challenges to children’s health. As the children and screens report and the digital mental health medical devices plan demonstrate, it is imperative to establish a European-wide initiative to address the risks associated with excessive screen use and ensure the responsible integration of technology into mental health care. Through a collaborative and holistic approach, Europe can safeguard the well-being of its youth and provide them with a balanced, healthy relationship with the digital world, including cybersecurity, data governance, and mental health protection actions. 

Sources:  

1. French report on children and adolescents’ exposure to screens (April 2024) https://www.elysee.fr/admin/upload/default/0001/16/fbec6abe9d9cc1bff3043d87b9f7951e62779b09.pdf 
2. French national action plan about digital mental heath technologies (June 2024) https://sante.gouv.fr/img/pdf/grand-defi-dm-numerique-en-sante-mentale.pdf  
3. Santé publique france. Santé mentale des jeunes, des conseils pour prendre soin de sa santé mentale. 2023. Available at: https://www.santepubliquefrance.fr/presse/2023/sante-mentale-des-jeunes-des-conseils-pour-prendre-soin-de-sa-sante-mentale  
4. Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health. 2015 Mar;1(1):40-43. 
5. Li W, Liu Q, Deng X, Chen Y, Liu S, Story M. Association between Obesity and Puberty Timing: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2017 Oct 24;14(10):1266. 
6. Fang K, Mu M, Liu K, He Y. Screen time and childhood overweight/obesity: A systematic review and meta-analysis. Child Care Health Dev. 2019 Sep;45(5):744-753. doi: 10.1111/cch.12701. 
7. Lanningham-Foster L, Jensen TB, Foster RC, Redmond AB, Walker BA, Heinz D et al. Energy expenditure of sedentary screen time compared with active screen time for children. Pediatrics. 2006;118:e1831-1835. 
8. Courbet D, Fourquet-Courbet MP. Usage des écrans, surpoids et obésité. Obésité. 2019;14:131-138; Cessna T, Raudenbush B, Reed A, Hunker R. Effects of video game play on snacking behavior. Appetite. 2007.49:282. 
9. Boyland EJ, Nolan S, Kelly B, Tudur-Smith C, Jones A, Halford JCG et al. Advertising as a crue to consume: a systematic review and meta-analysis of the effects of acute exposure to unhealthy food and nonalcoholic beverage advertising on intake in children and adults. Am. J. Clin . Nutr. 2016;103:519-533.