Nearly one in five pediatric psychiatric crisis encounters reviewed by University of Rochester researchers involved a digital media or device-related problem, with those cases also associated with higher rates of suicidal thoughts, repeat crisis visits and recommendations for inpatient psychiatric care.
The study examined more than 3,700 psychiatric crisis encounters involving patients ages 6 to 17 at a large tertiary children’s hospital during 2021 and 2022. Researchers found that 19.2% of those encounters included what they classified as a digital media-related problem, including cyberbullying, exposure to harmful online content, excessive device use and risky online sexual interactions.
The findings add local evidence to a broader national concern about how social media, online interactions and device use intersect with youth mental health. Researchers cautioned that the study does not prove digital media caused the psychiatric crises. Instead, the analysis shows that technology-related issues were frequently present and were associated with greater psychiatric severity in some cases.
Meredith Gansner, an assistant professor in the Division of Psychiatry at University of Rochester Medicine Golisano Children’s and a co-author of the study, said the findings suggest digital media should become a more routine part of psychiatric crisis evaluations.
“Digital media is now woven into nearly every aspect of adolescents’ lives, but until now, we’ve had limited data on how often it actually plays a role in psychiatric crises,” Gansner said. “Our findings show that these issues are not rare, and they are clinically meaningful.”
Researchers reviewed more than 3,700 crisis encounters
The study was based on electronic medical records from pediatric psychiatric crisis encounters during 2021 and 2022.
Researchers looked for evidence of digital media or device-related problems, referred to in the study as DMRPs, and then examined how those issues related to diagnosis, patient characteristics, suicidal ideation, hospitalization recommendations and repeat crisis visits.
The digital problems identified in the records covered several categories rather than a single type of technology use.
They included cyberbullying, online conflict, exposure to harmful or high-risk content, excessive device use that interfered with daily life, disputes over device access and risky online sexual behaviors or relationships.
That distinction is important because the study did not treat all screen time or social media use as harmful. The findings instead focused on situations where digital media or devices were documented as part of the psychiatric crisis.
Researchers found DMRPs in 19.2% of the encounters reviewed.
Mood disorders were more common in digital media-related cases
Youth whose crisis encounters involved a digital media-related problem were slightly older on average and were more likely to have a mood disorder diagnosis.
Mood disorders were the only diagnostic category significantly associated with DMRP presentations overall, according to the study.
Patients with mood disorder diagnoses were nearly twice as likely to have a digital media-related crisis compared with youth who did not have those diagnoses.
Researchers did not conclude that digital media causes mood disorders or that mood disorders cause technology-related crises.
Instead, the association may indicate that some young people with existing psychiatric vulnerabilities are more likely to encounter online experiences or device-related conflicts that become part of an acute crisis.
Gansner said digital media-related problems often sit at the intersection of a child’s behavior, environment and mental health.
“For some youth, devices may serve as a coping tool, and for others, online interactions can intensify distress,” she said.
Boys and girls showed different patterns
The study also identified differences between male and female patients in the types of digital media problems associated with psychiatric crises.
Female patients were significantly more likely to have crises involving high-risk online sexual behaviors or relationships.
Male patients were more likely to have crises involving device-access conflicts and excessive use that interfered with daily functioning.
Gansner said those differences are consistent with patterns seen in other research, where girls have been more likely to experience online sexual victimization while boys have more often shown signs of problematic or excessive digital use.
The findings could have practical implications for how clinicians, parents and caregivers assess technology-related risks.
A general question about how much time a child spends online may not identify the same risks as more specific questions about online relationships, cyberbullying, harmful content, sexual interactions, gaming or conflict over access to devices.
Researchers said recognizing those distinctions could help clinicians tailor screening, counseling and prevention strategies.
Suicidal ideation was more common in digital media-related crises
One of the study’s most significant findings involved psychiatric severity.
Crisis encounters that included digital media-related problems were more likely to involve suicidal ideation.
They were also more likely to result in a recommendation for inpatient psychiatric hospitalization.
Certain digital problem categories appeared to carry stronger associations than others.
Online conflict and exposure to high-risk content were particularly associated with suicidal thoughts, according to the researchers.
The findings do not establish that the digital experiences triggered suicidal ideation.
A young person already experiencing severe psychiatric symptoms may be more vulnerable to harmful online interactions, or the same underlying mental health condition could contribute to both the digital behavior and the crisis.
That uncertainty is one reason the study’s authors emphasized screening rather than making broad causal claims about technology.
The presence of digital media issues may still provide clinicians with useful information about the circumstances surrounding a crisis and the kinds of risks a patient is facing.
Repeat crisis visits were nearly twice as common
Researchers also found that youth whose encounters involved digital media-related problems were nearly twice as likely to have multiple psychiatric crisis visits during the study period.
Patients with device-access problems were particularly likely to return for additional crisis care.
That could include situations where conflict develops around parents or caregivers restricting a device, internet access or online activity.
The repeat-visit finding suggests that technology-related issues may not always disappear after a single psychiatric evaluation.
For some families, device rules, online relationships, digital conflict or excessive use may remain part of the environment a child returns to after leaving crisis care.
Researchers said that creates an opportunity for more targeted intervention.
Brief counseling with families about device-related conflict, for example, could potentially become part of discharge planning or crisis stabilization when those issues are documented.
Clinicians could also screen for specific online behaviors rather than treating digital media as a secondary or unrelated part of a patient’s psychiatric history.
Study points toward routine digital media screening
The researchers argue that digital media assessment could become a practical component of youth psychiatric care.
Gansner said incorporating questions about digital media into crisis evaluations may help clinicians identify at-risk youth earlier and understand the circumstances surrounding a crisis more precisely.
That does not necessarily mean asking only how many hours a child spends on a phone or computer.
The study’s categories suggest a broader assessment could include questions about cyberbullying, harmful content, sexual interactions, online relationships, gaming, compulsive use, access restrictions and conflicts with parents or caregivers.
Such screening could also help distinguish between situations where digital devices are part of the problem and those where technology is being used as a coping mechanism or source of social support.
“As clinicians, we are increasingly aware that we need to meet adolescents where they are — both emotionally and digitally,” Gansner said.
The study does not show that technology caused the crises
The authors emphasized an important limitation: The research identifies associations, not cause and effect.
Because the study reviewed medical records after the encounters occurred, researchers could determine whether digital media-related problems were documented and whether those encounters were associated with outcomes such as suicidal ideation or hospitalization.
They could not establish that a particular online interaction, amount of screen time or device conflict caused a psychiatric emergency.
The records also reflect what clinicians documented during crisis evaluations, meaning some digital issues may have gone unrecorded.
The study was conducted at one tertiary children’s hospital, which may also limit how broadly the findings can be applied to other hospitals, communities or patient populations.
The data came from 2021 and 2022, a period that also overlapped with the effects of the COVID-19 pandemic on children’s schooling, social lives and technology use.
Even with those limitations, the size of the study provides a substantial look at how often digital media appears in real-world pediatric psychiatric crises.
Rochester researchers see opportunities for earlier intervention
The study comes as pediatric mental health emergencies continue to place pressure on hospitals and crisis systems.
Researchers said the frequency of digital media-related problems creates an opportunity for clinicians to incorporate technology questions into existing assessments rather than treating them as a separate issue.
For Rochester-area families, the findings also underscore that a psychiatric crisis involving social media or devices may be more complicated than a simple dispute over screen time.
Cyberbullying, online sexual behavior, exposure to disturbing content, excessive use and arguments over device access may carry different risks and require different responses.
The study does not support a conclusion that removing devices will prevent psychiatric crises, nor does it suggest that digital media is harmful for every child.
Instead, researchers found that technology-related problems were common enough in acute psychiatric care to warrant closer attention.
“Our findings show that these issues are not rare, and they are clinically meaningful,” Gansner said.
For clinicians, that could mean asking more precise questions about what young patients are doing online, what they are encountering there and whether those experiences are contributing to distress.
For researchers, the next step will be developing evidence-based approaches that can identify which digital risks matter most and whether targeted interventions can reduce repeat crises or improve psychiatric outcomes.
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