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Mental Health and Substance Use Challenges (Volume 103)
Quarterly Article
Marco Thimm-Kaiser
Katherine Keyes
Jul 30, 2026
May 6, 2026
June 2026
Back to The Milbank Quarterly
Policy Points:
See all articles in the special issue, Mental Health and Substance Use Challenges Facing the United States: What Can State Policymakers Do?
Context: The potential adverse effects of social media use for adolescents have received substantial attention. In response, a growing number of state-level social media regulations are emerging in the United States. These policy interventions are being implemented in the context of mixed scientific evidence, forcing policymakers to weigh the need for proactive regulation against the limitations of extant research. We explore policymakers’ publicly stated rationales for social media regulations and contextualize their claims within extant scientific literature.
Methods: We conducted a media content analysis of elected government officials’ statements about 69 state social media legislative initiatives that were adopted or enacted prior to September 2024 using Google News. Subsequently, we critically reviewed the strength of the evidence underlying common themes.
Findings: We screened 637 documents, included 161, and extracted three main themes connected to claims about social media-related adolescent harms: (1) harm to adolescents’ mental health (mentioned in 55 articles), including six subthemes (e.g., social media addiction, self-harm or suicide, anxiety and depression); (2) exposure to dangerous online content (73 mentions), including five subthemes (e.g., access to pornography, risks of sexual exploitation); and (3) harm to adolescent development (38 mentions), including three subthemes (i.e., negative impacts on learning, social relationships, and brain development). We identified some evidence to support associations between social media use and adverse outcomes, particularly for vulnerable youth, but, overall, the current research base has significant limitations and cannot definitively establish causal effects.
Conclusions: State policymakers have moved rapidly to regulate adolescent social media use, often citing concerns about mental health, harmful content, and developmental impacts. The evidence to substantiate these assertions remains preliminary, but some promising directions are emerging around targeted protections for highly susceptible youth. We formulate a research agenda to inform evidence-based policy.