Literature Review

This rapid review frames the project’s context and provides key points from the literature, and from practice in Scotland, the UK and beyond.

We begin with a brief analysis of quantitative data gathered by Young Scot survey. We continue with a summary of literature and practice available as of November 2013. There has been several recent comprehensive literature reviews in this area, including on technology, mental health and young people generally (Powell et al 2010), the benefits of social networking to wellbeing (Collin et all 2011), vulnerability (Singh et al 2011, 2013), and the mental health impact of gaming (Johnson et al 2013). We draw on these to summarise key learning here, but urge readers wanting a more detailed analysis to consult these reviews.

Finally, a prototype presents examples of digital initiatives. This prototype map is presented for discussion and welcomes feedback. We have not conducted a detailed assessment of the content, so cannot quality assure them.

There are challenges in presenting evidence in the digital field, when the pace of developments outstrips conventional methodologies for building an evidence base.

Internet is ubiquitous

Internet use is ubiquitous amongst young people in Scotland. Young people use personal devices and mobile technology to access the Internet. They prioritise access to the Internet in making choices on what to spend money on.

Digital participation is beneficial

There is good evidence that digital participation benefits young people’s mental health – whether it is through social networking services, gaming and peer communities. It is associated with developing a positive identity, creative skills, social capital and participating in campaigns and political activities both online and offline.

But media literacy is key

For young people to use digital technology to improve their mental health and wellbeing, media literacy is key – including technical, social and academic aspects. Young people need the skills to use devices, software and apps usefully and responsibly. They need to be aware of appropriate social use of the web – managing unwanted attention and conducting online relationships with respect. Finally, they need the critical skills to evaluate content and sources but evidence suggests these skills are not always available in schools.

Creativity has long been associated with good mental health, and indeed with helping people make sense of and communicate their feelings. Young people have been at the leading edge of using digital media to express themselves and creativity to develop their identities. Collating and curating media, producing video, graphic and written content – individually and collaboratively – have been associated with both positive mental health and peer support in recovery. There is work to be done to ensure young people understand copyright and intellectual property law, and are able to negotiate challenging content, including around suicide, eating disorders and sexual content.

Gaming can be beneficial too

A comprehensive review on research links video games to flourishing mental health, in contrast to concerns about the potential negative effects of gaming.

The review discuses evidence to support a positive role for gaming in emotional intelligence and control, building of healthy relationships and social capital, including between those from marginalised groups, and improvements in self-esteem.

Clinical practice benefits from technology

A body of encouraging practice demonstrates clinical use of technology for young people’s mental health. Online counselling and peer support show some promise, and eCBT has been used successfully with young people. Mood trackers specific to young people have been developed and services have also begun to use online modalities. For example SPARX in New Zealand uses online gaming and avatars (game characters representing the player) to guide young people through CBT activities.

On risk and vulnerability

Evidence suggests that young people who are most at risk in the offline world are at most risk online, a general theme in terms of assessing risk in digital environments. Young people with poor mental health are therefore even more likely than the general youth population to need support to make the best use of the digital world, and manage the risks and opportunities.


Collin (2011) makes three central recommendations to policy and practice in relation to social networking use:

  • The concept of cyber-citizenship should not be confined to young people. Most policy frameworks emphasise young people and therefore talk in terms of what they should become, rather than what they already are. Collin proposes that cyber-citizenship policies and practice should include the community as a whole, as opposed to being constructed as a set of policies to protect young people from the digital environment; which they may be more adept at negotiating safely than many adults. Young people working alongside adults in policy and practice could help close the intergenerational gap that could otherwise widen as the pace of technology developments increases.
  • Expand the paradigm of cyber-citizenship from one concentrated on risk management and protection, to one that includes nurturing and recognising the positive aspects of participation, such as creativity, sharing self-generated content and engagement with civil society. This may challenge notions people in charge commonly hold about childhood, gender and youth. The way legal and ethical information on digital citizenship is presented will need to be reviewed.
  • Finally, Collin recommends that in considering cyber-citizenship, policy makers and practitioners should take a holistic view of the way people’s digital lives interrelate with their work, home, school and leisure time, as opposed to emphasising an artificial distinction between online and offline worlds.