Is social media putting our children at risk? Episode 103

Monika Rachtan
Hi Monika Rachtan. I welcome you very warmly to the next episode of the programme. First of all, the Patient. Today I'm going to invite you to an unusual formula because, as you can see, I'm not sitting in my chair and my guest is not sitting on the sofa, but I have a number of guests with whom I'm going to talk about a very important topic. Children's Day is approaching and it is the little ones who will be the main protagonists of our conversation today. And we will talk about whether social media is putting our children at risk? As always, I will now introduce my guests. With me is Grzegorz Juszczyk, MD, PhD in health sciences. Department of Public Health, Medical University of Warsaw. A warm welcome to you. With us is Magdalena Skotnicka Chaberek, PhD, a child and adolescent psychotherapist from the Polish Association for Cognitive and Behavioural Psychotherapy. Welcome, doctor. Also with us is Kamila Kadzidłowska, an activist from the Parents for Climate movement. Hi, welcome. Kamila. With us is Martyna Szaniawska, pharmacist, manager of the open pharmacy at the MSWiA hospital in Warsaw. Hi, welcome. Martyna. With us is Paweł Mrozek, founder of Student Action. Hi, welcome and I am very happy that young people have agreed to come to my programme. This is the first time we have had young people like this. So I am very pleased and welcome you warmly. Also with us is Ms Maria Gałczyk Wojciechowska, Senior Specialist in the Department of Mental Health at the Office of the Patient Ombudsman. Good afternoon, and welcome. I would like to start with Magdalena Skotnicka Chaberek, MD. Doctor, does it often happen in a psychotherapist's office that a parent comes to him or her saying that their child has a problem with social media, that there is too much of it on the internet, that their life is spent mainly on TikTok and Facebook. And in the real world this child is missing.

Magdalena Skotnicka-Chaberek
This is very rarely the case. Most often it happens that parents come forward with much more serious problems, such as lowered mood, increased anxiety. This is when the child no longer wants to go to school because he or she is afraid that everyone will laugh at him or her, because he or she has been ostracised or bullied while sitting online. Rarely is the fact of spending time online such a direct indication that parents pay attention to their children.

Monika Rachtan
But that's what the doctor wants to tell me, that we don't notice this problem of our children, that if our child is looking at their phone for four hours a day, that parents don't check, don't verify what they're doing on that network and all that time.

Magdalena Skotnicka-Chaberek
I think children are lonely online, they are left alone. Many times parents don't know at all what social media their children have set up, who they are talking to and about what, what issues concern them. The kids are simply on their own and controlling this reality for themselves. And usually when parents notice it is when the child says I don't have the strength anymore, stops getting out of bed, or when their grades are flying down, or when they refuse to go somewhere. It's very rare that there are parents who say listen, you know, the last time you turned your phone off you were upset, we can talk it through somewhere. If you don't believe me that's a problem, it's really rare.

Monika Rachtan
Professor, but don't we as adults have this awareness? Because we ourselves also use social media very actively. Many of us spend hours there, browsing, scrolling, but also many of us just have a problem with social media. We are addicted to it and we don't notice this addiction in our children.

Grzegorz Juszczyk
Thank you very much for this question, because I think we should also start from this perspective of parents. We are at such an age that it is perhaps easier for us to talk even about parents than about children, who we probably also bring up, but we are not the best example. As the editor said, we spend a great deal of time. Of course, part of that time is our professional responsibilities, but when our or other children watch us, well, they also see us with mobile phones, so they perceive this behaviour as altogether natural. Research also shows that parents are already so busy with everyday things. I'll also tell you immediately why, that they don't set those boundaries that the doctor mentioned.

Monika Rachtan
That is, there's not this conversation that they're giving the phone to the child now faster and faster and there's no boundaries that the phone can be used for this, this and this, you just have it and get on with it.

Grzegorz Juszczyk
Firstly, there is no set time that a child can spend with the phone. And the second theme is also very important, that we don't control what the child is occupied with when even we designate as such an acceptable time to use it. And just one more sentence about us parents. We simply have to bear in mind that the so-called 'sandwich generation' has emerged in Poland, that is, people between the ages of 38 and 48 are still taking care of their children because they were born a little later. The average age at which the first child is born is more or less 28-29, and we already have to look after our ageing parents. Hence, it's sandwiched as a representation of such two elements that squeeze us. We have work commitments, so even if we would like to spend more time with the child, it just starts to run out. But we cannot justify ourselves in this way, for the reason that all our activity and not only that of the children, but also that of the adults, will depend on both mental and physical health, which are interconnected. The economy Here, of course, does not. There is no need to talk about it, but this potential for children's health is particularly important, and if we as adults, including health politicians, don't get on top of it, well, the consequences will be unforeseen and on a scale we probably don't even try to imagine yet.

Monika Rachtan
Mrs Mary, I would ask if we could consider that giving a child access to social media, which is what this phone is, in some way could be seen as a violation of patients' rights, Well, de facto, these children, by being exposed to these factors, which we will probably talk about in a moment, on the Internet in some way already. We, by giving them this tool, are influencing their future health.

Maria Galczyk-Wojciechowska
I mean I wouldn't so directly call it a violation of the patient's rights, but we have to mention the fact that by simply becoming uncontrolled, this time is spent outside the parents' control. As a rule, there is a very large amount of it. Young children also spend this time in such a way that media is more important than meeting their peers, than talking to their peers, than playing outdoors even. This makes them close themselves off. It's like time spent with themselves and with that screen. And this can cause such things as a sense of anxiety, a sense of not being accepted because someone else is prettier. I'm a little bit less attractive because I saw something in certain apps or on certain social networks and it makes me. This can cause and effect that this person, this child will become a patient in the future, will be given the status of a patient, because sooner or later they will become addicted to this internet, they will become addicted to these media and they will end up in a ward or a psychiatric ward or a centre. And then the patient's right may be violated, because then he will already have patient status.

Maria Galczyk-Wojciechowska
So in this way, I would most definitely see this cause and effect relationship here, that mere access to the media is not a violation of patients, is not a violation of patients' rights. However, a progressive involvement in these media, a very large amount of time spent in these media can result in that person reaching patient status and that is when patient rights can be violated.

Monika Rachtan
Yes, doctor.

Magdalena Skotnicka-Chaberek
I would be the one to join in. I, I think, would like us not to talk about control, but rather to talk about the fact that children need our attention, interest, involvement and not knowing where my child spends most of his time and with what. This is a kind of neglect of his needs.

Maria Galczyk-Wojciechowska
Yes, exactly.

Magdalena Skotnicka-Chaberek
And it's not even about how much time he spends there, it's about how and whether I share that time. Do I know how it learns and from whom? I'm not talking about schooling, but does it browse the internet? How successful is suicide? Is he browsing? How do they cope with everyday life? Because it makes a huge difference. But probably the most important thing is that if we want children to share with us, we have to share the world with them. We can't just order them around. To say you are allowed so much, you are not allowed so much, because that will breed rebellion. And if we thought to ourselves We want to be there with you, we want to know what you are doing. Maybe we would be in a little bit of a different logic, Because I'm always a little bit afraid that those who don't control, they're not going to control anyway, and those who hear the word control, they're going to think you have to control even more. And their children will then run away from control even more into the network.

Maria Galczyk-Wojciechowska
Sure, I think it's also primarily about the quality of that time. Yes? If it's used in a really constructive way, because here we also can't take the extreme view that all social media or the internet is evil. Yes, only the amount of time and the quality of this time spent online is an indicator of what the causes of this might be. Sorry. So it's as if here the very, very conclusions that you have given here are very appropriate.

Monika Rachtan
So it is precisely about quality. About attentiveness, about being with that child and not ordering and forbidding. Martyna But tell me from your perspective do you work in a pharmacy? In an open pharmacy where people come in every day, queue up. Do you watch them? Sure. Or do you have this feeling that we've got this phone glued to our hand, that we're already. That you have, for example, situations where someone comes up to the window and listens to some stream on headphones and wants to buy medicines from you.

Martyna Szaniawska
Yes, it is a very common, very big surprise when. It is raining. Asking simply to join the conversation, because a pharmacy is not a shop. And sometimes you have to ask what dose, for whom, what were the symptoms, what was taken before. And patients have headphones and can't even switch off for a second. Also, the other people who are waiting to be served, even the few minutes they spend there, are either on their phone or listening to music. This also drowns out the work and it is hard to calculate things when there are ten such patients in one visit to the pharmacy. So we observe this. Unfortunately, we don't meet the patient's understanding if we ask them to mute a little bit, that it's the place for your sake that this patient just needs to be served in focus and in silence. I've been working for 10 years now and I see some things that were there before and some things, trends like that I see in young people. Now the Anti-Drug Addiction Act has come in and I can already see my patients, whether younger or older, but just before the Act and after the Act, where the legislator has set us how much of an active, psychoactive substance can be given to an adult. It used to not be so verified. We didn't have the right to check the ID card and verify. And it was very common for young people to come and buy these drugs, which have a stimulating and stimulating effect, which improves concentration at a certain point. But then they became strictly addictive. Now, of course, young people are coping with other drugs, alcohol and cigarettes. They also deal with access to drugs. They ask their elders, their older friends, to buy such drugs. But this is also where the attention of the parents of first aid kits comes into play. Because these medicines are available in cold medicines, cough medicines. They are available to these younger patients and are often simply taken from the medicine cabinet. Parents don't control that a certain medicine disappears more often, or that no one has been ill and they don't have that pack already. So it exists. This problem is there and it exists. Here, too, we need to look at controlling the medicine cabinets and the medicines that are there.

Monika Rachtan
Exactly, because this mechanism of addiction he Whether for social media, or for cigarettes, alcohol, drugs works in the same way. And sometimes this exclusion, this loneliness that occurs in a child, caused precisely by being on social media and not in the here and now, ends up in another addiction that is realised, for example, in a pharmacy.

Martyna Szaniawska
I would also add that these young people want to fulfil expectations. We have expectations of them, that they have to have lots of hobbies, they have to be the best at everything, and they actually don't have enough energy anymore. And it's apparent that they must be at a stage when they are absorbing everything not eight hours, not ten hours, but actually from 8 a.m. to 8 p.m. These tutoring sessions are all And they want to help themselves in some way. These tests, all these credits. There's less and less of that time, there's more and more expectations. Including us adults.

Monika Rachtan
This is now to ask the younger generation. What do you do online?

Paweł Mrozek
In fact, online, the younger generation does everything. I assure you everything on possible social media. Whether it's uploading photos of really everyday life, of everyday routines. It is only worth pointing out here that there are certainly some important voices here, but also that we must not close ourselves off a little to the times in which we currently live. We are living in times where social media, the Internet and the telephone are inseparable places where young people spend their time. And this is where

Monika Rachtan
Paul tell me, would you as a young person be able to function, let's say at school, get things done at school, at university, without access to social media, without access to the internet? Would you be able to function? And I'm not talking about whether you would be able to talk to your friends, just the kind of things that you have to do, that are your responsibility.

Paweł Mrozek
Well, yes, looking at the fact that I've been active in activism for a few years now, there's no guarantee that it wouldn't be possible to do exactly that on a scale, that is, nationwide, or even in student government at a particular school, if you didn't have access to these social media. But of course social media has a lot of disadvantages, it has a lot of places where you have to react and you have to counteract things. But social media also helps a lot in dealing with everyday issues. And, of course, as we've just talked about control here, it's about control in consultation with the child, in consultation with the young person, so that this doesn't turn into so-called surveillance. Because if young people feel that they are being controlled very strongly, that it is against their will, then they will become even more isolated and distrustful of the parent. So here parents and adults in general have a really hard task to approach such a young person, a child, consciously. And to discuss together how to introduce such control, so that it is not control, but more trust.

Monika Rachtan
Partnership.

Paweł Mrozek
Partnership in conversation.

Monika Rachtan
Kamila We are ready.

Grzegorz Juszczyk
If I may add one thing, it is indeed crucial, as you have now said, because we like to control, we do not like to be controlled, and this applies to every age group. On the other hand, I have this impression that in the wave of development of the popularity of social media, the instruction manual was missing. In other words, we have not received from any state or private institutions, not even from the creators of social media, an instruction manual which would tell us how these media work, just as you said, what the benefits are, what the potential limitations are, what we need to pay attention to, because social media are also a product designed in such a way that now we cannot imagine life without them, but both parents and young people need such guidelines. I'm very glad we're talking about this, because there's still a lack of understanding of how algorithms work, why what appears to us there is not entirely our personal preference, but the result of various other processes that even physicists often don't understand. But this is extremely important. Last sentence I don't use social media. Students always ask me why? I don't, I just say that I'm so busy that I would only get information about great things that I can't participate in, that I miss out on, which would cause me frustration. And so I'm freer from that. But really, people younger than me, students or just post-grads, are already functioning in just such a world and just need these instructions, tips on how to deal with heckling or overexposure in society too. Ugly words, but I'm sure your doctor will explain that too.

Monika Rachtan
But the professor said one very important thing, which is this operating manual. The only thing is that we are not going to come up with this instruction manual on our own. Nor do we have specialists who can create it for us, because de facto no one knows how the algorithms will work tomorrow, the day after tomorrow, next week. It is a great mystery. Maybe a bit of a surprise and maybe it's time that the very social media developers who know the problem know that it exists. They know that in many countries various solutions have been introduced to somehow regulate all this, to try and make it happen, that in Poland, too, it is time for such a discussion to begin. Because the fact that we are sitting here and working out, and actually discussing the problem, is not going to change anything. We already need to sit down at a round table and simply come to an agreement together so that everyone is happy with the situation. And that's exactly Kamila. Are we, as parents, are we ready to sit down at the table and have such a conversation? Are we aware enough now to know that it's impossible to function without social media? But on the other hand, are we so attentive that we know that our children can get hurt in that social media, somewhere, in that black place.

Kamila Kadzidłowska
I would very much like to answer your question in the affirmative, Monika, but I am afraid that there are, of course, some bubbles, the so-called bubbles of parents who are very aware, very attentive, who have long been distrustful of what our children and we have been given in the form of social media or highly addictive games. But I also have the experience that very often these aware and attentive parents, who have already given the first symptoms, these warning signs in their children's behaviour, have consulted psychological services, but very often also heard at school that Everything is for the people. We used to be afraid of television too, and please, nothing happened. I could simply quote endlessly these kinds of sentences coming from the mouths of adult authorities. And there is absolutely no support from legislators. Still Big Tech has really entered our lives very strongly. It is true that the European Union has a law on digital services, and these issues related to access to electronic devices and their content, including in the context of disinformation, should be regulated, but this has not yet been translated into our lives in any way. I still have the impression that the prevailing attitude, even of our new authorities, who theoretically have this subject on their agenda, is that the free market should not be regulated too much. So here we are again left with the problem alone and our children too.

Grzegorz Juszczyk
If I can just say one more sentence, because this is an extremely important voice. A recent report appeared on the Internet of Children. I highly recommend reading it in the context of digital hygiene. It contains a very important sentence. The big techies care about the language they use and whether we understand it in a similar way. What matters to the big techies is the user, and one of the theses in the report clearly states there are no users, there are people. So algorithms that subjugate some content that they call user engagement is actually human engagement, which can also have a number of negative consequences. So absolutely, as we've already talked about, if we don't regulate and yet these companies aren't 118 or 250 companies you only have to talk to.

Monika Rachtan
It really can be sorted out at one table.

Grzegorz Juszczyk
We will not succeed.

Kamila Kadzidłowska
I would just add one more sentence. It seems to me that a big problem is that even if the parents try to do something, they are not an island. However, this family functions in some, in some environment, in some society. In this case, of course, because we don't really have public spaces, such public spaces, where children could alternatively spend this time.

Monika Rachtan
They are shopping malls.

Kamila Kadzidłowska
Well, yes, but in these shopping malls we in turn have other addictions too, and shopping, and comparing ourselves and so on. But also the electronics, that's what's prevalent. We don't have these healthy spaces to spend time.

Monika Rachtan
I, of course, said this about the shopping malls with sarcasm, because I always wonder, when I am in such a place, what those children are doing there and why there are so many of them in that place.

Kamila Kadzidłowska
And where should they go? What my teenage son tells me. Mum, and where should I go? I don't have any place. We have a lot of discount stores around, also discount stores are springing up under schools to educate children to shop for things that are absolutely unhealthy for them and totally addictive. Not to mention stimulants that look like candy to children. Electronic cigarettes or alcohols that are beautiful and colourful. All of these things are being placed by officials in the name of the law in our space, where there should be healthy spaces for recreation and for children to develop. So we in our families are not these lonely islands, and I have a feeling that whatever we do, it may not succeed, unfortunately, if there is no systemic support at school, in the authorities, if such topics are not a priority.

Monika Rachtan
Paul I will ask you about the shopping mall. Why do you guys hang out in shopping malls? Is it actually the kind of place you sit in? Well, because it is not raining, there is reasonably pleasant music, you can have a coffee or. Do you come there for a specific purpose, that there are just stimulants available that you can reach for. Someone looks the oldest, so they go and buy such goods. What do you do in shopping malls?

Paweł Mrozek
This varies many times. It depends on the age group. To be honest, just using the example of my brother, who is now in his first year of high school, well, every possible available time just with his friends is spent in such a shopping mall many times, whether going to the cinema or even browsing through various shops. But it also doesn't always look like I'm talking about now. Many times, however, young people are looking for an escape from these stimulants. It is precisely these stimulants that show up, which is obviously very bad, but there is also no such thing as systemic, systemic control over this. In addition to what the professor said earlier, about the instruction manual for these social media, I also think that this instruction manual should be provided at school level, at the level of education, because I really will mention this many times at various conferences in a moment. What we are proposing is direct education about digital hygiene, so that young people learn about it at school, about what is good and what is bad. This is something that is currently not taught to young people in Polish schools, unfortunately, and at the same time, when we are talking about young people, it would also be useful to reach out to parents so that they can be listened to on this subject. And what the professor also said about the last report. Of course, there are a great many of these reports, and it is hard to count how many I have been to, and unfortunately after the conferences the report is published on the website, and those in power are no longer interested in it, and we need to find systemic solutions that will also be implemented, and implemented honestly, because, of course, politicians have different goals, different promises, different commitments, but there are subjects that should not and should not divide, but should unite. And this topic, in my opinion, is precisely the mental wellbeing, the mental wellbeing of children and young people.

Magdalena Skotnicka-Chaberek
If you can, because this is also very important, because mental wellbeing is not just about social media. It's very easy sometimes for those in power to grab Well, yes, let's restrict the internet, let's do some simple sham activities, let's do some 'no mobiles in school' campaign, let's take away something that children already have and continue to stay. With the fear, with the sadness, with the loneliness, with the ideals served to them where you have to be great, to cope, to be enterprising. You can't have failures.

Monika Rachtan
Don't look.

Magdalena Skotnicka-Chaberek
And a large proportion of these children don't actually always know how to. Often they have to spend a lot of time catching up with their peers, and they abstract from populations like kids with ADHD or kids with high-functioning symptoms of the autism spectrum, who for whom sometimes social media is the only place to exist in a group and for whom it is a help rather than a brake. Used well, of course. It's very easy for those in power to throw around the slogan now it's mobiles that are doing the damage. That's why we have so much depression, instead of looking at the fact that it's a situation that today's generation of children are facing. It's not the stable situation of the 1980s. But the world has changed slightly. There are children in their classrooms who survived the war. There is an emerging fear, an anxiety. Kids are becoming more climate-conscious, smarter, and smarter, and we're trying, as adults do, to put it together somehow, to measure our fears too. And instead of thinking that we actually want what has already been said here today, that we want it to be an actual person on the other side, as a user of these social media. I think to myself that we are also looking for solutions that will allow us, as it were, to direct prevention not globally, but to choose which things. Well, nowadays, the best way to find out how children use the web is from them. They are the masters, they will tell you all the nuances, the bits and pieces. Everything I learned about the computer, I learned from my charges. When I come and I have a problem and I don't understand a phenomenon on the web, I ask a question.

Monika Rachtan
They are the helping hand.

Magdalena Skotnicka-Chaberek
And all of a sudden a group sits down and says Well, because it's like, you're a bit old and stupid in this area already and it would be good for you to have a look here, here, here and here. And when a dangerous phenomenon occurs, it's common for older patients to send an email. Pay attention, because it is, because children will live in a certain virtual reality, because that's what the world has become. That is, we will not learn to live there with them, to look at what is important there. In Roblox we will find all the same things that we find in life from religious practices imitated to violent phenomena. And it looks innocent, it's a simple game for children. I won't mention Minecraft. These things are on different servers.

Monika Rachtan
Maria, the Patient Ombudsman is taking many initiatives. These are also initiatives to cooperate with the Ministry of Health, with the creation of various programmes. This is the case with disinformation, which is also on the web, which also appears, also very difficult to identify, very harmful, and we will also talk about this in a moment. But here, in terms of this very protection of the rights of children, of patients, yes? Because they are patients too. Are you considering any measures here, or are you already carrying out any measures that will aim to make this round table that we have mentioned and this social media manual together with the companies that create these social media possible.

Maria Galczyk-Wojciechowska
I mean, I think it is worth emphasising the fact that the Patient Ombudsman is very actively involved in various systemic solutions that he runs together with the Ministry of Health. And one such recent development I can just mention was the establishment of cooperation between the Ombudsman for Patients' Rights and the Chief Pharmaceutical Inspectorate. It is such an agreement, which is aimed at taking action, exchanging information between the Ombudsman and this Main Pharmaceutical Inspectorate in terms of ensuring that we, because practically all of us will one day be, or have been, or will be, patients of such safety on the Internet, because there are more and more of these. Such paramedical sites where medicines are sold that are not, in fact, medicines. Therapies are offered which generally have nothing to do with the application of current medical knowledge, but are therapies. Just as there is now a buzz about charlatanry, yes? It is very popular and I think that this cooperation will also be fruitful in this respect, because the Chief Pharmaceutical Inspector is the guardian of this drug safety, pharmaceutical safety, and the Patient Ombudsman is the guardian of the welfare of patients and making sure that their rights are respected. And we cannot hide the fact that it is the sense of safety of the patient, the quality of services provided in medical entities, that is a priority for the ombudsman. So in order to take care of this, this cooperation was established in the Ministry of Health, because this cooperation was there, this agreement was signed and we count on the fact that it was done relatively recently, so we count on the fact that this cooperation will develop and will have a very positive impact on the fact that each one of us will feel safe when we just browse the websites where I can actually buy Yes, because there are online pharmacies, that the medicine that I buy is a medicine and not a paramedic, So here it should be emphasised. We also participate in meetings of the Health Committee, as well as in meetings of such parliamentary teams, e.g. recently we actively participated in a meeting of the Child and Adolescent Mental Health Team, where the topic of digital addiction and online gambling was discussed. So our activities are very much ongoing.

Monika Rachtan
Martine Does it happen to you that patients just come into the pharmacy and tell you about the advice of charlatans? They consult or ask you for some medicine that de facto doesn't exist?

Martyna Szaniawska
This is the everyday, this is the everyday. Practices that they have picked up on the internet somewhere and do not translate at all into medical data and current knowledge, medical knowledge. It is an everyday occurrence from the simplest headache relief to vaccinations, which we have also talked about more than once, so it is a river subject, it is on this topic of acquiring medicines on the Internet. When it comes to adolescents, I observe the willingness and the acquisition of these drugs when it comes to steroid drugs. And it's just that I'm different and I want to be taller, I want to catch up with the looks of my peers so these drugs are harder to acquire, so normally, legally, so so it's an environment of such gyms, an environment of just acquiring this on the internet. And unfortunately, here I have to say that we adults, when we buy weight-loss drugs, which are expensive drugs in a pharmacy, but on the Internet it turns out that somehow they are cheaper. They also pick it up from us and imitate it. But steroids are another one, another group of drugs that I observe. In addition to codeine, dexomethorphan or these types of substances, where patients, those who are in their adolescence, want to acquire them there and they acquire them yes? And this is also what happens in the galleries, that they are, they make an appointment just to pick them up in such public places, where it doesn't cause any embarrassment to give something or, any exchange.

Monika Rachtan
In other words, it turns out that social media can not only be addictive in themselves, but can also be a platform through which children, young people, but also us adults, can obtain addictive substances. With this in mind, I will leave you for a short break, and in a moment I will invite you to the second part of our meeting. Thank you very much. My guests were Professor Grzegorz Juszczyk, PhD, Magdalena Skotnicka Chaberek, PhD, Kamila Kadzidłowska, Martyna Szaniawski, Paweł Mrozek and Maria Gałczyk Wojciechowska. Thank you. I would like to invite you after the break.