Social media use frequency and adolescent mental health: context-dependent associations by school connectedness and parental monitoring in the 2023 YRBS

Abstract Objective To examine associations between social media use frequency and poor mental health among U.S. adolescents and to assess whether these associations vary by school connectedness and parental monitoring. Methods We analyzed data from the 2023 National Youth Risk Behavior Survey, a nationally representative survey of U.S. students in grades 9–12 (n = 10,340). Social media use frequency was modeled as an ordered exposure, and poor mental health was defined as reporting mental health “not good” most of the time or always in the past 30 days. Survey-weighted logistic regression models estimated associations between social media use and poor mental health, adjusting for grade, sex, and race/ethnicity, with effect modification assessed using interaction terms. Results Overall, 28.5% (95% CI: 26.7–30.4) of adolescents reported poor mental health, and 77.0% reported high-frequency social media use. Higher social media use frequency was associated with higher adjusted odds and predicted probabilities of poor mental health. Associations differed by social context (interaction p < 0.01). At the highest levels of social media use, adolescents reporting low school connectedness had approximately 15 percentage points higher predicted probability of poor mental health than those reporting high connectedness, with similar differences observed by parental monitoring. Conclusions Associations between social media use frequency and adolescent mental health are context-dependent. Supportive school and family environments are associated with lower risk across levels of social media use, highlighting the importance of social context in adolescent mental health prevention research.