Intended for healthcare professionals

Letters Child and adolescent wellbeing during covid-19 pandemic

Consider internet use when assessing young people’s mental health

BMJ 2021; 374 doi: (Published 24 September 2021) Cite this as: BMJ 2021;374:n2324
  1. Vaishnavi Sornarajah, core psychiatry trainee
  1. London, UK
  1. v.sornarajah{at}

Having worked in child and adolescent mental health services, I recognised many of the approaches described by Rider and colleagues for assessing the mental health and wellbeing of children and adolescents in the covid-19 pandemic.1 But they didn’t discuss internet use.

While working with young people, I was struck by just how much of their current lives are spent online and how unprepared I was to explore this. I found myself asking about social media use around pro-anorexia and self-harm forums. The number of visits to these websites has exploded over the pandemic as we were forced to be inside with our thoughts and mirrors, and this is now reflected in the numbers of young people presenting to services.

Clinicians need to be more aware of patients accessing of harmful material online, as well as being open to the possibilities of the digital phenotype. By considering not just the patient in front of me but also the phone in their pocket, I was able to gather a fuller picture of each person.


  • Competing interests: None declared.

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