By Ellen Passloff, MD, FAAP.
Trustee, King County Medical Society
When I started out in primary care pediatrics in 1994, we used paper charts, we had more time with each patient, and we diagnosed at most one patient with anxiety or depression each year.
Currently, I stare at computers all day, and I don’t have enough time to spend with my patients. My days are filled with an overwhelming In Basket of MyChart messages, phone calls, prior authorization requests, medication refills, and too many patients with mental health concerns.
My daily well-child counseling has also changed. Now I spend a good deal of time stressing the importance of screen time limits, getting outside, exercising, and getting enough sleep at night (with phones outside bedrooms and NOT used as their alarm clock). I also discuss gun storage safety, car safety, drug avoidance, and the importance of learning how to swim and ride a bicycle (it shocks me when I discover that some middle schoolers and high schoolers still don’t have these important life skills). However, the conversation about screens is always the longest, and the one most fraught with arguments from my patients.
Some of my patients report between 4 and 6 hours of non-academic screen time each day, on school days. These same patients report poor sleep, limited exercise, and anxiety and depression. Some of my patients have smartphones before they even reach middle school. Currently, I am grateful if I have fewer than three patients in a day with a diagnosis of anxiety and/or depression. I know many articles have been written about the ills of social media and how much it affects the lives of children and teens. I fully agree that technology has truly had a negative effect on the mental health of children today. I feel we need to do more to educate parents about the detrimental effects of technology on their children.
I am thrilled that schools are now restricting phone use during the school day. I’d also love to see more emphasis on outdoor exercise and healthy activities. Some of my patients don’t have PE because it rotates with music or art. All kids should have regular exercise built into the curriculum. I wish schools still used pencils and paper to teach children. And good old blackboards. Children need to write things down, work math problems out on paper, and take handwritten notes. Studies have shown that taking notes by hand helps with information recall. When schools rely on the use of screens so heavily, students have no qualms about spending so much of their non-academic time on video games, video watching, and social media.
When children and teens do end up suffering from anxiety and/or depression, therapy and medication are essential. However, it would be great to prevent the development of these mental health conditions in the first place. I would love to see a return to the days when computers and phones had no place in schools. Let’s bring back composition notebooks and pencils. I would love for cell phones to be reserved for older teens and adults only. There are simpler devices for parents who need to be able to communicate with their children who may be coming back from school on their own. I would also like to see regular exercise return to schools during all semesters, not just when they are rotating from music or art. Limited screen time, regular exercise, healthy eating, and adequate amounts of sleep are the best way to prevent mental health disorders.
We have all had to adapt to the use of technology in our professions, but it should not be the norm in schools or for entertainment during non-school hours. This is one area where I believe we will make more progress by reverting to the “good old days.”