Nearly one in five pediatric psychiatric crises involve digital media, new study finds

A new study analyzing more than 3,700 pediatric psychiatric crisis encounters at a large tertiary children’s hospital finds that nearly 1 in 5 visits involved a digital media or device-related problem (DMRP), shedding light on an increasingly important but understudied factor in youth mental health emergencies.

The research, which reviewed electronic medical records from 2021 to 2022, identified DMRPs in 19.2% of crisis encounters among patients aged 6 to 17 years. These problems included a range of digital behaviors such as cyberbullying, exposure to harmful online content, excessive device use, and risky online sexual interactions.

“Digital media is now woven into nearly every aspect of adolescents’ lives, but until now, we’ve had limited data on how often it actually plays a role in psychiatric crises,” said Meredith Gansner, MD, assistant professor in the Division of Psychiatry at University of Rochester Medicine Golisano Children’s and co-author of the study. “Our findings show that these issues are not rare, and they are clinically meaningful. Incorporating questions about digital media use into crisis evaluations could help identify at-risk youth earlier and more precisely.”

Age and sex-based differences in crises cases

The study found that youth with DMRP-related crises were slightly older on average and more likely to have a mood disorder diagnosis. Mood disorders were the only diagnostic category significantly associated with DMRP presentations overall, with these patients nearly twice as likely to have a digital media–related crisis compared to peers without such diagnoses.

Sex-based differences were also notable. Female patients were significantly more likely to present with crises involving high-risk online sexual behaviors or relationships, while male patients were more likely to present with crises related to device access issues and excessive use that interfered with daily functioning.

“These differences align with patterns we see in community-based studies, where girls are more likely to experience online sexual victimization and boys more often show signs of problematic or excessive use,” Gansner explained. “Understanding these distinctions can help clinicians tailor anticipatory guidance and prevention strategies.”

Increased hospitalization and suicidal ideation

The study also highlights the connection between digital media–related problems and psychiatric severity. Encounters involving DMRPs were more likely to include suicidal ideation and to result in recommendations for inpatient psychiatric hospitalization. Certain subtypes, such as online conflict and exposure to high-risk content, showed especially strong associations with suicidal thoughts.

Importantly, the findings suggest that digital media may not only be a contributing factor to crisis but also a reflection of underlying psychiatric vulnerability. Youth with DMRP-related presentations were nearly twice as likely to have multiple psychiatric crisis visits during the study period, and those with access-related problems were especially prone to repeat presentations.

“Digital media-related crises often sit at the intersection of behavior, environment, and mental health,” Gansner said. “For some youth, devices may serve as a coping tool, and for others, online interactions can intensify distress. Recognizing these dynamics opens the door to more personalized care.”

The authors emphasize that while the study does not establish causation, it provides critical evidence that digital media issues are frequently present in acute psychiatric settings and may warrant routine assessment. The research also points to opportunities for intervention, including brief counseling for families dealing with device-related conflict and targeted screening for specific high-risk behaviors.

Given the rising rates of pediatric mental health emergencies nationwide, the authors argue that integrating digital media assessment into clinical practice could offer a practical step toward prevention.

“As clinicians, we are increasingly aware that we need to meet adolescents where they are—both emotionally and digitally,” Gansner said. “This study is a first step toward building evidence-based strategies that address the realities of today’s youth, and ultimately, toward reducing psychiatric crises.”