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Research problem and specific questionsThere is growing concern that use of social media can have negative effects on young people’s development, and can lead to depression, substance use and poor school performance. However, recent reviews have highlighted the lack of high-quality longitudinal studies that examine potential negative effects in a scientifically rigorous manner. As we move beyond examining the consequences of social media use in general adolescent populations, the next step is to identify subgroups that are particularly vulnerable to negative consequences of social media. Also, engagement in different social media activities might have different consequences, and different consequences for different adolescents. However, few high-quality studies have examined these questions.  The proposed project has three specific objectives: 1) To examine the directionality and magnitude of the associations between social media use and depression, alcohol use and school performance. 2) To identify subgroups for whom social media use has negative, neutral and positive effects. 3) To examine which types of social media activities might be associated with negative or positive outcomes, in both the general adolescent populations, and in subgroups of adolescents.Data and methodsWe will analyse data from two large longitudinal studies from Sweden and Norway that are among the first to include multiple measurements for social media use as well as validated measures of mental health, alcohol use and school performance. State of the art statistical methods such as random intercept cross-lagged panel models, and growth curve modeling will be used to analyse the data.Societal relevance and utilisationThe project will greatly improve the basis on which parents, teachers and policy makers make decisions about social media. If the results show strong negative consequences of social media use in the general populations of adolescents, universal prevention strategies and structural limitations on social media might be in order. If negative consequence are evident only in certain subgroups, more focussed prevention might be in order. No negative effect will mean little need for prevention efforts.Plan for project realisationOur team has direct access to already collected research data, and has sufficient methodological knowhow and research experience to execute this ambitions but realistic project in time, and to disseminate the the results to the wider community.

Research Problem and specific questions: Mental illness contributes to over one-fifth of the total disease burden in high-income countries, with mental illness that onset in childhood to have longer duration and poorer clinical and functional outcomes. Health promotion/prevention in Sweden is guided by the national public health policy with its eight target areas. The aim of the research programme is to develop a research line that takes a comprehensive approach on promotion/prevention for child mental health (0-18 years) by addressing policy, actions, and their effects on local level. In particular, four research questions divided into five work packages (WP) will be addressed.Data and methods: WP 1 address the role of societal investments for child mental health on local level where aggregated public health expenditures on county and municipality level are related to aggregated child mental health outcomes. National administrative register data for 2 12 457 children will also be used to examine if societal investments contribute to decreased mental health inequality and if the impact of income inequality is reduced by societal investments. WP 2 address how steering documents on local level target child mental health and inequality where steering documents from 20 counties and 290 municipalities are analyzed and whether their steering documents change after the implementation of the first structured long-term national policy on mental health and suicide. In addition to analyses of documents, qualitative interviews will be conducted with municipality representatives. WP 3 address the extent and quality of current child mental health promotion/initiatives in six municipalities with different population size, income level, and urban-rural density. Further, a child mental health index will be developed, tested, and associated with aggregated data on child mental health. WP 4 and 5 addresses which children that participates in promotion/preventive initiatives on local level and their collective effect on child mental health and inequality. Surveys will be distributed to 10,000 randomly selected caregivers of children (0-12 years) and 10,000 adolescents (15-18 years). Frequency and duration of different initiatives will be asked for as self-reported symptoms on mental health.Relevance and utilization: Child mental health problems increase in Sweden and while most promotion/prevention work is conducted on local level, their quality and effect are unknown. By addressing policy, actions and their effects on local level, the programme will remedy this knowledge gap.Plan for programme realization: Data will be obtained from open-source databases (aggregated data), from administrative registers, qualitative from interviews, and self-reported from surveys. Costs consist of salary costs for participating researchers, assistant and doctoral students, costs for data collection, and travel costs to municipalities and to international conferences.

Research problem and specific questionsYouth has been described as a life phase characterised by instability and challenges with potential implications for mental health. Yet, there is a lack of studies of the prevalence of psychiatric conditions among youth in Sweden. Accordingly, there is also limited knowledge about the degree to which young persons with psychiatric conditions receive care. This project follows a Swedish cohort of young people from age 15, and the aim is to study depression and anxiety at ages 20-23 years and to examine treatment gaps for these conditions. Another aim is to analyse differences in prevalence and in treatment gaps by gender, socioeconomic position and parental country of birth. Additionally, we will study how different coping strategies are related to depression and anxiety and to the treatment gaps for these conditions.Data and methodData are drawn from the Swedish national cohort study Futura01, combining survey and register data. The baseline study in 2017 was a school survey with students in grade 9 (t1, 15-16 y

n=5549, response rate 82%). The participants were followed up with a web survey in 2019 (t2, 17-18 y

n=4161). In spring 2022, the participants are followed up again with a web survey (t3, 20-21 y). In t3, the self-report instrument Patient Health Questionnaire-4 (PHQ-4) which screens for depression and anxiety is included. We will also carry out a fourth data collection (t4, 22-23 y) in 2024. All survey waves include measures on mental health, stress, social support and health behaviours. The statistical methods to be used include various multivariate techniques adapted to panel data.Plan for project realisationThe project will build on survey data from t1, t2, t3 and t4 and linked register information on specialist psychiatric care, prescriptions of medication, and sociodemographic characteristics. For parts of the data we also intend to link information on primary care from regional registers.RelevanceThe project will generate knowledge about the prevalence of depression and anxiety among young people in Sweden and about the unmet care needs for these conditions. More specifically, the project will inform about differences in prevalence and in treatment gaps between societal groups, as well as about the role of different coping strategies. Such knowledge is relevant for preventive work and early interventions, e.g., “first line” care which is a relatively new type of care that is still under development.