Yesterday, I tweeted—sorry, in Dutch—a lot of reactions to a debate program on TV. Yes, I feel old. In the discussion, the claim was repeated that the current mental health crisis among young people is caused by social media and smartphones. This claim has now become very popular because of the new book by Jon Haidt. One problem is that most of the studies Haidt is using are correlational in nature. On this blog, you can find a lot of studies showing that it’s not necessarily the cause that this causal direction is correct.

Last week, I discussed this topic with other researchers in this field, and we agreed that making bold claims can make things worse, as it puts people like us who want to remain cautious almost immediately in the other corner of the discussion.

My biggest fear about putting a strong emphasis on social media alone without hard evidence is that we may be overlooking other possible explanations for something that probably has multiple causes.

My dear friend Paul Kirschner shared this paper by Foulkes and Andrews on social media—yes, I do get the irony—with a possible other, extra explanation: our extra attention and care for well-being. Their article calls to test the prevalence inflation hypothesis. For the people who can read Dutch, there was a good, accessible article in De Standaard the past weekend examining the same claim.

What are they talking about?

Here we present the hypothesis that, paradoxically, awareness efforts are an additional factor contributing to the recent rise in mental health problems. Moreover, we argue that the relationship between these two constructs is bidirectional. Increased rates of mental health problems understandably drive more awareness efforts, but the awareness efforts themselves might lead to increased reporting and experiencing of symptoms, as we describe below. We therefore propose that mental health problems and awareness efforts are affecting each other in a cyclical, intensifying manner (see Fig. 1). We term this the prevalence inflation hypothesis.

The biggest challenge is that one might think that many young people are exaggerating or faking it. This would be a huge mistake. They are rather part of the mechanism; I wouldn’t dare not take them seriously. But is something extra worth examining.