U.S. Surgeon General: How to Address the Youth Mental Health Crisis

Children are the future — but they need our help now.

The United States is experiencing a youth mental health crisis that is more than a decade in the making, and COVID-19 has exacerbated issues that had been looming in the shadows.

Even before the pandemic, marginalized groups were presented with social and economic challenges that disproportionately affected their mental well-being.

In March 2022, the Centers for Disease Control and Prevention (CDC) published a report highlighting a steep decline in teen mental health, with more than 1 in 3 students feeling persistently sad or hopeless. Mental health outcomes were worse among BIPOC and LGBTQ youth.

Kids these days are not alright — and for many children in the United States, the pandemic is far from over.

While most kids are back in classrooms and mask mandates and social distancing measures have lifted, we don’t yet know the long-term repercussions of the pandemic on youth mental health.

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Q&A with U.S. Surgeon General Vivek Murthy, MD, on Youth Mental Health

​​Many mental health conditions are treatable when diagnosed early. Yet a large national study from 2019 shows that nearly half of children with mental health disorders don’t receive appropriate care due to barriers, disparities, and a lack of policies that prioritize well-being.

Vice Admiral Vivek H. Murthy, MD, MBA, the 21st surgeon general of the United States and father of two young children, is advocating for the mental health of our nation’s young people.

As the nation’s doctor, Dr. Murthy has traveled to schools across the country and witnessed the mental health challenges that today’s kids are grappling with. His book, “Together: The Healing Power of Human Connection in a Sometimes Lonely World,” is a testament to his passion for emotional wellness.

“I can’t think of something more important than making sure our kids are well and taking care of their physical and mental health,” Dr. Murthy told Psych Central. “We have so much work to do — but as a country, we’ve been behind when it comes to investing in taking care of the mental health of our kids.”

I recently spoke with Dr. Murthy via Zoom to learn more about the state of our nation’s youth mental health crisis and what can be done to support the well-being of young people.Courtesy of the Office of the Surgeon General

What are some of the biggest immediate and long-term risk factors for youth mental health and well-being?

Dr. Murthy: I’m worried that we don’t always see the impact that COVID is having on the mental health of our kids — it can be difficult to measure. Kids don’t always come out and tell us they’re having a hard time and may not always realize it themselves.

Then there’s the physical health impact, as we’re still learning more about long COVID, and the impact on both kids and adults. Our children do much better with COVID overall, but some of our kids have struggled with long COVID.

In fact, thousands have been hospitalized and hundreds of lost their lives. I want to make sure we’re doing everything we can to protect our kids from this virus, which includes making sure they’re vaccinated.

Kids don’t live in a vacuum — they’re sensitive to the stress levels and the mental health and well-being of the people around them, particularly their family.

We also know that more than 160,000 young people have lost a caregiver to COVID-19 — that’s a very traumatic experience, and that trauma may be with a child for years.

Many kids have had their lives disrupted and many have lost friendships or fallen behind in school. These are all elements of the broader impact of COVID we have to consider.

I’m worried about the learning loss that kids have experienced and I’m concerned about kids’ physical health and their mental health in terms of anxiety, depression, and loneliness.

I’m also worried about the mental health impact on the people who care for them — their educators and parents. Kids don’t live in a vacuum — they’re sensitive to the stress levels and the mental health and well-being of the people around them, particularly their family.

We have to give care and consideration to how COVID has impacted parents and recognize the toll it’s taken on educators. These are the people who are caring for our kids. If they’re not well, it’s hard for our kids to be well, too.

What challenges do kids from marginalized groups and communities face and what can be done to address them?

Dr. Murthy: Racial and ethnic minorities, immigrant families, and LGBTQ children were struggling the most before the pandemic, and they’re also the ones who’ve been hardest hit. We know that Children of Color have disproportionately experienced the loss of caregivers.

Many marginalized communities face critical roadblocks when it comes to accessing physical and mental health care. Many have experienced language barriers, racism, and discrimination in treatment settings, and are also contending with a distrust of the healthcare system due to historic bad experiences.

When you put all of this together, you begin to understand why marginalized communities have experienced worse healthcare outcomes over the years. This is something that we absolutely have to change right now.

We’ve got to recognize that these disparities exist and acknowledge them, and make commitments to closing the equity gap when it comes to access to care.

We’ve got to measure our progress and hold ourselves accountable, not just with an eye toward increasing treatment and prevention but making sure these resources actually get to the communities that have been hardest hit.

It’s so important for your mental health and well-being to know you matter — to know you’re valued.

One of the most damning things about disparities in healthcare is they tell kids that they matter less.

If you feel that you have less access to the healthcare system, if you feel like society cares about you less, that sends a powerful and negative message that can negatively impact your mental health.

I believe we all have three basic needs across cultures:

  1. We all want to be seen and understood for who we are.
  2. We all want to know that we matter.
  3. We all want to feel that we are loved.

One of the most damning things about disparities in healthcare is they tell kids that they matter less. And that’s one of the reasons why we have to make sure that help is available to those who need it, whether that means access to affordable insurance coverage or healthcare providers.

We’ve also got to make sure the healthcare workforce reflects diversity. Right now, we don’t have enough People of Color serving as mental health providers in the United States. In fact, the American Psychological Association estimates that only about 3% of the 110,000 psychologists in the United States are Black.

We’ve got to make representation matter. One of the many things we’ve got to do to close these equity gaps is to make sure we’re building a workforce that reflects the community it’s seeking to serve.Courtesy of the Office of the Surgeon General

What can be done to support student and teacher well-being at schools?

Dr. Murthy: Two populations that have put their hearts and souls into caring for the rest of us during the pandemic have been educators and healthcare workers — and they are burning out at an extraordinary rate. We have a moral obligation to care for those who’ve been caring for us.

Just recently, I was at an elementary school and the teachers were telling me how they’re seeing a significant increase in anxiety and depression among elementary school students. They’re seeing an increased amount of self-harm taking place among their students — and it breaks their hearts.

As educators, they know that even if it’s not their explicit job to address the mental health impact of the pandemic among kids, they want to be able to help. They came to their profession because they wanted to serve and support kids.

We have to bring mental health resources to educational settings and to communities where people are often disconnected from the healthcare system. This is where school counselors are so important; why high quality virtual care is so important.

We’ve got to provide teachers with the right kind of training and support so they know how to recognize when kids are struggling, but also have people and resources they can direct those children to. If we place the entire burden for addressing mental health concerns on teachers I don’t think that’s fair to them and I don’t think that will lead to the most optimal outcome.

Ideally, we want to have a healing environment at school and at home.

We have to find ways to support parents as well. Our kids spend a lot of time in school, but they also spend a lot of time at home. Both environments matter to their mental health and well-being. We’ve got to recognize that parents have been through so much during this pandemic and so many have faced economic challenges — and many have lost loved ones themselves.

Ideally, we want to have a healing environment at school and at home. If we can help schools to be a resource for parents to help them understand what’s happening with their kids, that would be a win-win for everyone.

How can parents, caregivers, educators, and even healthcare professionals, talk with kids about concerns about an uncertain future?

Dr. Murthy: COVID is not the only source of stress in kids’ lives. Both during and before the pandemic, many young people were grappling with violence and racism in their communities. And we know that climate change exists as an ongoing threat in the lives of many young people.

These broader threats color how our kids feel about their lives and reduce the hope they feel about the future.

It’s important to talk with our kids about these issues so that we understand what they’re feeling — and to let our kids know that mental health struggles are part of the human experience. We need to make sure our kids know they’re not broken or defective.

And we need to remind our kids that it’s OK to ask for help. I’ve encountered so many children over the years who don’t ask for help because they feel ashamed — but there is no shame in asking for help.

It’s so important during times like these where our kids are facing uncertainty and seeing many threats — whether it’s racism, violence, war, climate change, or COVID-19 — to remind them that you as a parent are a source of unconditional love in their lives.

Unconditional love and support go a long way — it’s something our kids will hold on to and look back on as a source of comfort.

It’s true that as parents, we can’t fix everything for our kids. We can’t make sure they’re never going to get hurt — and we want them to be able to face adversity in a healthy way to become even stronger thereafter.

That’s why unconditional love and support can go a long way. It’s something our kids will hold onto and look back on as a source of comfort.

Decreased physical activity during the pandemic is associated with increased depression, anxiety, and screen time. How important are diet and exercise for mental health?

Dr. Murthy: Our mental health and our physical health are closely connected. Exercise and diet are an important part of any plan to support and sustain one’s mental well-being.

Regular exercise has wide-ranging health benefits. Even short bursts of physical activity, like going for a walk or taking the stairs, can improve your energy and mood. We know that diet can improve our mood as well because what we eat has an impact on how we feel.

So we have to think about diet and exercise as part of our broader mental health plan. I think it’s important to have your own personal mental health toolkit of things you can reach for when you’re feeling down.

It takes time and dedication to exercise and eat well. That’s why we need to draw boundaries around how we use technology so we can spend time with people and be physically active together — whether it’s going for walks with friends or playing sports with classmates. Courtesy of the Office of the Surgeon General

How do you set boundaries around screen time with your children?

Dr. Murthy: A lot of us, myself included, struggle with our use of technology and how to draw boundaries. Parents who are thinking about how to guide their kids’ technology use can start a conversation with them about what a healthy use of technology looks like.

Technology can be helpful to us at times, but it can also be harmful. It’s about how we use technology and the boundaries we draw, and making sure we don’t crowd out healthy sources of human interaction with family and friends, and even strangers.

It’s important for us as parents to work on a plan with our kids to set those boundaries. Decide together which times of the day are going to be free from tech and screens. One thing we do in our house is we make dinnertime a time we try to protect just for us for face-to-face interaction and conversation.

It’s also important to lead by example. I remember when my wife and I were pregnant with our first child and a friend said, ‘your kids will sometimes listen to what you say, but they will more often listen to what you do,’ and that has proven to be true.

There’s nothing more humbling than being a parent — it’s the hardest job I’ve had, much harder than serving as surgeon general.

We try to make sure we’re practicing good technology hygiene and preserving and protecting sacred spaces in our lives to be with family and friends, to be physically active, and to have time to ourselves — and recognize that we’re imperfect parents as well.

I think it goes a long way for kids to feel like they have a partnership with their parents in figuring this out.

What else can parents and caregivers do at home to normalize the discussion about mental health with their kids?

Dr. Murthy: There’s nothing more humbling than being a parent — it’s the hardest job I’ve had, much harder than serving as surgeon general. Being a parent forces you to grapple with your own inadequacies, and at times, failures.

I think that parents are one of the most powerful influences on our kids when it comes to mental health. So just starting that conversation with your kids about their mental health is so important. It will mean something to them to know you were there to support them.

And finally, to all the parents out there, remember to take care of yourselves during this process as well. I know that as parents, we can feel selfish if we’re taking some time to ourselves to look after our health — but it’s not selfish and is in your own best interest.

Your kids will be their best if you’re in a good place, and you’ll be better able to care for them. Take time to look after your own needs and engage in activities that ground you and bring you joy because your well-being matters.

Parents have been taxed extraordinarily during this pandemic and it’s taken a toll on all of us. Please be kind to yourselves during this journey as we seek to take care of our kids.

Looking ahead

What can a brighter future for our young people look like?

According to research from 2022, changes to policy and investments in programming and care could help improve the mental health and well-being of children and their families. Other research shows that early intervention is key to better mental health outcomes.

While institutional changes won’t happen overnight, new policies around mental health are already being instilled at the federal level.

For instance, the U.S. Preventive Services Task Force recently drafted a set of guidelines recommending that children ages 8 to 18 be screened for anxiety disorders. And in President Biden’s State of the Union address, he pledged $1 billion in funding to increase the number of counselors and psychologists at schools.

These are promising developments, but as Dr. Murthy said, healing can also begin right at home.

“Love can last a lifetime,” Dr. Murthy said. “We just have to make sure that our kids know that we feel that for them — and that our love is unconditional.”

This interview has been edited for brevity, length, and clarity.

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Source: healthline