New report from US Surgeon General spells out mental health crisis and offers steps forward

The article below is Murthy’s introduction to “Protecting Youth Mental Health: The US Surgeon General’s Advisory”

Every child’s path to adulthood—reaching developmental and emotional milestones, learning healthy social skills, and dealing with problems—is different and difficult. Many face added challenges along the way, often beyond their control. There’s no map, and the road is never straight.

US Surgeon General Vivek Murthy. Official photo.

But the challenges today’s generation of young people face are unprecedented and uniquely hard to navigate. And the effect these challenges have had on their mental health is devastating.

Recent national surveys of young people have shown alarming increases in the prevalence of certain mental health challenges—in 2019, one in three high school students and half of female students reported persistent feelings of sadness or hopelessness, an overall increase of 40% from 2009. We know that mental health is shaped by many factors, from our genes and brain chemistry to our relationships with family and friends, neighborhood conditions, and larger social forces and policies. We also know that, too often, young people are bombarded with messages through the media and popular culture that erode their sense of self-worth—telling them they are not good looking enough, popular enough, smart enough, or rich enough. That comes as progress on legitimate, and distressing, issues like climate change, income inequality, racial injustice, the opioid epidemic, and gun violence feels too slow.

And while technology platforms have improved our lives in important ways, increasing our ability to build new communities, deliver resources, and access information, we know that, for many people, they can also have adverse effects. When not deployed responsibly and safely, these tools can pit us against each other, reinforce negative behaviors like bullying and exclusion, and undermine the safe and supportive environments young people need and deserve.

All of that was true even before the COVID-19 pandemic dramatically altered young peoples’ experiences at home, at school, and in the community. The pandemic era’s unfathomable number of deaths, pervasive sense of fear, economic instability, and forced physical distancing from loved ones, friends, and communities have exacerbated the unprecedented stresses young people already faced.

It would be a tragedy if we beat back one public health crisis only to allow another to grow in its place. That’s why I am issuing this Surgeon General’s Advisory. Mental health challenges in children, adolescents, and young adults are real, and they are widespread. But most importantly, they are treatable, and often preventable. This Advisory shows us how.

To be sure, this isn’t an issue we can fix overnight or with a single prescription. Ensuring healthy children and families will take an all-of- society effort, including policy, institutional, and individual changes in how we view and prioritize mental health. This Advisory provides actionable recommendations for young people and their families, schools and health care systems, technology and media companies, employers, community organizations, and governments alike.

Our obligation to act is not just medical—it’s moral. I believe that, coming out of the COVID-19 pandemic, we have an unprecedented opportunity as a country to rebuild in a way that refocuses our identity and common values, puts people first, and strengthens our connections to each other.

If we seize this moment, step up for our children and their families in their moment of need, and lead with inclusion, kindness, and respect, we can lay the foundation for a healthier, more resilient, and more fulfilled nation.

Vice Admiral Vivek H. Murthy, MD, MBA is the 21st Surgeon General of the United States.