U.S. Youth Face Unprecedented Mental Health Challenges, Says Surgeon General

The U.S. Surgeon General said he is gravely concerned about the “unprecedented” obstacles facing young people — from climate change and racism, to the “culture of comparison” embraced by social media.

“We think of high school as a time where your life is opening up for you, but nearly half of high school kids are feeling despondent about themselves and about the future,” noted Vivek Murthy, MD, MBA, speaking at a Washington Post live event on Wednesday.

According to a nationwide survey, 44% of high school students said they feel “persistently sad or hopeless.” Even before the COVID-19 pandemic, suicide rates jumped 57% among kids and young adults ages 10 to 24, and have only worsened in some states since.

On top of these alarming statistics, there are other concerns, Murthy said. For example, it takes, on average, 11 years for a child to receive treatment after developing symptoms of a mental health problem

Asked whether it’s possible that “social media contagion” has led susceptible children to mistakenly believe they have a mental health problem or disorder, Murthy said he’s heard this concern, but does not believe that to be the case for the majority of children. In fact, he noted, the bigger concern is children who are struggling in silence.

“There are so many children I encounter who are bullied that don’t feel comfortable admitting that because they feel that that says something about them, that they’re weak, that they’re not worthy, that they can’t defend themselves. And so there is still a heavy burden of stigma and shame that people carry around the country,” he said.

Asked what makes this era uniquely challenging for children, Murthy offered a few examples. For one, when he was a kid, if he embarrassed himself in class, only 25 or 30 people knew about it. “Now, a child does something that may be embarrassing and hundreds of thousands of people may learn about it online,” he said.

Bullies aside, social media can still be deeply damaging to a child’s self-esteem, he added.

“What social media does for many people is it accelerates a culture of comparison that already exists in society,” and allows that comparison to persist on a “moment-to-moment” basis throughout a child’s day, he explained. “And all of this leads to an experience of technology that can be really hurtful to people in terms of their relationships and their sense of self at a time where kids are still developing in terms of their identity.”

Young people today are also feeling the weight of multiple “existential, profound crises,” all of which impact how they see the future, Murthy said. While none of these problems are new, kids are now exposed to news on the internet around the clock.

Asked specifically about the dangers of screen time and social media, Murthy stressed that technology isn’t always bad. Some children have found friends online who share their interests or communities accepting of their identities.

However, parents should be aware of how much time their children spend on social media. It’s also important to know if their child is being bullied or if the experience of being online is making them feel worse about themselves and their relationships.

“Is it crowding out their time with family and friends? Is it reducing the amount of time that they actually spend going out and playing? Is it compromising their ability to do their work for school?” If the answer to any of these questions is yes, then something needs to change, he said.

Asked whether he wished he could eliminate all social media for children, Murthy didn’t dismiss the idea outright. “If it was left up to me, I think that I certainly wouldn’t want kids using social media in middle school and I’d also be quite concerned about them using it … early in high school,” he said.

One solution that he’s started to see is parents making pacts with each other to keep their children off social media until a certain age — usually somewhere between 15 and 17 years old. “These pacts are actually much more effective than an individual parent trying to make the decision, because then at least your child looks around and they have peers who are similarly not using social media at that age,” he noted.

For both children and parents, the concept of having a “sacred space” free of phones, tablets, and other technology is another promising solution, Murthy said. It could be the dinner table, or it could be a point in time — just before bed, or as everyone is waking up in the morning.

It’s vital that parents model good behavior here, he added. “If we’re going to prioritize our time with people, and make sure we’re fully present and not distracted by our phones and want our kids to do that, we’ve got to do that as well,” he said.