Youth mental health cited as urgent public health issue

U.S. Surgeon General Vivek Murthy has issued a public health advisory on mental health issues in youth. “The challenges today’s generation of young people face are unprecedented and uniquely hard to navigate,” Murthy writes in Protecting Youth Mental Health. “And the effect these challenges have had on their mental health is devastating.”

According to the document, a Surgeon General’s Advisory is a public statement that calls the American people’s attention to an urgent public health issue and provides recommendations for how it should be addressed. Advisories are reserved for significant public health challenges that need the nation’s immediate awareness and action.

Even before the challenges presented by the COVID-19 pandemic, youth mental health has been in a steady decline. National youth surveys have shown that from 2009 to 2019, the proportion of high school students reporting persistent feelings of sadness or hopelessness increased by 40 percent; the share seriously considering attempting suicide increased by 36 percent; and the share creating
a suicide plan increased by 44 percent. Between 2011 and 2015, youth psychiatric visits to emergency
departments for depression, anxiety and behavioral challenges increased by 28 percent. Between 2007 and 2018, suicide rates among youth ages 10-24 in the U.S. increased by 57 percent. And early estimates from the National Center for Health Statistics suggest there were tragically more than 6,600 deaths by suicide among the 10-24 age group in 2020, according to the advisory.

“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,” Murthy writes.

Pandemic-related challenges

Recent research including youth around the world found that symptoms of depression and anxiety doubled during the pandemic, with 25 percent of youth experiencing depressive symptoms and 20 percent experiencing anxiety symptoms. Statistics from early 2021 show that emergency room visits in the U.S. for suspected suicide attempts were 51 percent higher for adolescent girls and 4 percent higher for adolescent boys compared to the same time period in early 2019. Experts also suspect that signs of mental health distress and other concerning childhood circumstances such as abuse were harder to recognize and report in the isolated environment of the pandemic.

The advisory notes that certain groups are at higher risk of mental health challenges during the pandemic, including youth with disabilities, youth of color, LGBTQ youth, low-income youth, youth in rural areas, youth in immigrant households, and foster and homeless youth.

The advisory notes that “although the pandemic’s long-term impact on children and young people is not fully understood, there is some cause for optimism. According to more than 50 years of research, increases in distress symptoms are common during disasters, but most people cope well and do not go on to develop mental health disorders.”

Everyone has a role to play in supporting youth well-being

The advisory states that “supporting the mental health of children and youth will require a whole-of-society effort to address longstanding challenges strengthen the resilience of young people, support their families and communities, and mitigate the pandemic’s mental health impacts.”

Key actions:

  • Recognize that mental health is an essential part of overall health. Mental health conditions are real, common and treatable, and people experiencing mental health challenges deserve support, compassion and care, not stigma and shame.
  • Empower youth and their families to recognize, manage and learn from difficult emotions.
    For youth, this includes building strong relationships with peers and supportive adults, practicing
    techniques to manage emotions, taking care of body and mind, being attentive to use of social media and technology, and seeking help when needed. For families and caregivers, this means addressing their own mental health and substance use conditions, being positive role models for children, promoting positive relationships between children and others as well as with social media and technology, and learning to identify and address challenges early.
  • Ensure that every child has access to high-quality, affordable and culturally competent mental
    health care.
    Care should be tailored to children’s developmental stages and health needs, and
    available in primary care practices, schools and other community-based settings.
  • Support the mental health of children and youth in educational, community and child care
    This includes creating positive, safe and affirming educational environments, expanding social- emotional learning and providing a continuum of supports to meet the social, emotional, behavioral and mental health needs of children and youth.
  • Address the economic and social barriers that contribute to poor mental health for young
    people, families and caregivers.
    Priorities should include reducing child poverty and ensuring
    access to quality child care, early childhood services, education, healthy food, affordable health care, stable housing and safe neighborhoods.
  • Increase timely data collection and research to identify and respond to youth mental health
    needs more rapidly.
    The advisory calls for integrated, real-time data infrastructure for understanding youth mental health trends. More research is also needed on the relationship between technology and mental health, and technology companies should be more transparent with their data and algorithmic processes to enable this research.

The advisory goes on to provide steps that different groups can take to support youth mental health, including actions for young people; family members and caregivers; educators, school staff and school districts; health care organizations; the media; social media and technology companies; community organizations; funders and foundations; employers; and federal, state, local and tribal governments.

Stay tuned for a follow-up blog post in January on how the advisory recommends school leaders support student mental health.