Surgeon General Says Mental Health of America’s Youth Is in Crisis. Where Do We Go From Here?

The COVID-19 pandemic has amplified an already pressing problem: the mental health crisis of kids and teens in the United States.

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Vivek Murthy, U.S. surgeon general, speaks during a news conference in the James S. Brady Press Briefing Room at the White House in Washington, D.C.

U.S. Surgeon General Vivek Murthy, MD, issued an advisory on mental health among youths, calling it an “urgent public health crisis” that’ll require an all-hands-on-deck effort to address.

Saul Loeb/AFP/Getty Images, Adobe Stock

U.S. Surgeon General Vivek Murthy, MD, added to the chorus of experts expressing concern of the state of the mental health of American youths last week, issuing an advisory about the pressing need to address the mental health crisis among the nation’s youth.

In the advisory, Dr. Murthy called the challenges that American youths are facing today “unprecedented and uniquely hard to navigate.” The “unfathomable” number of deaths due to COVID-19, high levels of fear, economic instability, and forced physical distancing from loved ones have all played key roles in worsened mental health among youths, Murthy added.

But the youth mental health crisis was looming even before the pandemic started, Murthy wrote.

RELATED: Pediatricians Declare Kids’ Mental Health a National Emergency

The COVID-19 Pandemic: A Tipping Point?

Maya Smith, executive director of Lady Gaga’s Born This Way Foundation for youth mental health, agrees with Murthy’s assessment. “Young people across the globe, especially members of marginalized communities, were facing significant challenges long before the pandemic,” Smith explains. “Many young people — honestly, many people — felt lonely, isolated, and unable to access mental health resources.”

From 2009 to 2019, the proportion of high school students who reported persistent feelings of sadness or hopelessness increased by 40 percent, those who seriously contemplated suicide increased by 36 percent, and those who made a plan to take their own lives increased by 44 percent, according to the 2009–2019 Youth Risk Behavior Survey?(PDF)?from the Centers for Disease Control and Prevention (PDF).

The pandemic, experts say, has worsened all of this.

“The pandemic has proven that many youths are now existing in a space muddled with the need to motivate themselves, reconnect with their peers, and prioritize the things that matter most, including hobbies, study time, and physical activity,” says David Vidaurre, licensed master social worker and senior therapist at The Dorm, which specializes in mental healthcare for young adults in New York City and Washington, DC.

This loss of routine and structure has contributed to feelings of despair, uncertainty, and disconnection, adding to feelings of isolation and loneliness that existed long before the pandemic, Vidaurre adds.

According to the advisory, youths who may be most prone to mental health challenges during the pandemic include youths with intellectual disabilities, racial and ethnic minority youths, LGBTQ+ youths, youths living in immigrant households, among others.

And several risk factors for mental health issues as COVID-19 rages on include having mental health issues before the pandemic, living in an area with more severe outbreaks of COVID-19, having parents or caregivers working on the frontlines, losing a loved one to COVID-19, and experiencing abuse, neglect, discrimination, or community violence.

RELATED: Under Pressure: How Social Media, Drugs, and the Changing Landscape of Sexuality Are Challenging Younger Generations’ Mental Health

Protecting and Rebuilding Youth Mental Health: Strategies for Parents

The looming question, of course, is what can be done about it? Mental health experts agree that parents need to play a major role.

“The most important thing for young people is for them to feel seen, heard, and supported,” says Smith. “Having someone like a parent or otherwise who listens, believes in them, and checks in on them has a huge impact on mental wellness, and these acts are among the top ways to show respect and kindness to your children.”

The advisory recommends parents create a home environment that’s safe and loving, where family members can openly discuss mental health, and where people listen to each other. Parents should also encourage their kids to engage in physical activity and form social relationships with peers, and practice self-care, while also monitoring children’s social media use.

Laura Gray, PhD, a psychologist at Children's National Hospital in Washington, DC, agrees: Remaining active, engaging in enjoyable activities, and staying socially connected all help protect mental health. She recommends the following strategies for parents:

  • Structure daily activities. Plan physical and social activities help your children avoid becoming isolated and stay active.
  • Model healthy coping strategies. For example, if you burnt dinner while cooking, say something like, “I’m feeling so frustrated right now. I can walk away for a minute and take some deep breaths to calm down. Then I’ll come back to make a new plan,” suggests Dr. Gray.
  • Make a list of coping strategies. Start a “calming corner” or “cool-down spot,” and engage in meditation or mindfulness exercises as a family. Use coping cards for younger (preschool through elementary and middle school) children.
  • Check in with specific questions. According to Gray, some examples include, “I’ve noticed you have a lot going on. How are you managing your stress? How has your mood been lately? Are there times when you're feeling completely overwhelmed or hopeless?”
  • Seek professional help. Schedule an appointment with your child’s primary care doctor or reach out to the school guidance counselor. Other trusted adults can also check in with your child and determine if they need professional help or more support at home or school.

It’s also important to tell your kids that it’s okay to not be okay, adds Smith. “As a parent myself, I try to model the type of (age appropriate) vulnerability that I hope to receive from my children,” she says.

“For example, I tell my 6-year-old daughter when I’ve made a mistake, and that I make them often,” Smith explains. “I tell my 9-year-old son how I feel when I’m left out, empathizing with his experience on the soccer field or with friends. I listen, nonjudgmentally and hope that as their needs grow, so will my capacity to listen and support.”

Gray also recommends asking your child if they’ve been considering self-harm or suicide. And if your child says “yes” to any questions about contemplating suicide, let them know their feelings are normal and contact a health professional immediately.

“Youths with suicidal thoughts are often afraid to upset their parents and choose to not share,” says Gray. “It’s common to think about suicide, but we want to prevent suicide attempts. We want kids and teens to talk to trusted adults to create a plan to keep them safe such as removing any items they have thought about using to hurt themselves, keeping them in the public parts of the house, connecting with support systems, and finding a therapist.”

Health professionals also recommend removing unsafe objects from the home, such as medications, sharp objects, bleach or cleaning products, or guns. “Reducing access to methods for suicide can save your child’s life when they are in the midst of a mental health crisis and feeling impulsive,” says Gray.

Self-Help and Professional Help for Kids

In his advisory, Murthy encourages young people to protect their personal mental health with some foundational strategies, including eating well, exercising, sticking to a schedule, and staying hydrated.

According to Gray, it’s also important for kids to recognize when they need a social media break. Signs that it’s negatively impacting mental health include feeling down, guilty, jealous, or self-conscious, or having low self-esteem after looking at social media.

Gray recommends that kids take a social media break for a set time — one to two weeks, for example, "to reflect and consider changes to social media use, such as reducing who they follow, how often they use it, finding positive and supportive platforms, or extending their social media break.”

Setting aside time to engage in hobbies and recharge when getting tired can also help, suggests Vidaurre. “Youths should lean into the things they love, such as journaling, shooting hoops with friends, redesigning their bedroom, and seek out opportunities to discover a new hobby or passion.”

All of which is easy to say if you’re feeling well enough, emotionally, to act on it. Not all kids are right now. In this case, kids may need professional help. But sometimes, youths struggle to access the services they need.

"Access to mental health care for our youths has been a long term issue, but the COVID-19 pandemic has made the lack of access even more acute," says psychiatrist Patrice Harris, MD, medical editor in chief at large at Everyday Health, and a former president of the American Medical Association. "The time is now to commit?to the infrastructure and funding that will be required to meet the need for timely access to quality care that meets the unique?needs of children and youths."

In the meantime, how can youths reach mental health treatment options such as therapy or medication? Getting the conversation started with a trusted adult is often a first step.

“If you are struggling to manage negative emotions, reach out to a school nurse or counselor, a teacher, a parent or caregiver, a coach, a faith leader, or someone else you look up to and trust,” Murthy recommends in his advisory. “Look into therapy or counseling resources to get support when something causes distress and interferes with your life. Reaching out to others can be hard and takes courage, but it is worth the effort and reminds us we are not alone.”

Resources We Love

American Foundation for Suicide Prevention

This organization supports people with thoughts of suicide. Learn?how to talk to a loved one who is thinking of taking their own life, or get help for yourself or someone you know. You can reach the National Suicide Prevention Lifeline by dialing 800-273-TALK (800-273-8255) or texting HOME to 741741. If you’re worried for your or someone else’s immediate safety, dial 911.

American Psychiatric Association

This association offers educational material, as well as?help finding a psychiatrist, on its website. Learn more on its website about what kinds of services psychiatrists offer.

Depressed While Black

This online community supports access to Black-affirming mental health care for Black people with severe depression. Consider liking the?Facebook page to stay up-to-date on community happenings,?or sign up for the email?newsletter.

The Trevor Project

This organization aims to prevent suicide among young people who are lesbian, gay, bisexual, transgender, or queer. Call 866-488-7386 or texting START to 678-678 to reach its crisis helpline.

RELATED: The Right Resources Can Help You Manage Depression

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