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The U.S. surgeon general warns of a mental health crisis among young people, worsened by the pandemic.


The United States surgeon general on Tuesday warned that young people are facing “devastating” mental health effects as a result of the challenges experienced by their generation, including the coronavirus pandemic.

The message came as part of a rare public advisory from the nation’s top physician, Dr. Vivek H. Murthy, in a 53-page report noting that the pandemic intensified mental health issues that were already widespread by the spring of 2020.

The report cited significant increases in self-reports of depression, anxiety and emergency-room visits for mental health challenges. In the United States, emergency room visits for suicide attempts rose 51 percent for adolescent girls in early 2021 as compared to the same period in 2019. The figure rose 4 percent for boys.

Globally, symptoms of anxiety and depression doubled during the pandemic, the report noted. But mental health issues were already on the rise in the United States, with emergency room visits related to depression, anxiety and related issues up 28 percent from 2007 to 2018.

The reasons are complex and not yet definitive. Adolescent brain chemistry and relationships with friends and family are important factors, the report noted, as is a fast-paced media culture, which can leave some young minds feeling helpless.

“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,” Dr. Murthy wrote in the report. “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.”

The surgeon general’s advisory adds to a growing number of calls for attention and action around adolescent mental health. In October, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association joined to declare “a national emergency” in youth mental health.

Although blame for adolescent distress is often pinned on social media, the research suggests that screen time alone does not account for crisis. Rather, social media and other online activities act more to amplify an adolescent’s existing mental state, causing some to feel more distress and others to experience enhanced feelings of connection.

Bonnie Nagel, a pediatric neuropsychologist at Oregon Health & Science University who treats and studies adolescents, said that online interactions appear not to satisfy core needs for connection.

Recent research she co-authored shows that loneliness is a key predictor in feelings of depression and suicidal ideation.

“I don’t think it is genuine human connection when talking to somebody with a fake façade online,” Dr. Nagel said.

At the same time, screen time may be displacing activities known to be vital to physical and mental health, including sleep, exercise and in-person activity, research shows. The current generation of youth express heightened levels of loneliness — more than any other age group — despite spending countless hours connected over media.

Authorities and scientists widely acknowledge that there has been insufficient research into the underlying causes. Dr. Murthy’s advisory calls for more resources to be devoted to understanding and addressing mental health challenges, and it urges a greater appreciation of mental health as a key factor in overall health.

“This is a moment to demand change,” the report concludes.


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