Protecting Youth Mental Health: The U.S. Surgeon General’s Advisory

Authors: Vivek Murthy

Overview 

During the pandemic, children, adolescents, and young adults have faced unprecedented challenges. The COVID-19 pandemic has dramatically changed their world, including how they attend school, interact with friends, and receive health care. They missed first days of school, months or even years of in-person schooling, graduation ceremonies, sports competitions, playdates, and time with relatives. They and their family may have lost access to mental health care, social services, income, food, or housing.41 They may have had COVID-19 themselves, suffered from long COVID symptoms, or lost a loved one to the disease—it’s estimated that as of June 2021, more than 140,000 children in the US had lost a parent or grandparent caregiver to COVID-19.

Since the pandemic began, rates of psychological distress among young people, including symptoms of anxiety, depression, and other mental health disorders, have increased. Recent research covering 80,000 youth globally found that depressive and anxiety symptoms doubled during the pandemic, with 25% of youth experiencing depressive symptoms and 20% experiencing anxiety symptoms. Negative emotions or behaviors such as impulsivity and irritability—associated with conditions such as ADHD— appear to have moderately increased. Early clinical data are also concerning: In early 2021, emergency department visits in the United States for suspected suicide attempts were 51% higher for adolescent girls and 4% higher for adolescent boys compared to the same time period in early 2019. Moreover, pandemic-related measures reduced in-person interactions among children, friends, social supports, and professionals such as teachers, school counselors, pediatricians, and child welfare workers. This made it harder to recognize signs of child abuse, mental health concerns, and other challenges.

During the pandemic, young people also experienced other challenges that may have affected their mental and emotional wellbeing: the national reckoning over the deaths of Black Americans at the hands of police officers, including the murder of George Floyd; COVID-related violence against Asian Americans; gun violence; an increasingly polarized political dialogue; growing concerns about climate change; and emotionally-charged misinformation.