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What the Surgeon General’s Public Health Advisory Means

Addressing youth mental health.

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Mother putting a face mask on her son.
Source: August de Richelieu/Pexels

The U.S. Surgeon General, Dr. Vivek Murphy, declared a week ago that youth mental health has significantly deteriorated over the past decade. The report cites a 40 percent increase in the number of high school students reporting persistent feelings of sadness and hopelessness from 2009 to 2019. Feelings of anxiety and suicidal attempts have gone up dramatically as well.

Referencing issues such as climate change, racial injustice, gun violence, and the negative effects of social media on self-worth, Dr. Murphy concluded that youth are facing multiple challenges, even before factoring in the ravaging effects of coronavirus. The report cites scores of academic studies and publications, including data from the Centers for Disease Control and Prevention. The Surgeon General includes detailed, actionable steps that can be taken by students, caregivers, social media giants, and more to combat the crisis of worsening youth mental health.

What does the advisory itself mean, and why did he release it? According to the report, Dr. Murphy’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.” To paraphrase Dr. Murphy's words: Youth mental health needs America’s immediate attention and action.

Unraveling the subject from my own perspective as a public health professional, it seems there are multiple questions for parents or caregivers to grapple with:

  1. What is mental health exactly, and what is behind its unprecedented decline among youth?
  2. Is the current approach to mental health a good one?
  3. What are the building blocks for strong mental health at any age?

Defining Mental Health

According to The Lancet in 2018, mental health is defined as "an asset or a resource that enables positive states of wellbeing and provides the capability for people to achieve their full potential.” The Lancet report also highlights that “despite substantial research advances showing what can be done to prevent and treat mental disorders and to promote mental health, translation into real-world effects has been painfully slow.”

In terms of public health and wellbeing, then, mental health is not only the absence of disease. In my view, it's a combination of multiple strengths and assets—starting with those that encourage positive physical health habits such as diet and exercise, up to practices that support regulation of positive and negative emotions alike. Mental health can nurture growth, unleash motivation, sustain joy, and foster success—all critical components of young people's lives.

Youth Mental Health

When it comes to youth mental health in particular, the specific stressors they're facing are often a key component. Even the most resilient children and teens are not capable of withstanding infinite stressors without being affected.

Children, in Dr. Murphy’s assessment, face mounting stress, including relentless social media usage and unprecedented levels of screen time. Dr. Murphy notes that youth’s mental health was already getting worse long before the pandemic, but suggests that COVID has perhaps convinced us to actually talk about the matter. In other words, COVID’s effects may have made us notice youth’s deteriorating mental health.

The idea that children's mental health is suffering may be a difficult subject to swallow—yet acknowledging this fact could also allow us to also acknowledge that our current approach to mental health could be much better. Our current approach typically focuses on acute treatment in times of crisis. But what needs to happen, from a public health perspective, is a preventive approach with no socioeconomic barriers to care. Many healthcare experts agree, according to a 2018 article in The Lancet Psychiatry.

Why aren’t we there yet? The transition has been “painfully slow” as experts have noted. Perhaps the time has come for a major makeover.

Strengthening Mental Health

What are the building blocks for strong mental health at any age? Among other things, exercise, diet, and healthy lifestyle habits can nourish our bodies and our minds. Such lifestyle changes include:

  1. directing our attention to the present
  2. positive social media use
  3. using gratitude consistently and regularly to generate motivation and good habits for an inspired approach to living

Listening to our bodies is critical to prevent common modern challenges, such as excessive caffeine and sugar consumption or unhealthy weight gain. Avoiding sugar can be especially hard for children, so parental modeling of good eating habits, as well as the preparation of healthy meals, is key. Regularly engaging in hobbies and creative activities also help sustain an inspired approach to living. Lastly, having a reliable support network—even a small one—of family and or friends is invaluable. Sometimes we can’t do things alone.

In summary, the Surgeon General’s public health advisory may finally convince us to give youth mental health the attention it deserves. The discussion need not end with the report, however. Parents and caregivers can utilize the steps above and the actionable steps in Dr. Murphy’s report to continue to act.


Patel, V. et al. (2018). The Lancet Commission on global mental health and sustainable development. The Lancet.

Arango, C. et al. (2018). Preventive strategies for mental health. The Lancet Psychiatry.