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February 1, 2024
Vol. 81
No. 5
Interview

"You’re Not Alone”: A Conversation with U.S. Surgeon General Vivek Murthy

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    Educators can play an important connective role in helping today’s students manage “unprecedented” mental health challenges.

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    You’re Not Alone”: A Conversation with U.S. Surgeon General Vivek Murthy Header Image
    Credit: Photo courtesy of the U.S. Office of the Surgeon General
      U.S. Surgeon General Vivek Murthy has been sounding the alarm on youth mental health from the moment his second tenure began as the nation’s top doctor under President Biden. In December 2021, Murthy issued a public statement with a stark message: “The challenges today’s generation of young people face are unprecedented and uniquely hard to navigate. And the effect these challenges have had on their mental health is devastating.”
      Young people’s struggles have been compounded by societal trends. As a practicing physician, Murthy noticed that many of his patients weren’t coming in to be seen for physical health issues; instead, they were struggling with loneliness. Now he’s seeing its impact on young adults.
      In May 2023, Murthy issued an advisory calling attention to the “public health crisis of loneliness, isolation, and lack of connection in our country.” Just weeks later, he issued another advisory on the harmful impact of social media on youth mental health.
      Three advisories in less than three years. Three issues that are deeply connected. For our nation’s youth, says Murthy, “change can’t come soon enough.”

      In your conversations with students around the country, what are they saying about mental health?

      Students are remarkably insightful about the mental health challenges their generation is facing, and they’re much more willing to talk about them than prior generations. I find that encouraging because part of the persistent challenge we still have is eradicating stigma around mental health. It’s a lot better than it was when I was growing up, but we still need to do more work.
      What young people tell me often is that they are struggling with a sense of loneliness and isolation, that they feel like all of the burdens that they’re contending with in their life, they’re dealing with alone.
      They also say that technology—social media in particular—has been a mixed blessing for them. Young people, here too, have a remarkable amount of insight. They tell me three things about social media: They say it often makes them feel worse about themselves; feel worse about their friendships; and they can’t get off it. None of these, sadly, are surprising because these platforms are designed to maximize how much time young people spend on them.

      In your May 2023 advisory about the impact of social media on youth mental health, you outlined what different groups like policymakers and tech companies can do to make social media safer for children. Do educators have a role?

      I do think educators have a role, but I want to emphasize that I don’t think the entire responsibility or burden for managing social media should fall on the shoulders of educators or parents alone. One of the reasons I issued the advisory was that I wanted to make it clear that not only are we facing a profound challenge in terms of the harmful effects of social media on the mental health of youth, but we also need policymakers to step in and have the backs of parents and educators.
      With that said, I do think one of the things that can be very powerful if done in learning institutions is to begin a dialogue with young people about how they are experiencing social media. Many young people are experiencing some positive effects, often many negative effects, but they’re not always sure how to process those or who to talk to about that. We can start those ­conversations in schools.
      The second thing is, many young people are diving into social media without any training or skills in how to identify potential harmful effects and then manage those harmful effects, whether it’s exposure to violence or other harmful content, whether it’s harassment from a stranger or somebody who’s a known bully in their lives, or whether it’s sleep deprivation or other consequences that result from excessive use. In the same way that we teach children how to drive, we have to teach them how to use social media safely.
      The last thing I’ll say is that educators can have an incredibly powerful role in bringing parents together to dialogue about the impact of social media on their kids. Many parents are struggling with this on their own. They are looking around them. They’re assuming that every other parent has figured this out because you can’t always tell from the outside if kids are struggling with social media in terms of negative mental health effects. So when they look at their own struggles, they feel like they are somehow the only ones and that it reflects their failure as a parent. And that’s absolutely not the case.
      One of the reasons I began working on this topic is because the most common question I was being asked by parents around the country was about social media. They were asking me, “Is social media safe for my kids?” So I think any role educators can play in helping to bring parents together to talk about their children’s experiences with social media and about how to manage it as a parent would be immensely helpful.

      People are really good at putting on a mask—especially online. But often, under the surface, they’re struggling.

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      Is there a conversation around mental health we’re not having in schools that we should be?

      Well, I think the conversation we’re not having enough is about how to manage technology in a healthy way. Many people realize it’s a profound challenge. Educators in particular are on the front lines. One educator I was speaking to recently said that her kids won’t talk to each other in between classes; everyone is on their devices, so there’s very little interaction.
      When I’ve been going to college campuses, I have noticed—and administrators have remarked on the fact—that the volume is low in the dining hall because people are interacting less. They’ve got their earbuds in, they’re looking at their phones. They’re on their laptops. They’re not talking to each other as much. So, the conversation we need to be having is about how we renegotiate our relationship with technology. That can involve having tech-free zones, like in school settings and in our children’s lives more broadly.

      Speaking of relationships and connection, you openly talk about the loneliness you experienced as a child in elementary and middle school. If you could go back and tell your teachers what you needed, what would you say?

      I struggled a lot with loneliness as a child. One of the things that would have helped tremendously during that time was to have known that I wasn’t the only one. It was only in retrospect, years later, that I realized other classmates of mine were struggling with that sense of ­loneliness and being left out.
      The second thing that would have been helpful is to have had some affirmation that my being lonely didn’t necessarily mean that I was broken as a child or fundamentally flawed in some way. I spent years thinking that. I spent years feeling ashamed that my loneliness was a reflection of not being likable or being socially deficient in some way. And that wasn’t the case.
      I think the third thing that would have been helpful is to have had opportunities to engage with other kids in small groups. In elementary and middle school, that often wasn’t the setting in which kids got to know each other. It was all about being thrown together during recess or during the lunch hour or bumping into each other in the hallways. That works for some people, especially if you’re an extrovert and you’re comfortable going up and engaging with other kids. But for those kids who are shy and who may be more introverted, they tend to do better getting to know other students in small group settings or one-on-one settings. So creating some opportunities for those kinds of ­interactions would have been helpful to me as a child.
      Murthy Image 2Credit: Photo courtesy of the U.S. Office of the Surgeon General

      Do you have any tips for students and educators on managing stress and feelings of anxiety, especially in such a tumultuous time?

      Yeah, it’s a really good question. The first thing I would say to students and educators is that if you’re feeling stressed and anxious, please know that you’re not alone. I think often the feelings of stress and anxiety can be made so much worse when we feel like we’re the only one going through it. And it feels that way because people are really good at putting up a brave face, at putting on a mask—especially online—and making it seem like everything is going great in their lives. But often, under the surface, they’re struggling as well. So that’s the first thing I want people to know; if you’re struggling with stress and anxiety, you are not alone.
      The second thing I want students and educators to know is that one of the most powerful buffers for stress is our relationships with one another. Whenever you can, invest in social connection. Just reach out, even for a few minutes, to check on a friend and see how they’re doing; reach out to a family member just to say hi on your way to class or on your way to work. Drop a line to somebody to let them know that you’re thinking about them. Those small moments of social connection make a big difference in how connected we feel—and they actually help to reduce our stress and anxiety.
      As you reach out to people, remember that one of the most powerful emotions that we can feel that also helps counteract stress is gratitude. It’s very difficult to be grateful and to be angry at the same time. When we are thinking about somebody that we’re grateful for, even if it’s just for 10 or 15 seconds, that can be a great source of relief for us. And that’s a practice that we can do first thing when we wake up in the morning, before we go to bed at night, and during the day when we’re feeling stressed.
      The last thing I would offer is this: I think one of the things we all have to do in our stressful lives is to spend more time offline rather than online. Sometimes that can be counterintuitive because we think if we’re feeling stressed, maybe we can check social media and feel connected to other people by seeing their updates in our feed. But often, it tends to make people feel more distant and disconnected and worse about their lives as they constantly compare themselves to the lives of the people they’re seeing on their feed. Actually getting offline and spending time either in nature or with other people in person, or doing activities that we find to be fun or enjoyable, or simply taking a walk or engaging in sports or exercise, all these offline activities have a powerful impact on us. They strengthen and center us and help quiet the noise around us. And there’s a lot of noise around us right now.
      These are just some small things I would suggest. But the key here is to remember that it is in the small steps and small actions that we can find great relief and can make big progress in addressing some of the stress and anxiety that pervades so many of our lives.

      We have to help kids believe that their self-worth is not dependent on how fancy a school they get into or whether they land a fancy job. Their self-worth is intrinsic.

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      You like to ask guests on your “House Calls” podcast what gives them hope. What gives you hope?

      There’s actually a lot that gives me hope. The reason in part I keep doing this work is because I firmly believe that we can create a world where people feel like they belong, where they’re deeply connected to each other, where they feel hopeful and optimistic about the world, and where they find fulfillment in school and in the years afterward.
      The students that I’m meeting all over the country aren’t waiting for somebody else to solve the mental health crisis. These students are beginning efforts on campus or in their high schools or middle schools to help connect peers to one another, especially those who may be struggling with loneliness. These students are building clubs and organizations to focus on strengthening the dialogue on mental health. That gives me tremendous hope because what we need to do is fundamentally change our culture. We have to help kids understand and believe that their self-worth is not dependent on how fancy a school they get into or whether they land a fancy job or what their GPA or SAT score is. We want our kids to ultimately know that their self-worth is intrinsic. That their worth and their value as a human being isn’t something that can be taken away from them—it’s based on their ability and willingness to be kind to one another, to be generous, to look out for each other, to be ­courageous.
      The movement that we have to build around mental health, I believe, has to be led by young people. Seeing their enthusiasm, seeing their insights, seeing the initiative that they’re taking—that gives me hope that we can truly create a better future for all children, including my kids, who I think about all the time. That’s why this work for me is not just a job. It’s ­personal because I’m thinking about the future of my kids as well.
      Editor’s note: This interview has been edited for length.

      Take the 5-for-5 Connection Challenge

      U.S. Surgeon General Vivek Murthy recently launched the 5-for-5 Connection Challenge, part of a national effort to encourage Americans to increase their social connections.

      To participate, the premise is simple: Complete five actions over five consecutive days to connect with people in your life.

      Each day, take one action of your choice to express gratitude, offer support to someone, or ask for help.

      At the end of the five days, reflect and share. How did connecting make you feel?

      Visit www.surgeongeneral.gov/challenge for ideas and resources.

      End Notes

      1 Office of the Surgeon General. (2021). Protecting youth mental health: The U.S. Surgeon General’s advisory. U.S. Department of Health and Human Services.

      2 Murthy, V. (2020) Together: The healing power of human connection in a sometimes lonely world. Harper.

      Sarah McKibben is the editor in chief of Educational Leadership magazine.

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