U.S. Surgeon General Issues Advisory on Youth Mental Health Issues, Offers Advice on How to Help

June 22, 2023

When the U.S. Surgeon General issues an “advisory,” it’s a rare public statement meant to call attention to “an urgent public health issue” and to offer recommendations for immediate action to address it.

That’s why it was notable when Surgeon General Dr. Vivek H. Murthy released such an advisory just over a year ago called “Protecting Youth Mental Health.” In his introduction, he noted that with a pandemic and the increasing use of technology and social media, “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.”

Mental health issues don’t lend themselves to one-size-fits-all solutions, either, he added: “Every child’s path to adulthood—reaching developmental and emotional milestones, learning healthy social skills, and dealing with problems—is different and difficult. There’s no map, and the road is never straight.”

The road does, however, include lots of time spent in classrooms, so the advisory offers some insight about what both educators and caregivers can do to help create a strong foundation for the mental health of the young people in their charge. Here’s a sample:

Be the best role model you can be for young people by taking care of your own mental and physical health. Young people often learn behaviors and habits from what they see around them. You can model good habits by talking to children about the importance of mental health, seeking help when you need it, and showing positive ways you deal with stress so children learn from you.
Create positive, safe, and affirming school environments. This could include developing and enforcing anti-bullying policies, training students and staff on how to prevent harm (e.g., implementing bystander interventions for staff and students—see page 24), being proactive about talking to students and families about mental health, and using inclusive language and behaviors.
Help children and youth develop strong, safe, and stable relationships with you and other supportive adults. Research shows that the most important thing a child needs to be resilient is a stable and committed relationship with a supportive adult. Show children love and acceptance, praise them for the things they do well, listen to them, and communicate openly about their feelings. Encourage them to ask for help and connect them with other adults who can serve as mentors.
Protect and prioritize students with higher needs and those at higher risk of mental health challenges, such as students with disabilities, personal or family mental health challenges, or other risk factors (e.g., adverse childhood experiences, trauma, poverty).
Expand social and emotional learning programs and other evidence-based approaches that promote healthy development. Examples of social, emotional, and behavioral learning programs include Sources of Strength, The Good Behavior Game, Life Skills Training, Check-In/Check-Out, and PATHS. Examples of other approaches include positive behavioral interventions and supports and digital media literacy education.
Learn how to recognize signs of changes in mental and physical health among students, including trauma and behavior changes. Educators are often the first to notice if a student is struggling or behaving differently than usual (for example, withdrawing from normal activities or acting out). And educators are well-positioned to connect students to school counselors, nurses, or administrators who can further support students, including by providing or connecting students with services.
Provide a continuum of supports to meet student mental health needs, including evidence-based prevention practices and trauma-informed mental health care. For example, the Project AWARE (Advancing Wellness and Resilience in Education) program provides funds for state, local, and tribal governments to build school-provider partnerships and coordinate resources to support prevention, screening, early intervention, and mental health treatment for youth in school-based settings. Districts could also implement mental health literacy training for school personnel (e.g., Mental Health Awareness Training, QPR training).
Promote enrolling and retaining eligible children in Medicaid, CHIP, or a Marketplace plan, so that children have health coverage that includes behavioral health services. The Connecting Kids to Coverage National Campaign also has outreach resources for schools, providers, and community-based organizations to use to encourage parents and caregivers to enroll in Medicaid and CHIP to access important mental health benefits. Families can be directed to HealthCare.gov or InsureKidsNow.gov. Schools can use Medicaid funds to support enrollment activities and mental health services.
Try to minimize negative influences and behaviors in young people’s lives. Talk about the risks of alcohol and other drugs, both short-term (such as car crashes and other accidents) and long-term (such as reduced cognitive abilities). The earlier a child or adolescent begins using substances, the greater their chances of developing substance use problems. Mental health and substance use problems can also occur at the same time—some young people struggling with stress or difficult feelings turn to alcohol or drug use. And alcohol and other drugs can also affect mental health, for example by altering mood or energy levels.
Support the mental health of all school personnel. Opportunities include establishing realistic workloads and student-to-staff ratios, providing competitive wages and benefits (including health insurance with affordable mental health coverage), regularly assessing staff well-being, and integrating wellness into professional development. In addition to directly benefitting school staff, these measures will also help school personnel maintain their own ability to create positive environments for students.
Be a voice for mental health in your community. There are many ways to do this, from talking openly with friends and family about the importance of mental health, to going to school board meetings or a town hall, to volunteering with an advocacy group, to promoting greater funding and awareness of mental health programs.

You can read the Surgeon General’s Advisory in its entirety here: vea.link/SurgeonGeneral.

Another Source of Help

The National Center for School Mental Health (NCSMH) at the University of Maryland School of Medicine is a technical assistance and training center with a focus on advancing research, training, policy, and practice in school mental health.

NSCMH offers resources including publication, Webinars, newsletters, and conferences. You can learn more at www.schoolmentalhealth.org.

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