Surgeon general sounds alarm about youth mental health; children's hospital leader says this crisis also exists in Kentucky

By Melissa Patrick
Kentucky Health News

U.S. Surgeon General Vivek Murthy has issued his second health advisory, this one saying there's an urgent need to address a mental-health crisis among the nation's youth. And Dr. Scottie Day, physician-in-chief for Kentucky Children's Hospital, says Kentucky is part of the crisis.

Murthy said in a news release, “Mental-health challenges in children, adolescents, and young adults are real and widespread. Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide — and rates have increased over the past decade.” “The Covid-19 pandemic further altered their experiences at home, school, and in the community, and the effect on their mental health has been devastating. The future wellbeing of our country depends on how we support and invest in the next generation." 

Graphic is from the Protecting Youth Mental Health Advisory; to enlarge, click on it.

Murthy's 53-page advisory, titled Protecting Youth Mental Health, says that before the pandemic one in three high-school students reported persistent feelings of sadness or hopelessness, a 40% increase from 2009 to 2019.

And in a similar time frame, suicide rates went up 57% among youth 10-24.

Since then, rates of anxiety and depression have only gone up.

The report notes that the pandemic added to the pre-existing challenges that America’s youth faced and disrupted their lives, including disruptions of schooling, social opportunities, access to health care and social services, food, housing, and in many cases the health of their caregivers. Further, the report says the negative impacts from the pandemic have been greatest on youth who were most vulnerable to begin with, such as racial and ethnic minorities and low-income youth. 

"It would be a tragedy if we beat back one public-health crisis only to allow another to grow in its place," Murthy says in the introduction to the report, later adding, "Our obligation to act is not just medical—it’s moral." 

The advisory calls for a coordinated response and provides in-depth recommendations for 11 sectors, including young people and their families, educators and schools, community organizations and governments, and media and technology groups, for how they can work to improve the mental health of young people. 

Murthy's first advisory addressed Covid-19 misinformation. Advisories are reserved for significant public health challenges that need the nation’s immediate awareness and action.

Youth mental health in Kentucky

Day said the issue of youth mental health is so bad in Kentucky that it prompted Kentucky Children's Hospital to join a policy group called Sound the Alarm for Kids, created to urge Congress to enact legislation and increase funding to address the national mental health emergency in children and teens. 

"The reason we're engaging policymakers is the fact that we have seen an unbelievable crisis in mental health," he said. 

Sound the Alarm for Kids represents more than 200 children's hospitals and 77,000 physicians. It was launched by the Children's Hospital Association, American Academy of Pediatrics and American Academy of Child and Adolescent Psychiatrist, according to the hospital association's news release.

Scottie Day, M.D.

Day agreed with the surgeon general that the pandemic has made the youth mental health crisis even worse, saying it has gone from a gradual increase of cases prior to the pandemic to a steep incline, and that it has worsened since the second surge of cases. 

Day pointed to the challenges faced by so many of Kentucky's children that existed long before the pandemic hit, including high rates of poverty and the highest rate of child abuse in the nation. And it's part of another phenomenon: 140,000 U.S. children have lost at least one caregiver due to the pandemic.

"So you already have a state of fragility in a household that probably became more fragile," he said. 

Day pointed out that suicide is the second leading cause of death for youth and young adults in Kentucky, and that the rate of suicide death among Black youth has increased faster than in any racial or ethnic group, prompting him to ask, "What are we doing? What are we missing?" 

The Kentucky Youth Risk Behavior Survey found that in 2019 18.4% of Kentucky high-school students seriously considered attempting suicide, 15.9% had planned how they would do it and 8.1% had actually attempted it in the previous 12 months. In 2020, 105 children and young adults between the ages of 10 and 24 died by suicide in Kentucky, according to provisional data from The Kentucky Injury and Prevention Research Center. 

"We can't ignore this," Day said. "What Kentucky looks like 10 or 20 years from now is not going to be dependent upon what happens to the 50- or the 60- or the 70-year- old people. . . . What it's going to depend on is what we do about what's going in our children, right now, this minute." 

Another indicator that young people in Kentucky are struggling with their mental health  is the number of screenings done by youth at MHAScreening.org. 

According to data from Mental Health America of Kentucky, 17,419 people have taken a voluntary mental-health screening in the first three quarters of 2021. Of those, 61.68% were taken by 11- to 24-year-olds; 30.64% were taken by 11- to 17-year-olds; and 0.57% were taken by 4-to-10-year-olds.  

Day stressed that it will take a group effort to tackle this problem if we want to see results. "So we're trying to get everybody to wake up and talk about it," he said. 

Mental Health America of Kentucky's executive director, Marcie Timmerman, encouraged parents to talk to children about their mental health.

"It's important to have conversations about mental health in your home with people of all ages, but especially our youth and teens," said Timmerman. "We know they are struggling. The numbers show it and stories students are telling further underline the issue. Everyone has a brain, so everyone has mental health to maintain. This isn't about city or country, urban or rural, rich or poor. Our [youth] need us to step up and help them find good coping skills." 

Day said in addition to making sure Kentucky youth have access to "high quality and culturally competent health care," we also need to work to overcome the stigma that is attached to this topic and make sure that schools and health care providers are screening for mental health. Further he said, as a nation we need to address economic and social barriers that contribute to mental health.

"And part of it also is just getting people to talk about it," he said. "We need to recognize that mental health is an essential part of overall health." 

Asked when a parent should seek help for their child, Day said, "Anytime you have a concern, you seek help." 

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255.