It’s been dominating headlines for years. And for parents, faculty, or anyone who works closely with young adults, it’s a familiar concern.
The youth mental health crisis.
On Friday, Dr. Thomas Insel, a psychiatrist, neuroscientist, and former director of the National Institute of Mental Health from 2002 to 2015, tried to demystify what may be driving staggering mental health numbers to persist, despite some recent improvement. He was the first speaker in the Provost’s Distinguished Lecture Series, a new initiative started by Guillermo “Willy” Prado, interim executive vice president for academic affairs and provost, who is also a scholar in the mental health field.
“Dr. Thomas Insel has revolutionized the field of mental health and integrated it into the general discourse and discussion of health care and public policy,” said Prado, who has worked on behavioral interventions for Hispanic families.
During his talk hosted inside the Kislak Center at the University of Miami, Insel first laid out the mental health landscape across the nation and noted that in 2023 this crisis took the lives of more than 240,000 people. Overall, he noted that the nation’s life expectancy has gone down since just before the COVID-19 pandemic, and it has continued to do so since then.
Insel explained that people suffering from mental health issues typically fall into three categories: people with serious mental illnesses (like schizophrenia, severe mood disorders like bipolar disorder, and severe depression or anxiety disorders that are disabling), those with substance abuse issues (largely fentanyl today) or alcohol-related deaths, and youth mental health struggles.
What is so troubling about the youth mental health crisis, Insel said, is that it is increasing more than the other two areas. It’s mostly characterized by anxiety and depression and found more often in girls. There is also an increase in suicide deaths, a major increase in emergency room visits for self-harm, and a fivefold increase in suicide attempts among youth that identify as LGBTQ.
Fortunately, in the past two years, those numbers have slightly decreased, yet Insel said that does not explain the past 10 years of increasing mental health struggles tracked by the U.S. Centers for Disease Control and Prevention.
“We still don’t fully understand what brought them up and don’t understand what is bringing them down,” he said.
More recently, Insel said that while the COVID-19 pandemic affected adults in more physical ways, children and teens were impacted psychologically.
“It was a psychological pandemic for young people, and we are still seeing the tail of that,” he added. “Lots of kids haven’t been able to catch up socially and academically, so it will be an issue for this generation as we move forward.”
Insel then laid out his theories about what is driving the increase in youth mental health issues throughout the past two decades.
“It’s not one thing. Lots of people say it’s one thing, but I don’t think that’s how it is going to play out,” Insel said.
Instead, he believes many things are provoking youth mental health struggles.
One wildly popular idea is the rise of social media, as described in the Jonathan Haidt book “The Anxious Generation,” as well as the 2023 U.S. Surgeon General report “Social Media and Youth Mental Health.” Both describe how the rise in youth mental health issues correlates with the growth of smartphones and social media. Insel said there may be some truth to this idea, but there is little data to show it’s the only thing troubling teens. He does think spending six to seven hours on a screen or smartphone is harmful.
“The one inarguable truth here is that kids today are not doing things we all did as kids that are important to develop independence,” he said. “Grabbing a bike and riding around the block or climbing trees. If you’re on TikTok for those hours, you’re not doing the things your brain needs to develop normally, and that is a concern.”
Yet, Insel said there is also sleep deprivation present in youth today—kids born after 2000 are sleeping at least two hours less, on average, each night. So instead of 10 or 11 hours per night—which is recommended through adolescence—they are getting seven to eight hours.
“As a psychiatrist, there’s no single factor that contributes to mental health illness more than sleep deprivation,” he said.
In addition, there is a new sense of “grind culture.” This refers to the idea of increased pressure and expectations put on teens today that can become overwhelming to them, Insel said. Finally, he said many young adults feel there is a lack of opportunity for them because the costs of housing and college education are so high today. In addition, they are concerned about the environment, and many teens have come to distrust institutions. These help contribute to a lack of purpose among young adults.
Despite all these potential aggravators, Insel said he thinks the nation should take a public health approach to treating the youth mental health crisis. That is, the nation’s health leaders should be proactive to prevent future youth from developing mental health struggles.
His primary prevention suggestions?
Set limits on screen time. Particularly during school hours. Also, shift school hours to match sleep patterns. Teach kids today about ways to be resilient and to understand that life will have setbacks. And invest in programs for teachers, parents, and institutions to help kids who are struggling.
For kids who are at risk of suicide, Insel said schools and colleges should develop a campus-based risk approach to help adults and students notice the signs a classmate or friend is struggling. In addition, colleges should have parents sign a consent policy so they can be alerted about serious mental health issues with their child, Insel added.
“Seventy-five percent of mental health illnesses begin before the age of 25, so early detection is critical,” he said. “And often some of the most effective providers and interventions are often not the most expensive ones.”
Educational institutions can also leverage tech tools like artificial intelligence to help connect students who need it with therapy and care, Insel added.
“We know how to treat this problem. When someone gets depression, or PTSD, we know how to treat them,” he said. Some of these ideas are described in his latest book, “Healing: Our Path from Mental Illness to Mental Health,” which attendees received. “For a university, what you want to think about is how can you use innovation to scale this care, and how do you shift the narrative that you may have to miss a semester, but students can come back and have the opportunity to succeed.”
