To The Teacher
Studies indicate that isolation, anxiety, and hopelessness among young people have all increased since the Covid pandemic began in 2020. This rise is particularly concerning given the failure of our medical system to meet youth mental health needs even before the pandemic.
This lesson has students consider this issue through readings and discussion. The first reading looks at evidence about how Covid impacted young peoples’ mental health. The second reading focuses on how social and political factors affect mental health – and how understanding this can be important in shaping a collective response to this issue. Questions for discussion follow each reading.
Note: This activity invites students to discuss challenging issues that some might find upsetting. Please see these guidelines for discussing difficult issues.
Invite students to share, if they’d like, their responses to a few prompts about how the pandemic has affected them and their friends. Ask students:
- What is a difficult emotion that you have felt – or felt more strongly – since the start of the pandemic? Are you (or people you know) experiencing more sadness? Anxiety? Loneliness?
- What is a way that you have tried to handle these feelings in either yourself or your friends/family?
- In general, what are some things that we as individuals can do address these feelings?
- What can we do as a society? Can you think of policies or systems we could change that might reduce the sadness, anxiety, and loneliness that so many of us are feeling?
Share with students that we’ll be reading about and discussing these questions today.
Youth Mental Health in the Post-Pandemic Moment
Since the beginning of the Covid pandemic, sadness, and anxiety, and other emotional challenges have been on the rise among young people -- and adults as well.
Prior to the pandemic, young people in the United States were already facing a rise in mental health problems, with one in five children experiencing a mental health disorder. Unfortunately, according to the Centers for Disease Control and Prevention (CDC), only 20 percent of these young people received treatment from a mental health provider. Covid-19 significantly worsened the problem. As an article in the July-August issue of Harvard Magazine by staff writer Jacob Sweet reported:
In December 2021, U.S. Surgeon General Vivek Murthy… released a special public health advisory about a possible youth mental health crisis. “[T]he 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,” he wrote in the introduction. Before the pandemic, about one in eight kids had an anxiety disorder; in the first few months of the pandemic, that proportion doubled. From 2019 to 2021, emergency department visits for suspected suicide attempts increased by 51 percent for girls and 4 percent for adolescent boys.
So why has the pandemic worsened the mental health landscape for young people?
Many people think of mental health problems as individualized, having to do with a single person’s biochemistry and thought patterns. While such individual factors are no doubt important, doctors point out that social and political forces also play a large role in shaping the conditions for mental health across society.
Foundational to an individual’s sense of well-being are connections to friends and supportive social networks. During the pandemic, access to community support was hugely disrupted, greatly increasing the risk of loneliness and isolation. As Metro reporter John Leland wrote in a April 20, 2022, article for the New York Times:
Even before the pandemic, the United States surgeon general, Vivek Murthy, said the country was experiencing an “epidemic of loneliness,” driven by the accelerated pace of life and the spread of technology into all of our social interactions. With this acceleration, he said, efficiency and convenience have “edged out” the time-consuming messiness of real relationships.
The result is a public health crisis on the scale of the opioid epidemic or obesity, Dr. Murthy said. In a 2018 study by the Kaiser Family Foundation, one in five Americans said they always or often felt lonely or socially isolated.
The pandemic only exacerbated these feelings. In a recent citywide survey by New York’s health department, 57 percent of people said they felt lonely some or most of the time, and two-thirds said they felt socially isolated in the prior month.
“Loneliness,” Dr. Murthy said, “has real consequences to our health and well-being.”
Being lonely, like other forms of stress, increases the risk of emotional disorders like depression, anxiety and substance abuse. Less obviously, it also puts people at greater risk of physical ailments that seem unrelated, like heart disease, cancer, stroke, hypertension, dementia and premature death. In lab experiments, lonely people who were exposed to a cold virus were more likely to develop symptoms than people who were not lonely.
Physician Gabor Maté has taken this argument even further, contending that the current political and economic structures of our society bear much of the blame for worsening mental health. With regard to our economy, he argues that an ideology of “people being competitive, aggressive, selfish, individualistic creatures is almost guaranteed to isolate people.” In a November 2022 interview with journalist Nathan Sing for The Walrus, Maté explained:
In the UK, they had to appoint a minister of loneliness. Loneliness is as much of a health risk as smoking fifteen cigarettes a day, and the number of lonely people is going up all the time, significantly in the last several decades, particularly under [policies of economic] neoliberalism. So, when I talk about society being toxic, I literally mean that it actually undermines human health by the very assumptions that it makes about what’s necessary for human life.
People facing mental health difficulties certainly need individualized treatment that addresses their specific cases. At the same time, since social, political, and economic factors play a large role in influencing mental health, we can also act collectively to create conditions that promote more widespread well-being.
- How much of the material in this reading was new to you, and how much was already familiar? Do you have any questions about what you read?
- What resonated with you in this reading? What rang true?
- According to the reading, what were some of the reasons that the pandemic worsened mental health among youth?
- Has the pandemic affected how you and your family and friends connect with each other and the wider community? Have things changed in the past year, as pandemic restrictions have eased?
- Are there any other factors you think have impacted young people’s mental health during and after the pandemic that were not mentioned in the reading?
Finding a Collective Response to the Problem
How can we best respond to the mental health crisis young people – and adults – are experiencing?
Understanding that social, political, and economic factors play an important role in creating the underlying conditions for mental health can give us insights into different ways we can act collectively to address this issue.
One collective response to the crisis would be to ensure that all people have access to needed mental health services— including services provided through schools.
Efforts for such expanded access could build on the Bipartisan Safer Communities Act, signed into law by President Biden in June 2022.
Below, policy experts Emily Katz, Roby Chatterji, and Akilah Alleyne discuss this new law, which appropriates $240 million over four years for something called Project AWARE (Advancing Wellness and Resiliency in Education), including $28 million specifically focused on trauma. They write:
Schools and districts can use the grants to improve students’ awareness of mental health issues, improve access to school- and community-based mental health services, and train school staff on responding to trauma and mental health needs. The grant program… funds partnerships between state education and mental health agencies to support local education agencies.
Recipients can use Project AWARE funds to implement a wide variety of evidence-based practices that best serve students in various local education agencies, including hiring more clinical staff to improve provider-to-student ratios. For example, New Hampshire expanded the implementation of its multitiered behavioral health prevention framework to additional districts, with a focus on supporting integrated school and community mental health.
In Michigan, the Saginaw Chippewa Indian Tribe is collaborating with cultural healers to help students connect with their identities, which can improve student outcomes and increase resilience. The Tribe is also using grant money to hire additional school mental health providers and train educators, school staff, and community members on trauma-informed practices and mental health first aid.
Another way we might collectively address the youth mental health crisis would be to make the economy fairer, so that more people can experience financial security. In his 2018 book, Lost Connections, writer Johann Hari argued that economic policies that encourage a more equitable distribution of wealth can in fact have a major impact in promoting good mental health. In a June 2020 interview, he explained:
There’s very strong evidence that financial insecurity causes depression and anxiety….
And, of course, under the coronavirus crisis, there’s been an explosion—with the biggest increase in unemployment since the Great Depression, perhaps even in the history of the United States. Again, that’s obviously causing a lot of depression and anxiety.... [So] what we need to do is radically expand our idea of what an antidepressant is….
I would argue there is an antidepressant for that financial insecurity, and it’s been tried before. [In] the early 1970’s, the Canadian government did an experiment. They chose a town at random—it’s called Dauphin in Manitoba about four hours from Winnipeg—and they said to a large number of people in this town that they were going to give them a universal basic income. It was the equivalent of about $11,000 in today’s U.S. dollars, so it’s not a huge amount of money.
They said to everyone in this town that they would give them $11,000 a year. There was nothing that they needed to do in return for it, and there’s nothing the government could do to take it away unless you go to prison. They wanted to see what would happen, so this experiment went on for a few years, and lots of interesting things happened.
Revealingly, nobody gave up work. Everyone carried on working. But people had a greater baseline of financial security…. [And importantly,] there was a massive fall in all mental illnesses. In fact, mental illnesses that were so severe that people had to be shut away at mental hospitals fell by nine percent. That’s an extraordinary fall. You won’t find a drug that has a fall that big….
We can live in different ways, and we can treat people differently. More importantly, we can reclaim wealth from the people who contribute very little to society and redistribute it to people who contribute so much.
In the same interview, Hari described how directly addressing the need for community connection can be a powerful means of combating depression and anxiety. In particular, he pointed to the example of East London doctor Sam Everington, who decided to treat patients with this approach. Hari writes:
Firstly, [Everington’s] patients were depressed and anxious for perfectly understandable reasons. Secondly, although drugs gave some of them some relief, they often weren’t solving the problem. So, one day he decided to pioneer a different approach. A woman came to see him named Lisa Cunningham, who had been terribly depressed and anxious for seven years, and Sam said to Lisa, “Don’t worry, I’ll carry on giving you these drugs. I’m also going to prescribe something else. I’d like you to come to the doctor’s office twice a week to meet with a group of other depressed and anxious people, not to talk about how bad you feel—you can do that if you want—but the purpose of the group is to find something meaningful that you can all do together… The group started talking about what to do.
This inner-city East London, and people—like me—didn’t know anything about gardening, but decided maybe they could learn gardening. There was an area behind the doctor’s offices that was just scrubland. So they started watching clips on YouTube. They started taking books out of the library. They started to get their fingers in the soil. They started to plant seeds. They started to learn the rhythms of the seasons. There’s a lot of evidence that exposure to the natural world is really powerful and anti-depressing.
But they started to do something even more important. They started to form a tribe. They started to form a group. They started to care about each other. You know, when one man didn’t show up, the others would go looking for them to see if he was okay. The way Lisa put it to me, “As the garden began to bloom, we began to bloom.” There was a study in Norway of a very similar program that found it was more than twice as effective as chemical antidepressants for what I think is an obvious reason. It was dealing with some of the reasons why these people were depressed and anxious in the first place.
From access to medical care, to fairer economic policies, to treatment approaches that emphasize community, there are many ways we can begin to address mental health at a social level.
- How much of the material in this reading was new to you, and how much was already familiar? Do you have any questions about what you read?
- What resonated with you in the reading? Did it prompt any ideas for you?
- What do you think about the universal basic income experiment in Manitoba? Do you believe that the kind of programs that Johann Hari proposes would positively impact mental health outcomes in society if implemented more broadly? Why or why not?
- Does it make sense to you that creating a “tribe” through a collective project like gardening – might address the mental health challenges we are facing?
- What are actions you believe society should take to address the mental health crisis, particularly among youth? Are there other solutions might you propose that are not included in the reading?
— Research assistance provided by Sophia Zaia