Last month’s Sounding Board, “Childhood’s End,” discussed indicators and causes of this country’s children’s mental health crisis, which has become steadily worse for almost two decades, and was further accelerated during the first two years of the pandemic. There have been large increases among American children, youth and young adults in self harm, suicide attempts, suicide, drug overdose deaths, hopelessness, rates of depression and anxiety, obesity and diabetes, child asthma and heart failure deaths in recent years. The social isolation resulting from lockdowns and virtual education exacerbated these persistent trends to the point of not just a crisis but a national emergency.
In “Childhood’s End,” I asserted that the children’s mental health crisis is the result of decades of societal and cultural social disconnection intensified by smart phones (2007 to present) and social media and by economic and social divisions between “haves” and “have nots”. Indicators of social disconnection include:
- Feelings of loneliness resulting from reduced personal contact with friends and other peers, less dating and sexual experience, less social activity outside the home, less involvement in extracurricular activities or volunteering, reduced rates of religious affiliation and less physical activity, accompanied by a significant increase in screen time and use of social media. In The Lonely Century, Noreena Hertz maintains that loneliness is “not just about feeling ignored, unseen or uncared for by those with whom we interact on a regular basis … It’s also about feeling unsupported and uncared for by our fellow citizens, our employers, our community, our government. It’s not about only lacking support in a social or familial context but feeling economically and politically excluded as well.”
- A stark division in economic prospects, health, average life span, social regard and on lifestyle and cultural preferences between “haves” and “have nots” based to a large extent – but not solely – on having a BA degree, and on race/ethnicity. This division has developed both within and between racial/ethnic groups (see Charles Murray’s, Coming Apart: The State of White America, 1960-2010), and has had a powerful effect on low-income white men who often blame themselves for their economic plight. In a 2019 article in The New York Review of Books, Helen Epstein asserts that “their sense of personal worthlessness can be profound when jobs are unstable or disappear and is compounded by the loss of status in the community and the loss of respect within marriages and extended families.”
- An increase in experiences of everyday discrimination due to race, ancestry, or national origin. A recent study published in JAMA Psychiatry (Lee, et al 2022) found that “increased levels of discrimination were associated with higher odds of experiencing moderate to severe depressive symptoms,” and that there was a 30% increase in everyday experiences of racial discrimination during the pandemic for participants in the study. The authors comment: “Everyday discrimination has been implicated as a strong risk factor for adverse mental health outcomes.”
- The combination of physical pain and emotional pain. In We’re Still Here, Jennifer Silva asserts that pain “has become a powerful organizing force” in the lives of economically depressed communities whose white working class “seems to have fashioned a new culture of pain and trauma … and to personalize and depoliticize financial hardship.” Deaths due to drug overdoses, alcoholism and suicide have spiked in a culture impacted by economic decline. Epstein comments: “Addiction, violence, and despair are common to all human societies that have seen their cultures destroyed …” an observation that applies to some American Indian/Alaskan Native communities that have been devastated by alcoholism and high rates of suicide.
The same dynamics that have led to an increase in deaths of despair among middle aged Americans have also affected youth and young adults as they appraise their economic prospects. However, youth with no more than a high school degree (or less) would not be so emotionally harmed by low educational achievement in a society with easily accessible paths to earning a decent living other than higher education and/or creative or athletic talents.
Before smart phones and social media and before the shocking increase in opioid deaths and suicide, American families in all social classes had been withdrawing from community involvement for decades, as described in Robert Putnam’s famous book, Bowling Alone (2000). Putnam comments:
“It is as though the post-war generations were exposed to some anticivic x-ray that permanently and increasingly rendered them less likely to connect with the community.”
Arguably, it is this “anticivic x-ray” — which remains unidentified in Bowling Alone — which is the root cause of deteriorating mental health among both American adults and children. Putnam returns to the subject of the steady decline in community involvement, community spirit and community values in The Upswing (2020) and finds a culprit, the ethos of individualism, that he maintains surges in American society in 40 to 50-year cycles. Individualism is an inadequate name for the toxic force Putnam describes; I have renamed it Aberrant Individualism w variants – AI-v. Metaphorically, it is a social virus with lethal potential. Symptoms include:
- A substantial increase in income inequality justified by a “winners and losers” social ethos in which no amount of compensation is too great for top talent and no income too small for the homeless and other severely poor persons. According to Putnam, approximately one trillion dollars in annual income has been transferred from the bottom 99 percent of the US population to the top one percent of households since 1970! Extreme income inequality increases social distance and social tension between and among persons in all social classes.
- The loss of social cohesion and the very concept of “the common good” even during a pandemic that has led to more than one million deaths in the US; and global warming that is a threat to human civilization and, perhaps eventually, to life on earth through a mass extinction of species.
- The use of computer technology as a social prophylactic for unpleasant or tedious social interactions even to the point of sales calls from robots and the increasingly frequent practice of substituting menus accessed by smart phones for wait staff in restaurants. A growing number of Americans clearly prefer avoiding all unnecessary social contact, pandemic or no pandemic.
- The preference for prescription of psychotropic medications to reduce symptoms of mental health problems while dispensing with therapists, along with active consideration of social robots to meet the need of emotionally troubled children for consistent empathetic interaction (see Noreena Hertz’s, The Lonely Century) .
- A significant percentage of young adults, especially men, who prefer to live with their parents rather than with peers or intimate partners.
- An increase in the percentage of young adults, again especially men, who report having no sexual activity during the past year. In one recent study, 30% of young men 18-34 reported no sexual activity during the past year vs.18.9% in 2001-02. Rates of sexual activity for young men with an annual income higher than $50,000 were 2-3 times higher than for same age men with incomes less than $30,000! (Ueda, et al 2020) This statistic gives concrete meaning to the experience of social exclusion based on income and job prospects.
- The loss of trust in all social institutions, including schools, churches and government, and the willingness to embrace far-fetched conspiracy theories, absent the slightest evidence that can bear scrutiny.
- An increase in hate crimes directed at minorities, in antisemitism, and in both fantasies and acts of cathartic violence among alienated young men.
I could add to this list but there is no point. If readers are skeptical that the phenomena on the above list are connected to AI-v, more examples are unlikely to convince them. For unconvinced readers, I have three questions: 1) if AI-v is a fiction, what accounts for the multiple indicators of distress, i.e., chronic physical and emotional pain and desperation among children, adolescents, young adults and middle-age Americans?; 2) why is social disconnection such a pervasive feature of American society; and 3) why do corporations continue to invest in technologies that make social disconnection easier? Other than Putnam’s discussion in The Upswing, I have yet to hear or read plausible answers to these questions.
What Can Be Done?
The idea (largely unquestioned) that the best response to the children’s mental health crisis is to increase the availability of and access to standard mental health treatments, including prescription of psychotropic drugs and various therapies, is false. This is how to manage the crisis and mitigate suffering, but this approach will do little or nothing to prevent the mental health problems of children and might even increase the number of children and adolescents with mental health diagnoses required by insurance companies to pay the cost of care.
Any effective response to children’s emotional pain and suffering must have three main goals:
- Reduce loneliness.
- Increase educational and economic opportunity and hope of adolescents in the future.
- Rebuild communities, community spirit and commitment to the common good through investments in neighborhoods, rural areas, and reservations and through empowerment practices.
All three of these goals target social disconnection and depend on changes in cultural practices and beliefs as much as on changes in public policy. Dramatic increases in the experience of both physical and emotional pain among children and youth contains a clear implicit message: Do Something Different! This is not an easy sell in a country whose response to horrific events in recent years has been to double down on the values and practices that led to these disasters. Many Americans tenaciously cling to the tenets of AI-v, which is a social philosophy with libertarian roots. It acts like acid on community spirit.
Smart phones and social media have had a devastating effect on American children and adolescents (in part) because this technology was introduced into a society that had spent decades withdrawing from community involvement. First, many American families severed their connections with civic institutions and their neighbors, and then children were allowed to withdraw from families and friends into a virtual world of online relationships. For many (not all) children, this is a formula for loneliness, social exclusion and 24-hour exposure to cruelty, with an especially large impact on young girls, 10-13. Smart phones and screen time could not have restructured the social life of children without parents allowing this to happen.
I grew up in an era when most adults smoked. My parents and their friends and acquaintances smoked in the home, in cars, offices and other public places without a thought that second-hand smoke might harm children. If anyone had raised this objection, they would have been ridiculed or ignored. Many hours of daily screen time increase the loneliness of children and youth, per information in Jean Twenge’s book, iGen, which I discussed in the previous Sounding Board.
Prolonged loneliness is injurious to the health of both adults and children.
In The Lonely Century, Noreena Hertz states: “ … (loneliness) isn’t just a mental health crisis. It’s a crisis that is making us physically ill. … loneliness is worse for our health than not exercising, as harmful as being an alcoholic, and twice as harmful as being obese. Statistically, loneliness is equivalent to smoking fifteen cigarettes a day. … this is regardless of what we earn, our gender, age or nationality.” Hertz asserts that “our smartphones and social media are just two pieces of the puzzle though, … we now do ever less with each other, at least when it comes to traditional ways to commune,” e.g., attend church or synagogue, belong to a civic group, live or eat with others or have a close friend. Smart phones and social media have increased loneliness in developed societies whose citizens were already actively engaged in pulling apart and reducing community involvement. Nevertheless, children and youth in the US and other developed countries are paying a huge price for social disconnection, and they are immersed in a technology guaranteed to sustain these trends.
Parents can and should increase the age at which children and adolescents are allowed to have smart phones, and they can drastically reduce their children’s screen time at home. However, unless parents of their child’s peers do the same, these steps might increase, rather than decrease, social isolation. It is difficult to reduce the use of technology that has become embedded in the culture. Just as important, strict restrictions on the amount of screen time children are allowed cannot be effective unless parents are following much the same rules.
It is not enough to limit in-home use of smart phones; children must also be strongly encouraged to develop interests and friendships outside the family. The idea that children are safer and more secure sequestered within families to the maximum extent possible increases the risk of loneliness and may lead to the inability of youth to cope with social interactions in the wider world.
Increasing opportunity and hope in the future
According to widespread belief, the US used to be a land of opportunity in which upward social mobility was common and every generation was economically better off than the one that preceded it. The US is still viewed as a land of opportunity by immigrant populations, but less so by oppressed minorities and low-income Whites who have been relegated to “have not” status by the educational meritocracy. Higher education has become a means of sorting young people into social classes and locking in economic advantages for affluent families, while creating upward mobility for a small percentage of academically talented children of “have not” groups. Educational meritocracy has created a land of inopportunity in which widening social class divisions have begun to take on the appearance of caste.
This is a harsh world for almost two-thirds of American youth and young adults. It is a social system that must change to repair the unequal and unjust practices of the past 50 years:
- Public policy should support and fund integrated neighborhoods and integrated schools, and schools which contain a mixture of students from all social classes.
- Community college should be without cost for all young people, and exemplary performance in community college should be rewarded with scholarships to four-year colleges and universities.
- Philanthropies should fund nationwide talent searches in the creative arts, and in other prosocial skills such as farming, gardening, animal husbandry, etc. Many thousands of disadvantaged young people should be given financial awards to further develop their talents.
- State and local governments should fund “Transition to Adulthood” social workers whose mission is to assist youth,16-25, who have dropped out of high school and/or are not in school and not employed. Every tool of public policy should be employed to reduce the population of older adolescents and young adults not in school and unemployed to a bare minimum through job training, housing supports and mentoring programs. In a society organized around multiple opportunities for the development of talent, there should be no “throwaways,” no social exclusion.
Rebuilding neighborhoods and communities
Empowerment practices that build the “collective efficacy” of neighborhoods, communities and reservations have the potential to counteract hopeless/helpless attitudes and beliefs that underly depression and suicidal ideation. The main antidote to hopelessness is more power and control over life circumstances by joining with others to improve community life. In the next Sounding Board, I will discuss some effective efforts in the US and Canada to build stronger communities. When stories that demonstrate how to defeat social disconnection through community building become more interesting to Americans than stories of entrepreneurs who prevail in a “winners take all” competition for wealth and influence, children’s mental health will dramatically improve. Until this occurs, social disconnection in multiple variants will add to the pain of American life.
Epstein, H., “Left Behind” (2019), The New York Review of Books, March 26, 2020.
Hertz, N., The Lonely Century: How to Restore Human Connection in a World That’s Pulling Apart (2021), Currency Publishers, New York City.
Lee, Y., Liu, Z., Fatori, D., Baumeister, J., Luh, R., Clark C., Baumeister, S., Brunini, A., & Smoller, J., “ Association of Everyday Discrimination with Depressive Symptoms and Suicidal ideation During the COVID-19 Pandemic in the All of US Research Program,” (2022), JAMA Psychiatry, pub. online, July 27, 2022.
Leonhardt, D., “”A large new study offers clues about how lower-income children can rise up the economic ladder,” The New York Times, August 1, 2022.
Murray, C., Coming Apart: The State of White America, 1960-2010 (2012), Crown Forum, New York City.
Putnam, R., Bowling Alone: The Collapse and Revival of American Community (2000), Simon & Schuster, New York City.
Putnam, R.& Garrett, S., The Upswing: How America Came Together a century Ago and How We Can Do It Again (2020), Simon & Schuster, New York City.
Silva, J., We’re Still Here: Pain and Politics in the Heart of America (2019), Oxford University Press, New York City.
Twenge, J., iGen: Why Today’s Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy – and Completely Unprepared for Adulthood, (2017), Atria paperbacks, New York City.
Ueda, P., Mercer, C. & Ghaznavi, C., “Trends in frequency of sexual activity and number of sexual partners among adults, 18-44, in the US, 2000-2018,” JAMA Network Open, 3 (6), published online, June 12, 2020