If you were paying attention this spring, you probably saw a lot of headlines coming from college campuses. There was a wave of protests over the war in Gaza.

The struggle to control the ongoing chaos at college campuses across the United States.

There were thousands of arrests.

Last week, more than 100 people were arrested after the school asked police to remove.

There were even congressional hearings that put university presidents in the hotseat.

Do you have my commitment he'll be removed as chair today? I have my commitment that I will come back to you.

And I got to tell you, as a journalist, I, of course, was paying close attention to the news as it was developing. But as a dad of three teenage daughters, including one who was a college freshman at the time, I got to be honest with you. It was a pretty scary time. I felt helpless at times. Raising a teenager these days is challenging enough, and I know that I'm far from the only one who feels this way.

Parents are. They're not only contending with the usual stressors, but they're also worried about how to manage social media and phones for their kids, something that my parents didn't have to worry about. They're trying to figure out how to contend with a youth mental health crisis, and a loneliness epidemic that are hitting kids really hard right now.

That's a man I've known for a long time. U.S. Surgeon General Doctor Vivek Murthy. He's also a father of two, and he's appeared on this podcast in the past. Last week, he released an advisory calling parental stress a significant public health issue. In part, it was because a 2023 survey of adults from the American Psychological Association found 33% of parents reported high levels of stress in the past month, and that was compared to 20% of other adults. So the advisory basically is calling for a culture shift, respecting the important role of parents in our society and giving them more support. Now, I know it's not the most encouraging news to hear that parents and their children are experiencing these feelings of loneliness and anxiety, especially as college kids head back to campus. But that's exactly why I wanted to speak to psychologist doctor Nancy Roy.

We're seeing many students struggling coming back to campus after having been isolated for a couple of years during the pandemic, and really struggling to reconnect with peers, to reconnect in the classroom, to be on teams.

'She's chief clinical officer at The JED Foundation. That's a nonprofit dedicated to the emotional well-being of teens and young adults. She says simply that one of the best ways to promote student mental health is to try and build a campus wide culture of caring. Today, we're going to explain what that means, and we're going to take a look at some of the main issues impacting the mental health of young people and as a result, sometimes the parents. Plus, we got a lot of tips for heading into a new school year. I'm Doctor Sanjay Gupta, CNN's chief medical correspondent, and this is Chasing Life. I have to tell you, professor, I have three teenage girls. So this is a very, personal podcast, I would say in many ways. I think if you are living as a parent of teenagers right now. I think in some ways it's what you think about the most, it's every dinnertime conversation. It's every sidebar conversation with my wife. And I remember, reading a statistic. I think it was last year, sometime, that 1 in 3 teenage girls had contemplated suicide over the past year. I have three girls. I have dozens of girls who come by the house all the time that are my my kids, you know, playmates since they were young. Does this surprise you?

I'd like to say yes, it surprises me, but actually it does not. And all of the data that we keep hearing and tracking is exactly what you're talking about. And not just for young girls, clearly. Although I think young girls have, you know, the data showing it appears that they are more impacted by social media than perhaps young boys. But certainly young boys are also struggling. And I mean, we know that suicide is the second leading cause of death for young people between the ages of 12 and 24, which is a very scary statistic. We also have seen increases in anxiety and depression, certainly with especially young girls. Eating disorders. So unfortunately the picture is not a good one. And, and, you know, a lot of folks talk about, you know, we're having a mental health crisis right now among our young people. And I'd like to reframe that to say, first of all, crisis, I think is a difficult word. It suggests that there isn't hope, when in fact there is some hope. And the reality is these trends have been continuing for the past ten, 15 years. It's not like all of a sudden we have this crisis upon our hands. This is something that's been trending upwards for for quite some time.

I do want to to highlight that point, because I think that it's really critical to to sort of get a sense of how long this has been happening when trying to figure out why this is happening, and we'll come back to that. But. You know, in medicine, a lot of times, if you see an uptick in something, an uptick in a particular disorder or disease state, one of the, one of the questions that that epidemiologists will first ask is how much of this is because of increased awareness of the issue versus an actual increase in whatever it may be? Professor, do you think about that as well, when it comes to mental health, emotional health, with regard to to young people today? I mean, are we more aware of things and therefore the numbers seem larger? Or is it more than that?

'I think it's actually a both-and. I think we are more aware and I think, you know, one of the silver linings of the pandemic is that everyone became more aware of mental health. I think it began to impact people who never before thought about mental health. They were losing family members. They were ill themselves. They were losing jobs. And so I do think that awareness was increased and more and more people were talking about mental health and stigmas a little bit declined, certainly declined among our young people. So yes, increased awareness and more reporting, but at the same time, look at what's happening in our world. I mean, the environmental factors, the things that young people especially are dealing with: school shootings, hate crimes, political divisiveness, financial insecurity, war. I mean, these are these are the things that our young people are growing up with. They've not yet had a period of stability within which to sort of place the conflicts that they're living with right now and the challenges that they're facing. This is their only reality. And I will say I will add one more factor, you know, the neurobiology of the brain, where the prefrontal cortex isn't fully developed until age 25. And so that is the area of the brain that allows you to deal with stressors, with impulse control. And when that is not fully formed, you have all of these environmental stressors and there's increased awareness and talking about things. It's sort of a perfect storm to bring us where we are today.

The all the things going on in our society. You know, it's interesting, I think, about my own childhood and I think, you know, the Vietnam War was was basically over and there were no more wars on the horizon. The economy was relatively stable. We probably should have been talking about climate change, but we really weren't. We did not deal with the pandemic when I was my kids age. My kids were born into two wars. Ups and downs with the economy. Constant chatter, I think necessary chatter but constant chatter about climate change. And then obviously a pandemic. It's it's. They grew up in a different world in some ways than than I did.

Exactly. And and not only has that been their experience it's been their only experience.

Yeah it's an interesting point I guess if it's your only reality I don't know if that's worse or not, because if you had like a really good period and then all of a sudden you're immersed in a really tough period, you, you think, well the context here is awful. I used to be so good and now it's terrible. But for them, as you say, it's their only reality.

And I think, you know, what you talk about is, you know, it was the grass was pretty green. And then I went to the other side of the fence and it was pretty brown. Right. But I think the fact that you had a green experience and you know that grass can grow green again, can provide some hope, whereas if you've never seen the green, you have no concept of how that would ever emerge.

'How how hard is it to to measure, to get objective data when it comes to mental health? I mean, I imagine most of this has to be self self-report, right? Or are there other objective measures as well?

'There's both. So I would say that the majority self report. There are two major assessment tools that colleges and universities use for college age students, and those are the Healthy Mind study, which is out of the University of Michigan, and the National College Health Assessment, which is the American College Health Associations assessment. And they ask many, many questions, both physical and mental health. And so while much is self-report, they also have embedded in those surveys clinical tools. So clinical assessments of anxiety and depression so that it's not just a student saying oh I feel sad or oh, I feel depressed. It's actually scored on a clinical scale and we're seeing definite increases in anxiety and depression.

Obviously I think people always talk about suicide, which is the most catastrophic consequence, I think. And again, to borrow from medicine, you know, you know, in medicine, we always want to sort of, rule out the worst things first, address the worst things first. But leaving aside something as catastrophic as suicide, how else has this, we're not going to call a mental health crisis, but this mental health period with with these college students in particular, what does it look like? What does it feel like then on on college campuses?

Well, I would say probably, one of the things that we're seeing an increase in is loneliness among our young people on campus. And I'm sure you're very aware of the surgeon general's report on loneliness being an epidemic in our country right now, and especially for young people. And I think right now we're we're seeing many students struggling with relational skills and beginning to sort of coming back to campus after having been isolated for a couple of years during the pandemic, coming back and really struggling to reconnect with peers, to reconnect in the classroom, to be on teams in addition to academic remediation, because of a lot of academic skills were lost or impaired. So I think right now we're seeing sort of a catchup period, if you will.

Are you optimistic about that group of people? I mean, look, and I tend to be an optimistic person, maybe even a little pollyannaish. And I remember having these long conversations with my wife about our girls and, you know, sort of believing that. Yeah, I'll give you an example. I remember there was a birthday during the pandemic, and I think one of my daughters was, you know, she was sad that there was going to be no party, you know, given what was going on. And I said to her, you'll never forget this birthday. I promise you that you'll tell your kids and grandkids about it one day. And I don't know, I wasn't trying to be glib, but. But do you think that, you know, they might become even more resilient as a result of this? Or is there a positive shine at all?

I don't know about that. I don't know if they'll become more resilient. I think that one of the things we're not doing a great job of is remembering that these things take time to absorb and overcome and move forward from. You know, when you think about any catastrophic event, a natural disaster or a flood or whatever. You know, people don't recover, you know, the minute that the flood subsides, right? It takes many years for people to deal with sometimes the trauma that they experienced, the devastation. And so the pandemic is no different. Right. Just because the pandemic is over, as we say, doesn't mean all of a sudden everybody's back to normal. Right. We need to allow for people to, young people especially, to to repair, to be be able to come back to learning skills that got rusty reengaging in the world. And so I think especially when we work with schools, we talk with them about being mindful about what these students are bringing with them and helping them not dismiss it. But helping them navigate their way through it.

You know, one of the things you mention is, is loneliness. And I've been thinking about loneliness for a long time. Talked to Doctor Murthy about this quite a bit, the surgeon general. And you'll forgive my sort of simplistic maybe approach here, but I'm thinking about college students, and I'm thinking, okay, it's a period in life where in many ways, the culture of college comes with this almost built in community: dorms and clubs and sporting events and classes obviously and and all that. Why? Why would that be a time where people seem to really, really have a struggle to connect to one another? I mean, it's almost like college in some ways would be, I would think, the therapy to try and deal with the prevalence of loneliness.

I think our experience with, with colleges around loneliness is that we see really loneliness being the biggest issue for first year students. When you think about that, it makes sense right. They're moving away from their holding environments, moving away from family, friends, connections that they had. And most students don't go to college with, you know, a group of ready made friends, right? So they're entering an environment where, yes there's clubs. Yes, there's teams. Yes, there's, you know, all of what you just mentioned, but navigating your way into those things when you arrive on campus, you know, for many first years, one of the biggest worries is who's going to, who am I going to sit with at dinner? Like, you walk into a cafeteria and you don't know anybody, right? It's scary. It takes time to build connections and relationships. They're navigating their way for the first time independently. They're having to develop their own sense of routine and structures. Nothing's built in like it often is when they're in high school and living at home. Some colleges are really good at focusing on that transitional time and helping young people to connect and and others less so. Right. But it's those schools that deliberately put in activities and ways in which, even just organically, common rooms where young people can just gather, you know. They're not necessarily coming for a program because nine times out of ten they're not going to come to you program, but they may just find themselves sitting in a common room playing a video game with somebody or watching, you know, whatever on television. So being deliberate about setting up those opportunities that you described, being deliberate about engaging young people to, to take advantage of those communities. And then we also have certain populations that feel marginalized and are marginalized on campus. And I think the student data helps us to focus in on those groups of students who are most likely to be struggling with loneliness and isolation, and then targeting interventions to try and get them connected.

Who are those students that are most likely to to be at risk?

Typically, they're students that are less represented in the student population. So, you know, if you're in a college with predominantly white students, students of color are oftentimes a group that struggle. LGBTQ students. With all of the sort of conflict and controversy around diversity, equity and inclusion right now, students who have different identities, varying identities. Trans students. Many of those students feel very threatened, and services that have been targeted to help them are being either banned or certainly limited, which again, creates a very uncertain situation in world for specifically those students.

How how does the political climate and the scrutiny on administrators in higher education, which we've seen a lot of how does that impact the challenge of supporting students mental health needs?

'I think it's very scary for young people to be watching what's happening, not just politically, but in their own college community. And as we've seen college presidents being taken to task for, whether it's DEI initiatives or the war, their their leaders are leaving, the leaders are resigning. The people who -- we're supposed to, as leaders, be providing a sense of safety and security for our young people. You know, as a college president or as a president of the United States or Congress or Senate or whatever leadership you want to talk about. We're supposed to be the ones that are the leaders, that are the ones they can trust in and take stock in. And when they see those leaders being scrutinized, being, if you will, taken down to the point where they're leaving their positions, etc.. Who's in charge? That's a very scary place to be, if my leader and the people that are supposed to be in charge are no longer able to do that, or are dealing with such conflict and complexities themselves. It certainly doesn't give me, as a young person a sense of safety or security.

It is. It is really scary to me, professor, as well as as a parent of three biracial children. You know, I it's a strange to me a little bit how the conversation around DEI has been hijacked. I think it's a worthy conversation. But the idea that, to me, diversity in and of itself was a virtue. Like, I wanted my kids to be surrounded by kids who were not exactly like them because that's who they were going to learn from and see different points of view and learn about different things in the world. And and that is, you know, it's it's it's frightening to me that that has been given such short shrift and been, you know, sort of demonized the way that it has.

Truly. I mean, not only in the ways you describe, but even in terms of what, institutions are able to teach. Right? They're even restricting, you know, parts of history that are important to be able to teach our young people so they can understand how we've come to be, how we've evolved. Or I might even say right now, devolved. And so it's so broad, the implications of of what's happening now. And it really is scary because it's affecting even more so populations that were already marginalized and struggling.

After the break, we'll discuss what we can all do to support the mental health of teens and students. That's coming up. What do we get wrong in terms of our conceptions about college students and mental health? I mean, a lot of what you're describing, again, is heartbreaking. Are there some misconceptions?

'I do think one of the things we do get wrong is and this we saw quite a bit when, due to the pandemic, there was much more funding given to colleges and universities for mental health. And we saw that most colleges sort of knee jerk reaction was: We need to hire more counselors. That's never... I worked at an institution once -- I was on college campuses my whole life before coming to JED 11 years ago. And I remember one college president saying, "You can hire as many counselors as you want, and it's still not going to change the situation." And of course, at the time, as the director of the counseling center, I did want to argue at that point with her. But, you know, in retrospect, she was right, again, because one of the things we get wrong is that we think everyone needs to be in therapy, and not every college student needs to be in therapy. But we need to create a culture on campus for that sense of belonging, connection, caring, compassion. That's the deep underpinning that supports broad numbers of students. And I'm not dismissing those students who truly do need direct clinical care, and they should have it. But to think that whenever anyone is feeling a bit off or sad, that the answer is to get them to counseling really misses the point.

How would you grade, if you will, how well college campuses do in this regard in the ways that you're describing? I mean, I'm sure some colleges, some universities better than others, but overall, how much of a focus is there on this?

Again, I think the pandemic helped us in that regard. I think there's a much greater focus on mental health in colleges and universities. The American Council for Education, which is the organization that most college presidents belong to, they survey their college president population each year on what keeps them up at night. You know, what are the top three things. And mental health, student mental health is always among the top three, which is a shift. It never was the top thing on administrators minds. And so with them on board as senior leaders, you know, giving that message that this is important and that we really take this seriously, we're going to work to promote mental health has has helped our work tremendously.

Maybe it's a good opportunity to talk a little bit about the foundation, the JED Foundation, because when you use this term, allow these, these young people to repair. I'm curious what that what that means and what does it look like. And as a dad, what is my role in helping repair?

Well, I could go on forever about what we do at JED. But I'll try to be condense, and that is really taking a public health approach when we work with schools. And by that, I mean helping schools to understand that the responsibility for promoting mental health, whether we call it repairing what happened from the pandemic, but really, truly, just more broadly, promoting positive mental health is everyone's concern on a campus. It doesn't mean everyone has to be a therapist, right? But it does mean that everyone needs to be aware. Everyone needs to be able to offer a warm hand for support. Certainly, all can benefit from a warm hand from someone who is organically in their community who will notice if Nance's quiet for a couple of days in class and be able to say to me, hey, you've been quiet for a couple of days, you're usually pretty talkative. Is everything okay? Developing a sense of caring and compassion. A culture of care and compassion on your campus where there's no wrong door to walk through for support, for that gentle guidance, for that kind word. And we find that it's just one of the things that we work with schools. But that is really, I would say, the foundational principle. That along with having support from senior leadership. If you don't have support from the top down and you don't have a public health campus wide approach, it's very hard to move the needle in any kind of long term, systemic way.

And I wonder if there's lessons in there for people who are in, you know, professors. You know, I'm talking about parents or just people in communities as well, in terms of, as you say, just just being a human being and saying, hey, everything okay? You know, to to either one of your children or your children's friends. The typical response you'll get from teenagers is, yeah, fine. Everything's fine. So what next? I mean, how how do you know how far that sort of probe or push it?

'Yeah. One of the things that can be helpful is rather than having sort of that open question like, is everything okay? And they can say it yes or no, it can be better -- I'm not saying it's foolproof -- but to be able to state what you've noticed. So gee, I notice you haven't been sleeping lately, or I notice you're not eating like you normally do, or whatever the behavior changes that you're seeing that's causing you to think something might be going on to name that, because then they can respond. They they still say, no, you know, you don't know what you're talking about. I'm eating fine or whatever they might say to you to be dismissive, but it does help just slightly change the conversation so that a yes no answer is less likely to be the response.

Is college is the way that our society and our culture view college. It's different than it used to be. I mean, when I went to college, like my parents, like, we're paying all this money. You're getting an education, you know that. That's the primary obligation here. It wasn't about me joining clubs. They never talked to me about loneliness. Although you're quite right, professor. I think my freshman year was really hard for me. I just didn't know anybody there. And, you know, it was challenging, but we just didn't talk about it. Does the way that our our society and our culture view college somehow play a role in this?

I think. I mean, I think what we're seeing pretty much every day in the news is the questioning of the value of college in higher education, that that I think that is coming more and more into question. And I think that there has been sort of a I don't know if it's a refocus, but certainly a focus on the value in terms of I'm paying all this money to go to college and am I going to get a job, right? I mean, I think our young people are very afraid of financial insecurity. Their student loan debt is, you know, soaring. This is, you know, top concerns for families and young people about college, the value, all the money I'm spending on college. And am I going to get a job? I mean, you talked about potentially being pollyannaish. I, when I talk to young people about going to college, is it's a time for exploration and discovery, where you'll take some classes that you never even knew existed and it will open up a whole new world for you. And then when I talk to some parents, they're like, and that's what I'm spending $70,000 a year and.

It's it's it's not cheap. It's not. I'll tell you, part of the reason I wanted to have this conversation and wanted people to listen is just so they can recognize that they're not alone, that their concerns are probably much more widespread than maybe they realize, because I think that that's a source of stress. Are we the only ones dealing with this? Is anyone else dealing with this? So let me be selfish for a second and take advantage of the fact that I have you here, this this person of immense knowledge and experience when it comes to these issues. And again, I have three teenage girls. What advice would you give me, in terms of how I'm dealing with my students and my girls going into next year?

'So we always talk with parents about a few things. First off, looking at what's available on that campus, especially if your child has been in treatment or may need to engage in counseling. What are the services like? What is the culture like? What are the ways in which you see on the campus? Your child might be able to get activated in or engage in that's going to help him or her connect and feel that sense of belonging. Secondly, we also, I would encourage you to really talk about self-care. What is it things that your girls do to feel good about themselves, the basic things? Do they get enough sleep? Do they eat well? You know, the things that... Do they not spend 24 seven on, on social media? But also what are some things that bring them joy, you know, what can they be bringing with them that help them? I mean, people talk about mindfulness. Mindfulness takes many forms, right? Mindfulness can be going for a swim if you're a swimmer or playing the piano if you're a pianist, you know. What are some of the things that they can bring with them that help them to feel good about themselves and to relax and feel a sense of inner peace, if you will?

Yeah. Look, I really appreciate that. I think, you know, and I'm guilty of this as well. I think you get into the to the notion of, okay, it's school year. You're buying your your notebooks and your pencils and all that sort of stuff, what you should. But these other points you're making are so important. Early on when I had our girls and, you know, we didn't know we were going to have all girls, I and I never had little girls in my life. I had a brother. So like, all of a sudden, dealing with young girls was brand new for me. But every day, even when they're away at college now, I either usually by phone or, you know, in person, if they're home, I will tell them that they are smart, they are strong and they're beautiful. And, you know, in some ways it just became this sort of touch phrase in our family. But I realize now that my girls are, you know, young ladies, that it's made a difference in their lives because there can be people in their lives who are mean sometimes. And the fact that they have their dad saying this to them, it was never just a touch phrase for me. It always meant something. And now I realize how much it meant for them as well, which is it's really powerful.

It is totally powerful. And we don't realize, I think, the power of the messages we give positive and negative sometimes, but having those positive affirmations about you can do it. You know you're a good person, as you said, smart, intelligent. Whenever the things are that you said that, it's it sticks with them.

'It does stick with them. But also, I think it's pretty clear that turning this problem around won't be easy. It won't be simple. This is one of the biggest challenges of our time. And let's be frank. The mental health struggles of teens and young adults are immense. Addressing it is going to take some smart policies and thoughtful systemic changes. But as Doctor Roy points out, the situation is also not hopeless. College campuses and organizations like Jed are invested in finding solutions to improve the health and mental wellness of students. And there are things we can all do. Maybe first and foremost, we got to remember that just being human makes a difference, that we're all trying to pay attention to people in our community. And we should notice when our kid or another student seems off. Pay attention to that, and also be ready to offer a hand if they need some help. Before we go, we're trying out a new segment on the podcast. It's called Doctor Sanjay Gupta on Call, where, as you probably guess, I get to answer your questions. And that's right after the break. All right. Our first question for On-call comes from Katherine in California. She wants to know when will a new Covid 19 vaccine be available, and will it be a combination shot with the flu? Well, Catherine, I'm glad you asked this because just at the end of August, the FDA did approve Covid vaccines from Pfizer, Moderna and Novavax. We did speak to representatives from CVS and Walmart, and they say the updated vaccines should be available by the time you're hearing this. So then the question is when should you actually get the updated vaccine? Well, if you're over 65 or you're considered high risk, experts advise you get a shot sooner rather than later. Now, if you're healthy and young, you can probably afford to wait for a bit. Or if you recently had Covid. The CDC says you may wait three months before getting the vaccine. Now, as far as the seasonal flu vaccine goes, this is not part of the Covid vaccine. I know the reason you're asking is because there's been a lot of conversations about this idea, but there is not yet a combination shot. Though companies are working on a combination vaccine for the future. The 2024 version of the flu vaccine is already available at your local pharmacy or your doctor's office, so you can get both the Covid and the flu vaccines at the same time, even if they're not part of the same shot. I hope this helps keep the calls and the messages coming. You can ask me anything. Just leave me a voicemail. (470) 396-0832. I really love hearing from you. Keep chasing life. Chasing life is a production of CNN audio. Our podcast is produced by Aaron Matheson, Jennifer Ly, Grace Walker, and Jesse Remedios. Our senior producer and showrunner is Felicia Patinkin. Andrea Kane is our medical writer, and Zula is our technical director. And the executive producer of CNN Audio is Steve Lickteig, with support from Jamus Andrest, John Deanora, Haley Thomas, Alex Manessari, Robert Mathers, Lainie Steinhart, Nicole Passaro, and Lisa Nomura. Special thanks to Ben Tinker, Amanda Sealy, and Nadia Canning of CNN Health and Katie Hinman.