Washington:

US Surgeon General Vivek Murthy on Monday called for a warning label to be added to social media apps as a reminder that those platforms have caused harm to young people, especially adolescents.

Mr Murthy wrote in the New York Times on Monday that a warning label alone will not make social media safe for young people but that it can increase awareness and change behavior as shown in evidence from tobacco studies. The US Congress would need to pass legislation requiring such a warning label.

WHY IT IS IMPORTANT

For a long time, Mr Murthy has been warning that social media can profoundly harm the mental health of youth, particularly adolescent girls. In an advisory last year, he called for safeguards from tech companies for children who are at critical stages of brain development.

A 2019 American Medical Association study showed that the risk of depression doubled for teenagers who were spending three hours a day on social media.

KEY QUOTES

“It is time to require a surgeon general’s warning label on social media platforms, stating that social media is associated with significant mental health harms for adolescents,” Mr Murthy wrote on Monday. 

“A surgeon general’s warning label, which requires congressional action, would regularly remind parents and adolescents that social media has not been proved safe,” he added.

CONTEXT

Some US states have been working to pass legislation to safeguard children from the harmful effects of social media, such as anxiety, depression and other mental illnesses as a result.

New York state lawmakers this month passed legislation to bar social media platforms from exposing “addictive” algorithmic content to users under age 18 without parental consent.

In March, Florida Governor Ron DeSantis signed a bill that bans children under 14 from social media platforms and requires 14- and 15-year-olds to get parental consent.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

New Delhi:

Highlighting the significance of awareness about mental health, Prime Minister Narendra Modi on Friday appealed to digital content creators to create content on the issue in local languages in an effort to reach out to the mass audience.

PM Modi, while addressing an event after presenting the first-ever National Creators Award at Bharat Mandapam in New Delhi, also acknowledged the work being done by several content creators regarding mental health.

“Issues like mental health are very important…I have faith in the talent of my country, I appreciate the sensitivity of the people of my country…Many creators are doing very good work regarding mental health, but right now we need to work more on this and if possible, in the local language…” the PM said.

The PM also mentioned about the insomnia and said that many people do not take the disease seriously.

PM Modi, who presented the Disruptor of the Year award to YouTube creator Ranveer Allahbadia (BeerBiceps) also suggested him to delve into the importance of sleep on his show.

In a candid revelation, PM Modi disclosed his own sleep routine, highlighting his habit of minimal sleep over the years.

The event, held at Bharat Mandapam, saw content creators from across the country being felicitated by PM Modi.

Branding the content creators as ‘Most Valuable Person’, the PM said, “Your content is creating a tremendous impact across India today. In a way, you are the MVP of the internet. When I call you MVP, it means you have become the Most Valuable Person. You all know that when content and creativity are interconnected when we collaborate, it increases engagement. When content collaborates with digital, transformation comes. When content collaborates with purpose, it shows impact and today when you all have come here, I too have collab requests from you on many topics…”

Speaking at the National Creators’ Awards, the PM predicted that the event will hold an important place in the future, saying that he can sense time ahead of time.

“Main samay se pehle samay ko bhanp leta hoon (By God’s grace, I can sense time ahead of time). That is why I can say that this award will have an important place in future,” the Prime Minister said.

Among the awardees, Jahnvi Singh received the Heritage Fashion Icon Award, while Kabita Singh (Kabita’s Kitchen) clinched the Best Creator in Food Category Award.

Pankhti Pandey was honoured in the ‘Green Champion’ category, Keerthika Govindasamy for the best storyteller, and Maithili Thakur as the ‘Cultural Ambassador of the Year’. Gaurav Chaudhary was recognized as the Best Creator in the Tech Category, with Ankit Baiyanpuria securing the Best Health and Fitness Creator award. Naman Deshmukh and Kamiya J were awarded the Best Creator in Education and Favourite Travel Creator respectively.

In a diverse range of categories, Shraddha Jain (AiyyoShraddha) and RJ Raunac (Bauaa) clinched the Most Creative Creator titles in the female and male categories respectively.

The National Creators Award witnessed significant public engagement, with over 1.5 lakh nominations and approximately 10 lakh votes cast. This initiative aims to acknowledge excellence and impact across various domains including storytelling, social change advocacy, environmental sustainability, education, and gaming among others.

In its first round, more than 1.5 lakh nominations were received across 20 different categories. Subsequently, around 10 lakh votes were cast during the voting phase, resulting in 23 winners, including three international creators, being decided.

The award ceremony encompassed twenty categories, reflecting the diversity of digital content creation and its impact on society. These categories ranged from the Best Storyteller Award to the Best Health and Fitness Creator, showcasing the broad spectrum of talent and innovation in the digital space.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

India is a country teeming with more than 1.4 billion people, and is in the throes of a demographic transformation. Its adolescent population, aged 10-19 years, accounts for a substantial portion of the national total, some 253 million. This demographic segment is a significant part of what economists and demographers have come to call the ‘demographic dividend’.

These young minds hold the promise of economic prosperity and development – but few also acknowledge that this potential actually hinges on these young men’s and women’s physical as well as mental well-being.

Youth mental health out of focus

Adolescent health and well-being have become important in public health discourses worldwide. Acknowledging the adolescent cohort’s pivotal role in society, the governments of both the States and the nation have introduced numerous policies and programmes to protect and respond to the health-wise needs of these young individuals. However, a closer look reveals that mental health does not figure as predominantly as warranted in many of these policies.

Adolescence is a time of profound transformation. It marks the transition from childhood to adulthood, and is laden with challenges – including those related to the perception of one’s body and body image issues. Society’s expectations regarding the ‘ideal’ behaviour and body types can significantly affect physical and mental health. The weight of academic expectations, peer pressure, and concerns about the future also take a toll on mental health at this time.

The Rashtriya Kishor Swasthya Karyakram (RKSK) is a Government of India policy that deals exclusively with adolescent health. It was rolled out on January 7, 2014. But despite having been in operation for nearly a decade, the mental health strategies under this policy have been implemented painfully slowly.

Under the purview of the National Health Mission, State governments were responsible for implementing the RKSK policy – including setting up ‘Adolescent Friendly Health Clinics’ as part of its facility-based strategies.

But to this day, the RKSK has not shared data on its critical components, including (but not limited to) mental health, violence, injuries, and substance misuse. It has also initiated few discussions on the curative aspect of mental health. And despite having recruited and trained numerous counsellors (both male and female) dedicated to adolescent health within the first three years of RKSK, many district-level vacancies persist.

Other policies – like the Sarva Shiksha Yojana (focused on learning disabilities), the National Youth Policy (substance abuse), the National Mental Health Policy, the Yuva Spandana Yojana (only in Karnataka) – address various immediate and underlying factors that affect mental health. However, most policies that are centred on adolescents have regarded mental health as a secondary concern.

An epidemic in the wings

Adolescents in India are particularly vulnerable to mental health problems like anxiety disorders and depression. Official reports have stated that among Indians aged 13-17 years, the prevalence of severe mental illness was 7.3% (as of 2015-2016). Even three years after the onset of the COVID-19 pandemic, mental health disorders among adolescents – often concealed beneath the promise of prosperity associated with this demographic – continue to become more common and have their effects felt.

An informal survey conducted by one of the authors (Smriti Shalini) from the Tata Institute of Social Sciences, Mumbai, earlier this year revealed little awareness of RKSK among school-going adolescents, parents, and teachers in the urban slums of Mumbai – and less so of the digital interventions of RKSK, a mobile app called ‘Saathiya Salah’ and an e-counselling within that app. Further, during a focused group discussion, students attending a school that facilitated access to a school-based counsellor said that they had negatively labelled the counsellor as a “tension teacher”, and that they were reluctant to share their concerns with this individual, fearing that they might be reported and have their privacy violated.

In India, mental health disorders are underreported due to poor awareness, lack of help-seeking behaviour (stemming from stigma), a desire and/or expectations to be self-reliant, and insufficient prioritisation in the policy framework. Schemes designed to improve access to mental healthcare need to accommodate these factors.

In addition, through various studies, researchers have identified poverty, childhood adversity, and violence as the three main risk factors for the onset and persistence of mental-health disorders. They were also associated with poor access to good quality education, lack of employment, and reduced productivity. Educational failures and mental disorders in adolescence also interact in a vicious cycle.

Equity in healthcare remains a significant issue in India, and this also extends to mental health. Access to mental healthcare services is often skewed along the same lines – wealth, caste, location, gender, etc.

Gender disparities are particularly worrisome. Adolescent girls in India face unique challenges, including gender-based violence and discrimination, that can severely affect their mental well-being. Conversely, adolescent boys are commonly expected to conform to masculine ‘norms’ of stoicism and are victims of bullying and shaming. Many children from ‘broken homes’ also experience dysfunctional family relations and face discrimination within the family, often resulting in bottling-up as well as issues with managing anger and delegating authority.

A dividend beckons

Based on studies, surveys, and discussions with stakeholders, experts have identified the following solutions.

First, policymakers should endeavour to shift from the current “medical model” of mental health to the convergent model of mental health: the latter recognises the complex interplay of behavioural, environmental, biological, and genetic factors throughout an individual’s life, especially during the crucial stages of childhood and adolescence. To this end, well-meaning programs like RKSK can learn from the experiences of other countries to better implement its vision.

For example, the successful implementation of the ‘Whole School, Whole Community, Whole Child’ model in the U.S. embraces a holistic approach to children’s well-being by considering factors such as nutrition, physical activity, and emotional health within the school environment.

Initiatives like establishing peer support groups in schools and colleges and community-based interventions leveraging technology can also encourage help-seeking behaviour.

Second, a multi-sector approach that includes underlying factors like education and nutrition should be at the core of policies to realise the full potential of adolescents. India’s youth is aspirational and deserves a good education. We need better pedagogy and resources that provide well-rounded development as well as employment. A good education empowers youngsters to access resources, assert their rights, and tackle societal and family issues better.

Third, we must recognise that a healthy mind thrives within a healthy body. The government should continue to make the improvement of school environments and health-promoting conditions a priority in parallel with efforts to combat pressing health concerns like malnutrition and anaemia.

Our nation’s future is banking on evidence-based policy-making and unwavering political commitment to be able to move mountains.

Smriti Shalini is pursuing a Master of Public Health in Health Policy, Economics and Finance at the School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai. M. Sivakami is a professor here.

Heart in your throat. Butterflies in your stomach. Bad gut feeling. These are all phrases many people use to describe fear and anxiety. You have likely felt anxiety inside your chest or stomach, and your brain usually doesn’t hurt when you’re scared. Many cultures tie cowardice and bravery more to the heart or the guts than to the brain.

But science has traditionally seen the brain as the birthplace and processing site of fear and anxiety. Then why and how do you feel these emotions in other parts of your body?

I am a psychiatrist and neuroscientist who researches and treats fear and anxiety. In my book Afraid, I explain how fear works in the brain and the body and what too much anxiety does to the body. Research confirms that while emotions do originate in your brain, it’s your body that carries out the orders.

Also Read | Where the mind is without fear: What is anxiety and how can we beat it? 

Fear and the brain

While your brain evolved to save you from a falling rock or speeding predator, the anxieties of modern life are often a lot more abstract. Fifty-thousand years ago, being rejected by your tribe could mean death, but not doing a great job on a public speech at school or at work doesn’t have the same consequences. Your brain, however, might not know the difference.

There are a few key areas of the brain that are heavily involved in processing fear.

When you perceive something as dangerous, whether it’s a gun pointed at you or a group of people looking unhappily at you, these sensory inputs are first relayed to the amygdala. This small, almond-shaped area of the brain located near your ears detects salience, or the emotional relevance of a situation and how to react to it. When you see something, it determines whether you should eat it, attack it, run away from it or have sex with it.

Threat detection is a vital part of this process, and it has to be fast. Early humans did not have much time to think when a lion was lunging toward them. They had to act quickly. For this reason, the amygdala evolved to bypass brain areas involved in logical thinking and can directly engage physical responses. For example, seeing an angry face on a computer screen can immediately trigger a detectable response from the amygdala without the viewer even being aware of this reaction.

Also Read | Sadness, sleeplessness, stress, and anxiety top mental health concerns shared on Tele MANAS

The hippocampus is near and tightly connected to the amygdala. It’s involved in memorizing what is safe and what is dangerous, especially in relation to the environment – it puts fear in context. For example, seeing an angry lion in the zoo and in the Sahara both trigger a fear response in the amygdala. But the hippocampus steps in and blocks this response when you’re at the zoo because you aren’t in danger.

The prefrontal cortex, located above your eyes, is mostly involved in the cognitive and social aspects of fear processing. For example, you might be scared of a snake until you read a sign that the snake is nonpoisonous or the owner tells you it’s their friendly pet.

Although the prefrontal cortex is usually seen as the part of the brain that regulates emotions, it can also teach you fear based on your social environment. For example, you might feel neutral about a meeting with your boss but immediately feel nervous when a colleague tells you about rumors of layoffs. Many prejudices like racism are rooted in learning fear through tribalism.

Also Read | Mental health awareness month: how to cope in the age of anxiety  

Fear and the rest of the body

If your brain decides that a fear response is justified in a particular situation, it activates a cascade of neuronal and hormonal pathways to prepare you for immediate action. Some of the fight-or-flight response – like heightened attention and threat detection – takes place in the brain. But the body is where most of the action happens.

Several pathways prepare different body systems for intense physical action. The motor cortex of the brain sends rapid signals to your muscles to prepare them for quick and forceful movements. These include muscles in the chest and stomach that help protect vital organs in those areas. That might contribute to a feeling of tightness in your chest and stomach in stressful conditions.

The sympathetic nervous system is the gas pedal that speeds up the systems involved in fight or flight. Sympathetic neurons are spread throughout the body and are especially dense in places like the heart, lungs and intestines. These neurons trigger the adrenal gland to release hormones like adrenaline that travel through the blood to reach those organs and increase the rate at which they undergo the fear response.

Also Read | How anxiety can look different in children

To assure sufficient blood supply to your muscles when they’re in high demand, signals from the sympathetic nervous system increase the rate your heart beats and the force with which it contracts. You feel both increased heart rate and contraction force in your chest, which is why you may connect the feeling of intense emotions to your heart.

In your lungs, signals from the sympathetic nervous system dilate airways and often increase your breathing rate and depth. Sometimes this results in a feeling of shortness of breath.

As digestion is the last priority during a fight-or-flight situation, sympathetic activation slows down your gut and reduces blood flow to your stomach to save oxygen and nutrients for more vital organs like the heart and the brain. These changes to your gastrointestinal system can be perceived as the discomfort linked to fear and anxiety.

It all goes back to the brain

All bodily sensations, including those visceral feelings from your chest and stomach, are relayed back to the brain through the pathways via the spinal cord. Your already anxious and highly alert brain then processes these signals at both conscious and unconscious levels.

The insula is a part of the brain specifically involved in conscious awareness of your emotions, pain and bodily sensations. The prefrontal cortex also engages in self-awareness, especially by labeling and naming these physical sensations, like feeling tightness or pain in your stomach, and attributing cognitive value to them, like “this is fine and will go away” or “this is terrible and I am dying.” These physical sensations can sometimes create a loop of increasing anxiety as they make the brain feel more scared of the situation because of the turmoil it senses in the body.

Although the feelings of fear and anxiety start in your brain, you also feel them in your body because your brain alters your bodily functions. Emotions take place in both your body and your brain, but you become aware of their existence with your brain. As the rapper Eminem recounted in his song “Lose Yourself,” the reason his palms were sweaty, his knees weak and his arms heavy was because his brain was nervous.