Extroverts wake up each morning with an empty basket, and every person they talk to puts an apple in their basket until it’s filled. Introverts wake up each morning with a basket full of apples, and every person they talk with takes an apple, until their basket is empty and they need to recharge.
It’s a metaphor that U.S. Surgeon General Vivek Murthy used with students in a talk at Southern Connecticut State University on Thursday night about loneliness, mental health and the need for connection.
Students from Yale University, the University of New Haven, Southern Connecticut State University and Gateway Community College gathered in the student center for the event. Murthy has been traveling across the country giving similar presentations to students and young people to help grow awareness of the mental health crisis and hear about young people’s experiences with mental health.
“Each of the stories that we hear, each of the conversations that we have, these all add to the — if you will, the arsenal, I think, of evidence — that we use … to help tell the broader story of what’s happening in our country,” Murthy told reporters after the event.
In December 2021, Murthy published an advisory report warning on “alarming increases” in the number of youth struggling with mental health issues like persistent sadness and hopelessness. The advisory noted that between the years 2007 and 2018, suicide rates among youth ages 10 to 24 increased by 57 percent, and youth visits to the Emergency Department for depression and anxiety increased by 28 percent.
Murthy, who described social connection as being as necessary to human beings “as food and water” said that it was also critical to the function of a society.
“When people are feeling connected to one another … they’re more creative, they’re more productive. They tend to stay longer in the workplace when they feel connected to their colleagues,” he said. “And we also know that when society is dealing with big challenges, like we are right now, whether that’s climate change or violence or inequality, that requires us to come together as a country to listen to one another and work together to advance common solutions. But we can’t do that if we’re separated and isolated.”
Murthy started out with an interactive exercise, asking students to respond to questions — was it easy or hard to make friends on campus? Did they want more social connection or were they satisfied? — by moving to one side of the room or the other.
Students described some of the challenges they faced when trying to connect with their peers — being a commuter student and not being able to stay for club meetings, trying to adapt as an international student to a new culture — not to mention garden-variety social anxiety.
“Ever since moving on campus, my social anxiety has gone through the roof,” said Bianca, a student at the University of New Haven. “I’ve joined five clubs hoping to talk to people. I’ve tried to talk to people on my floor, but at the same time, I feel like I’m limiting myself … I want to try, but there’s something that’s stopping me and I’m trying to break through it, but I can’t. I don’t know how.”
Added to those more traditional challenges was the pandemic-driven isolation, forcing people to rely more on technology and weakening in-person communication skills.
“I’m a senior. This is my last year,” said Mary Lippa, a senior at the University of New Haven. “A lot of us have been online for the past two years and we don’t know how to connect anymore.”
“Everybody is too attached to their phones and they’re just too attached to Facebook,” said Tristan Johnson, a student at Gateway Community College. “When I was a kid, there was no Facebook. So when I was in a building, you had to communicate with the people around you. Now, everybody can just flip through the phone, nobody’s paying attention to what’s going on around them. It’s a little bit sad.”
After asking students whether they were more comfortable in large crowds or smaller intimate settings — and noting that the vast majority leaned toward the intimate — Murthy pointed out that events designed to welcome freshmen to college — mixers, movie nights, ice cream socials, etc. — are often large gatherings rather than the smaller gatherings that students said they preferred.
He said he remembered this from his own college days.
“I was an introvert. Still am. It wasn’t so comfortable to go to all those things,” he said. “But we do live in a bit of an extroverted world, right? Where large events are kind of the norm. So it’s interesting that so many of you say you prefer to be folks in intimate settings.”
Murthy also said that students needed to be made aware of where to go to seek mental health help. When he asked students if they knew where to go for mental health support on campus, about a third of the students in the room raised their hands. He spoke about the 988 hotline, which people can call if they want to talk with a mental health provider.
The conversation was followed by a panel discussion where four students representing each of the universities talked about making connections at college and what needed to be changed. The students said they wanted to see universities help students develop a sense of cultural identity and more opportunities for students to have conversations with college administration, as well as facilitating smaller group gatherings.
Lippa, who participated on the panel, said that it was critical to develop a community where students shared openly about their difficulties.
“When [the student leaders] opened up to me and they told me about the struggles they faced — about how they didn’t know if they were going to make it home walking down the streets of New Haven and West Haven after dark, because they needed to go get groceries … I found that I really connected to them and I understood the struggle,” she said. “Establishing a community where you can speak about your anxiety and your stress and any issues you are facing without judgment —That’s the most important thing.”
“A window of opportunity”
In his advisory report, Murthy included recommendations for how different sectors of society could improve access to mental healthcare for children, including strengthening insurance coverage for mental health services, offering evidence-based social emotional learning in schools and school-based mental health programs, expanding the mental health workforce and giving better supports to children in the juvenile justice system and foster care system.
Asked what progress had been made in the nine months since the advisory was published, Murthy said he had been working with legislators to pass bills . He said he has never before seen the level of public awareness about mental health needs or the agreement between politicians from both parties, the executive branch, and school and healthcare professionals that something needs to be done to address the issue.
“This alignment constitutes a window of opportunity, but windows don’t stay open forever,” he said. “And that’s why I feel a great sense of urgency to make sure we are doing everything we can to advance policies, to change institutional practices and ultimately to shift the culture from how we think about mental health.”
Murthy told reporters after the event that he believed technology was a critical component in making sure that people had access to healthcare in light of the shortage of mental health providers. He said that telemedicine can play a critical role in allowing people in rural or remote areas to access mental health services.
“I remember visiting a small fishing village in Alaska when I was Surgeon General in 2016,” said Murthy.
“And in that small fishing village of 150 people, they actually had a screen in the wall, where people could come and they could sit in front of that screen and get access to counseling services from providers who were located in the lower 48. And I wish we had that in every small town, in every community across America.”
Murthy added that there was another component to addressing the mental health crisis, one that goes beyond investing in workforce or changing policy. It has to do, he said, with bringing together a country that has been divided and disconnected — and it’s something that everyone can take part in.
“All of the stories that I’ve heard all across the country tell us something is wrong in this moment. And what’s called for is a return to that deeper connection, that sense of community, which is profoundly healing,” he said. “Through your ability to connect deeply with another human being, to look out for someone else, to listen to them, to give them the benefit of the doubt in a conversation — your ability to help somebody feel seen and heard and understood, to know that they matter — that is your ability to heal. It’s a power that you can wield right now. And we need you, too, because that’s the only way this gets better.”