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“How can he be so stupid?” a dad asked me in a telehealth visit. His voice shook with fear and rage as he described his adolescent son sneaking out to meet friends against legal and family orders to stay at home.

As a child psychiatrist, I’ve been fielding many such calls.

“What if he’s not stupid?” I asked. Youths who ignore orders to shelter in place are cast as insensitive, short sighted, and foolish by media and politicians. But what if adults are missing their logic? What if adolescents and young adults are actually acting according to the American ideals of self-interest and self-sufficiency that have been modeled for them?

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Leadership happens by example. Lawmakers and other adults have set very poor examples about acting selflessly to protect vulnerable populations. When nearly 8,000 Americans aged 24 and younger died from gun violence in 2018, youths’ pleas for gun control fell on deaf ears. After nearly 11,000 young American lives were lost to suicide and drug overdoses in 2018, mental health and substance abuse treatment has remained limited and difficult to access. Efforts to reduce climate change, despite urgent pleas to do so, have been sparse.

Should young Americans now be asked to protect the older adults who failed to protect them? Is that fair?

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If adults expect adolescents and young adults to act in ways we have not demonstrated and modeled for them, we are the stupid and selfish ones. Lawmakers are demanding enormous sacrifices from young Americans: their educations, their social lives, and sometimes their safety, as many of the 1 million abused and neglected American kids are now isolated at home with their abusers, with no plan to ensure their safety.

Young people have low odds of dying from Covid-19. As I write this, the Centers for Disease Control and Prevention reports that 25 Americans aged 24 or younger have died of Covid-19 in 2020, or 0.1% of the lives claimed by suicide and unintentional drug overdoses in this age group in 2018. (For comparison, 477 children and adolescents under age 17 in the United States died of influenza in the 2018-2019 flu season.)

No graduations. No sports. No time with friends. Lonely teenagers are more likely to become depressed, obese, and unhealthy adults. Social isolation in childhood is linked to poor health, high blood pressure, high cholesterol, and obesity in adulthood. Even in good times, about 8% of American teens try to kill themselves each year and about 70% suffer from loneliness. In 2020, these numbers will likely be higher.

Is it shocking that some young people see social isolation measures as a more deadly threat than Covid-19? Is it rational?

Our medical system’s insufficient capacity to treat Covid-19 patients is a crisis that needs urgent intervention. Meanwhile, we’ve brushed aside the same medical system’s insufficient capacity to treat the issues threatening the lives of America’s youths for years.

Rationing health care — an issue now in the news in the Covid-19 era — is something I was tasked to do from my first day as a psychiatrist. There were never enough beds in the psychiatric units for young people at risk of death from suicide or addiction. Now, as the need for mental health treatment rises, the pandemic has forced hospitals to further reduce their capacity to treat mental health issues.

All of the teens and young adults I treat have made valiant efforts to isolate themselves to protect others, even knowing that they are extremely unlikely to die from Covid-19. For the first two weeks, they did well. Now they are suffering. Some hit their limits and can’t do it anymore. More teens and young adults tell me this with each passing week. Their restlessness and boredom have morphed into depression, anxiety, and anger.

Is anyone considering them in deciding how our country moves forward? Is anyone thanking them for their selfless sacrifices?

Quite the opposite. They are shamed in the rare instances when they can’t, or refuse to, sacrifice their own well-being for the greater good. They are shamed for acting like teenagers — and for acting American.

Youths lack voting and spending power, so their voices don’t get heard. I am writing on their behalf because their perspectives matter. They will inherit the leadership of our troubled society and we are foolish not to prioritize their well-being.

While social isolation is necessary to reduce deaths and to keep hospitals functioning, I believe a more nuanced and sophisticated discussion of the risks and benefits to key groups is warranted. If we want our children and teens to help protect us, we must protect them first.

Lisa Jacobs, M.D., is a child, adolescent, and adult psychiatrist in Menlo Park, Calif., the assistant director of The Pegasus Physician Writers at Stanford, and editor at large of The Pegasus Review.

  • Dr. Jacobs has written an important article, inviting a “more nuanced and sophisticated discussion of the risks and benefits to key groups”, in particular our youth, and more specifically youth with mental health issues.

    The consequences of our current lockdown approach to Covid-19 for the mental health and wellbeing of our youth, among many other consequences, will be long lasting and severe. Dr. Jacobs outlines these with clarity and compassion, and gives a voice to this underrepresented group. It takes courage to do this, so thank you Dr. Jacobs for bringing this to the forefront.

  • reality check. Staying at home for a month, free to do pretty everything you want, including going out for some time, in the scale of sacrifice from 1 to 10, is 1 or 2. More like, we have reached pathological levels of spoiling.

    • Except it’s not going to be for a month. It’s already been a month and a half for many parts of the country, and we are being told to expect to do this for a year, year and a half, until there’s a vaccine and it’s given to the most vulnerable. The “going out for some time” you mention is what, going to the store, going for a walk by yourself?? I’m not sure why we can’t even have a discussion about ways to keep the most vulnerable safe and isolated, and to let those relatively safe meet amongst themselves, with precautions…

    • This depends *enormously* on who you are stuck at home with. Not all families are healthy or even safe places to stay.

  • On a related matter, consider the effect of school closures that will affect this generation for years. When schools do eventually reopen, some students will be prepared for grade level, some not. Teachers will be challenged by uneven levels of student preparedness, leading to academic dumbing-down in order to prevent the least-prepared students from struggling to keep up. Better-prepared students may become bored. An entire generation may never acquire the knowledge and skills to succeed and provide the ability to deal with the many challenges of the 21st century.

  • And oh who buy the way is going to pay the deficits left by all the stimulus money being thrown around? The young. Look at how Sweden has managed the epidemic; schools open, restaurants open and older people told to take responsibility and shelter in place. I would keep the schools open, especially for the younger children. Adults should act like adults and take preventative measures. Let the children get exposed and build up the antibodies for the future. Call me cruel and vicious, but I cannot help thinking this is nature’s way of culling the herd (look who has the highest mortality rates).

  • As a lonely 16-year-old, I thoroughly agree with this. I’ve had very few connections with people ever since I was a child. I used to be bullied, moved once and changed schools a few times. I’ve struggled with depression since the age of 13 and went to therapy for a while. Now I’m being asked to stay inside for an uncertain amount of time and sacrifice the few connections I ad done my best to cultivate before this. It’s been really hard for me.

  • This is a spicy think piece that reaches beyond the scope of Covid. Bravo Dr. Jacobs, for providing a fresh and underrepresented perspective!

  • I disagree with most of what you say, especially the part about climate change. As a mental health professional I would think you would be concerned about the depression needlessly inflicted on our young, many of whom are afraid to face life, afraid to grow up, get married and have children or even to stick to their studies because of the fear mongering of the climate alarmists all of whose major predictions for over 30 years have failed to materialize!

    • Mention the words “climate change” and it never fails to bring out the triggered right wing nut jobs. Do a little research, and realize that climate change is only a political issue in the United States.

  • Lisa. Thank you for the article. I am in agreement with 90% of it. I think it is criminal what we are doing to kids at this very moment. As a father of 2 small kids, not adolescents, but I can see it in my kids right now. parks closed, schools closed and now camps, pools, etc. might be closed. How can our society ignore what these draconian government mandated closures are doing to our children? Children can’t be locked in their homes, expected to sit still and learn on a computer for the foreseeable future. They need to be outdoors and interacting with other kids, and playing and being kids – unfortunately their is no lobby for children, and the teachers unions, instead of going lockstep with their party, need to be more vocal about the harm being inflicted on our youth. It sickens me to learn about how kids are being ignored, their graduations cancelled, their proms, their way of life.

  • The reality is not evident yet. I’m personally hearing amazing stories of families actually spending time together and enjoying one another. Where are your numbers to support this big scare about the “damage”. I will watch with interesting those suicide numbers. Your article giving kids an excuse to be selfish because “we have failed them” in gun control is crazy. We may have failed them in teaching them more self resilience and personal accountability and thus a mental health crisis that parents have tried to treat with medications. Disagree with just about everything said in this article. If this crisis has caused families to reconnect and reevaluate what is really important then all is not lost and much has been gained.

    • Should it really take a pandemic and the destruction of an economy, leaving many of these kids with no available jobs, the impetus to reconnect with family?

    • Every parent I know is struggling a lot right now. The stay at home orders (I’m writing from California) are quite obviously unsustainable. To deny children sports, parks, school, and visits with friends for more than a few months is criminal and deeply degrading.

      Buying some time to do some science on the virus, to get testing capacity up, and to get the healthcare apparatus better prepared is also necessary. Masks in public and social distancing will be with us for some time. But opening schools, universities, and public parks, and allowing for hygenic social gatherings are, in my opinion, essential. Management of the pandemic should absolutely allow for them sooner than later.

      The author is right to point out that we know quite well that this virus, of all things, is not a great threat to their well being. Of course, teenagers should aware that they could be vectors of disease.

  • Adolescents that defy these lockdown orders are VERY healthy. One could only hope their child has the critical thinking skills to question authority and defy it when their freedom has been revoked.

    • “Should young Americans now be asked to protect the older adults who failed to protect them? Is that fair?”……so the elderly should be sacrificed or punished?
      It is definitely a tragic and precarious situation for everyone. But, truthfully, nobody is paying a higher price than the elderly. Aren’t some of their lives worth our collective sacrifices?
      Hopefully, our children would never need to know what real “lock down” actually means in a life and death situation….without food, water and safety!
      Our children are learning priceless life lessons in looking out for one another. Of course, it is very hard for them. But they have their whole lives ahead of them.

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