America’s Top Doctor on Why He Wants Warning Labels on Social Media

from The New York Times I'm Sabrina. tavernes and this is the. [Music]. daily a rising tide of mental health. problems among teens has sent parents. teachers and doctors searching for. answers this week the nation's top. doctor offered. one. today I talk with Surgeon General Viv. morthy about his plan to take on what he.

sees as a central threat facing American. teens social. [Music]. [Applause]. media it's Friday June. [Music]. 21st Dr morthy nice to see you.

hey Sabrina it's good to see you too you. can call me Viv by the way I'm very. informal Viv okay well you know being. the nation's stop doctor I'm inclined to. call you doctor but uh we can go with v. yeah I'll tell you Sabrina I still think. of Dr morthy as my dad so. interesting so you are the country's. Surgeon General and we're talking to you. today because earlier this week you made. a pretty big announcement about the. dangers of social media for young people. and you suggested a potential fix for it.

you actually announced this move by. writing an oped in the New York Times. but before we get to that fix that. you're proposing let's talk about the. problem when did you start thinking of. this as an issue that you should be. focused. on well I first started seeing the roots. of the youth Mental Health crisis during. my first term as Surgeon General this. was during 2014 to 17 I was traveling. the country listening to communities and. big cities and small towns and I was.

hearing often about these struggles that. young people are having with loneliness. and isolation with depression and. anxiety over the course of two terms I. have seen this ratchet up with a. pandemic pouring fuel on a fire but a. fire that was already burning before the. pandemic arrived and what specifically. were you hearing I mean was there a. patient you saw or was it something that. happened to a friend or your own family. that made this problem especially real. for you well actually there have been a. series of things that made it real one.

is my own experience personally you know. as a young person I struggled a lot with. my mental health with feeling alone and. isolated I was very shy and introverted. as a child and at that time I thought I. was the only one who was struggling it. was only years later Sabrina that I. actually realized a lot of my classmates. were struggling too but then I think. about the conversations I had as Surgeon. General then I heard some stories I. expected but many I did not I remember. stopping at a college and one young. woman said to me I feel like I'm on this.

campus surrounded by thousands of other. students but but nobody really knows me. and I feel like I can't be myself and I. feel all alone I think about the moms. and dads who have come to visit me who. have talked about how social media has. impacted the mental health of their kids. the one mother whose son was also shy. and introverted and struggled a lot with. his mental health was being bullied and. and was having a really difficult time. and then the algorithm on his social. media platform started suggesting to him.

that he take his own life and started. directing him as to how to do that and. he ultimately followed his directions. and took his own life I heard just. countless stories like this of young. people who are struggling parents who. are struggling as well and those have. stuck with me and those go along with. the many statistics we now have that. demonstrate that we are indeed living in. a profound Mental Health crisis okay so. you're noticing this problem or this. looming problem and you're hearing these. really tragic stories how did you go.

from that kind of anecdotal information. gathering to actually studying this. issue more closely you know to inspect. this as a potential health hazard well. once I started hearing those stories and. hearing them at such volume and. consistency they what really compelled. me to dig more deeply into the data and. to try to understand what is driving. this deeper Mental Health crisis it. turns out it's not just one thing. loneliness and isolation are. contributing the experiences of violence.

and the fear of violence particularly. gun violence are contributing to the. Daily stress and strain that so many. families are going through right now but. it turns out again and again the issue. of social media kept coming up so when I. decided I needed to dig into this more. deeply I began essentially a research. project with my team to understand more. deeply what is the data telling us about. social media and youth mental health and. the data tells us that there is an in. fact an association between social media.

use among young people and the mental. health harms that they are experiencing. the second thing though that we know and. this is very important is we know a lot. based on what young people are telling. us themselves six out of 10 adolescent. girls talk about being approached by. strangers on social media in ways that. make them feel uncomfortable a third of. young people say they're staying up till. past midnight on their devices a lot of. that is social media use but nearly half.

of adolescence are also telling us on. these studies that using social media. makes them feel worse about their body. image and I want to just caveat this by. saying there are so open questions like. we want to know more about which. populations are most deeply impacted by. social media both positively and. negatively we want to know what types of. use of social media seem to contribute. to the most harm and the most benefit. these are really important questions to. address and we should be investing more. research and understanding them I want.

to return to something that you said. which is that there's an association. between social media use and mental. health problems among young people so. this is a point of dispute within the. scientific Community right like there. are some studies that show that these. two things are associated in other words. that there's some relationship there but. there really isn't much evidence that. one actually causes the other that. social media is the reason for the rise. in mental health problems one of my.

colleagues this week talked to the chief. science officer at the American. Psychological Association and she was. asking about whether the time a child. spent on social media contributed to. poor mental health and and he said and I. quote the results have been really mixed. with probably the consensus being that. no it's not related what is your. response to that well I I think look. it's important to look at the research. question broadly what we're trying to.

understand first and foremost is the. answer to the question parents are. asking us which is is social media safe. for my kids and if you ask researchers. what does the data tell us about safety. where is the data that tells us these. platforms are safe that data is not. there so there's not evidence of safety. there is growing evidence of harm there. is data showing an association between. social media use and youth mental health. harm now where there are debates and.

discussions in the research Community is. how big is that Association is it bigger. for boys versus girls and it seems like. it is bigger for girls does it differ. based on your socioeconomic status based. on other indicators and those are. important questions to debate but one of. the things that you learn in medicine. and in public health when you're faced. with the real world problems is that you. have to assess when you have enough. information to act recognizing that you. want to continue to get clarity that. will continue to home your approach as.

time goes on to give you an example from. a clinical circumstance if I have a. patient in front of me whose blood. pressure is dropping rapidly and who is. in danger of losing their life I have to. rapidly assess what are the potential. causes of that there could be many. different reasons I've got to quickly. assess it and I've got to move forward. with treating it and I keep Gathering. data along the way but the risk of. inaction of saying hold on let me not. take action here until every question I. have is answered the risk of that is the.

patient's life and that is literally. what we are seeing taking place right. now it's not to say that there aren't. kids who are having some benefits but. the measure of whether we should take. action or not is not are some kids. getting benefits from social media or. not that is not the threshold I lay out. in my advisory last year that there are. certain benefits but getting some. benefits does not justify forcing kids. to endure significant harms we can make. social media safer we should so that.

kids can get the benefits without having. to sustain the. harms so I want to talk more about the. warning advisory that you issued last. year as you said the moment when you. first started to act on this basically. your thinking was that there were these. findings on social media and mental. health you know they seem to be related. you were raising the alarm and you. called on parents on tech companies and. on lawmakers to do more to protect Young. people why did you take that approach.

well because I think to address the. harms of social media does in fact. require all of us to ask the question. what can we do to protect our kids and. we all do have a role and responsibility. here but I do think up until now the. vast majority of the burden of managing. the harms of social media has been. placed almost entirely on the shoulders. of parents and kids alone now think. about this for a moment because the. platforms themselves are designed by.

some of the best product engineers in. the world is supported and resourced by. some of the wealthiest companies in the. world and informed by cuttingedge brain. science ultimately to maximize how much. time our kids are spending on the. platforms and to tell a parent who. didn't grow up with these platforms that. they should somehow manage these rapidly. evolving tools and keep their kids safe. when they don't even understand the full. extent of harm here that is both.

unreasonable and unfair and that is why. in The Advisory I issued I called on a. number of other players to step. up and what did you hope would happen. after you issued your report last year. Well my Hope was that a few things would. happen number one that policy makers. would respond and would come together to. start putting in place the kind of. safety standards and data transparency. requirements and privacy protections. that we need My Hope also was that.

parents and young people would feel seen. would recognize that they're not alone. in their struggles and finally I wanted. platforms to know that they also have a. role here that they still have an. opportunity to fulfill social media has. been around for nearly two decades. there's been plenty of time for. platforms to make uh the experience of. young people safe sufficiently safe it's. one thing to say we're implementing. safety measures it's another thing to. actually provide evidence that those.

measures are working to keep our kids. safe so now we come to this week when. you decide to put forward your suggested. fix to the problem and that is a warning. label which is something you know we're. used to seeing on cigarette packages. surgeon general's warning how exactly. would a warning work in practice I mean. Which social media platforms are we. talking about and and what would it look. like in your ideal scenario so a warning. label would be a digital warning it.

would pop up at a regular basis when. individuals used social media there are. important details of what that warning. label looks like what kind of font size. it is with the literal wording of the. warning label does it have Graphics. associated with it what part of your. screen does it appear on those questions. are typically answered in a scientific. process that takes place after Congress. authorizes a label lastly it's important. for people to know that there is data. about warning labels and their.

effectiveness we have now Decades of. experience with tobacco and alcohol. warning labels and what they tell us. particularly from tobacco is that these. labels when done right can be effective. in increasing awareness and changing. Behavior but what gave you the idea to. propose this is it a reflection of any. frustration that you know not enough has. been done after you issued your report. last year well it's it's a reflection. more of the fact that we all have to. look at every tool we have in our toolbx.

and use them to help address the harms. that we may be seeing here with social. media and in our case a surgeon. general's warning is one of those tools. I want to be very clear that a warning. label in my mind is not the entire fix. to the harms that social media poses to. our kids I still firmly believe what I. stated last year in my advisory and what. I called for this week in the AED which. is Congress ultimately needs to make. social media safer and the way to do. that is by putting in place measures.

that protect kids from harmful content. and from manipulative features that lead. them to excessive use that is what. Congress has to do alongside that a. warning would help parents and kids. understand the risks that we. see but let me separately say that if. you're asking uh am I frustrated or. concerned that there hasn't been enough. action absolutely yes look I think all. of us should be deeply concerned about. how long it has taken for us to. ultimately take action to make social.

media safer we've got to do better and. that starts ultimately with the. platforms as well as with Congress. stepping up to take. action we'll be right back. [Music].

I wanted to ask you Dr Mory about the. benefits actually because we're talking. that this is a complicated problem but. that there are benefits of course you. know social media can be particularly. helpful for marginalized kids people. maybe who don't have access to a. supportive group of people around them. that it is meaningfully good in their. lives so how do you think about putting.

a warning label kind of just in a. blanket way on all social media. Platforms in that respect so I think. about a warning label is providing. people with information about the risk. of harms now risk of harm doesn't mean. that every single person is harmed it. doesn't mean that there aren't benefits. as well that's true with tobacco it's. true with alcohol and we have warning. labels on both of those products but. what it does mean is that there are. significant risks that people should be.

aware of and when it comes to special. populations and groups of people and. individuals who are helped by social. media we also have to look at the full. picture there think about lgbtq youth. for a moment we do know that in some. cases social media can be a way for. lgbtq youth to find Community to find. support that in some cases they may not. have in person right that can be. positive but what is less mentioned is. the fact that lgbtq youth are much more. likely to be bullied and harassed on.

social media compared to straight youth. so how do we put that together how do we. balance those the bottom line is that we. can't assume as I worry we have been. doing in some of the debate around this. that because there are some benefits. that justifies all the harms that means. we shouldn't talk about the. harms people have compared this moment. in social media to moments in America. when New Media arrived on the scene and. created a kind of social Panic or say. new things arrived on the scene seen and. created a kind of social Panic you know.

TV video games that these things would. be dangerous for kids that these things. would be bad for kids growing up and for. their brains and and all of that what do. you say to that criticism that maybe. right now we're just in the midst of. another moral Panic about this because. we don't quite understand it yet what do. you say to. that well I think it's an important. question to consider we want to make. sure ouris responses are appropriate to.

the gravity of the situation but in the. case of social media there's something. here that is fundamentally different. from some of the other technologies that. have propped up and created temporary. moral panics whether that was TV radio. even going way back you know the. printing press and books what's. different here is that social media has. fundamentally transformed childhood in a. way that these previous Technologies did. not when TV came onto the scene I wasn't. bringing my TV into my bed and watching.

it throughout the night I wasn't able to. be contacted by strangers through the TV. in ways that would lead to bullying and. exploitation I didn't have my personal. data stolen because I was watching TV in. ways that also could lead to. exploitation and abuse all of these. things are very unique to social media. and the pervasiveness of it the fact. that young people can now carry it in. their pockets and have 247 access to it. that has fundamentally Chang the game.

and this point is just important to. underscore adolescence are not little. adults they are fundamentally in a very. different stage of brain development and. in that stage of brain development their. impulse control hasn't developed as much. they are more susceptible to social. comparison and social suggestion so the. things that even to us adults might seem. as just willpower questions you might. just say ah it's about just draw a few. boundaries around your use of social.

media no problem one I would argue it's. quite hard for adults to do that by the. way but especially for young people this. is exceedingly hard and Sabrina I got to. say that like for me and I know for many. others this is very personal you know. I'm a father of two young kids who's. watching them grow up you know faster. than I would like every day and who is. seeing the world coming at them rapidly. and I know I'm not alone as a parent and. I think about. the day when they come up to me and ask.

me if they can have a social media. account I think about what's going to. happen when their friends are bullied. and harassed online how are they going. to respond are their friends going to. feel comfortable talking to them about. it um these are the questions that all. of us have to Grapple with uh as parents. how old are your. children my kids are six and seven now. and even though they're young I will say. that a couple years ago when my daughter. was in preschool she came home one day. and asked us about posting a picture on. social media wow that's how early it's.

coming at us and what did you say to her. we said no and she went on her way and. she was fine but this is going to happen. more and more it's happening earlier and. earlier to kids and parents are out. there trying to manage this all on their. own there's no manual for how to manage. social media for your kids there's no. set of Ideal practices for how to tailor. your kids needs to the evolving nature. of social media that's actually why I. believe that parents need to also come. together and support one another uh you.

know around taking a set of shared rules. so that not only is it easier for us but. it's easier for our kids when we tell. our kids for example as my wife and I. are planning to do for our kids that we. are not going to consider them being on. social media until at least after Middle. School it will be helpful to us if there. are other parents in our friend. community and our school Community who. are doing the same because then we can. say no you're not the only one but Bobby. and Mary and Jack are also waiting until. after middle school and are there other. parents who want to do the same to wait.

until after middle school or are you. guys. outliers well so this is what has been. fascinating I would say even in our own. School community in the last few weeks. alone there has been more conversation. in our school about how to manage. technology for our kids and there are. many more parents than I had even. realized in our school who want to wait. until later but the reason many don't is. because they want to assume that. everyone is just doing this they don't. want their kid to be left out so this is. a collective action problem but many of.

them are also Unsure how to manage some. of those harms or may not even be sure. what the harms are and there's a lot of. pressure too you know the number of. parents I talk to who say my child came. up to me and said if you don't let me. open up an account on social media I'll. be the only one right in my class I'll. be left out do you want me to be more. lonely and if you're a parent facing. that of course you don't want your child. to be lonely so I really feel for. parents because our kids shouldn't be. alone in this and we shouldn't be alone. either as parents in managing social.

media so as the daughter of parents who. decided that their child should not have. a television I can identify with those. kids who say I feel more lonely you're. not part of the conversation you can't. participate in the games because you. don't hear and you don't see and it is. difficult it's the hardest thing for a. parent right are you worried that could. happen to you that you know your kids. would you would somehow kind of deepen. the loneliness I mean you yourself were. lonely child growing up you said how do.

you think about. this well this is why I think it's so. important for us to build this broader. movement together to re-engineer the. relationship that our kids have with. technology because imagine if we delay. the age at which kids start using social. media imagine even after they use social. media if we build tech-free zones in. their lives in their days to protect. sleep in-person interaction physical. activity and learning think about what. we would do and could do with at that. time I think about the school in Indiana.

that I went to which had put in place. restrictions around the use of social. media and phones during class time and. they said that what they noticed was. kids started playing games together in. the library and in the hallway they were. talking more the volume in the hallways. went up and this has been one of the. most striking things to me about the. college tour that I've done I remember. college as a time where the most noisy. place on campus was the dining hall. because was coming together to talk. about what they did it was just you.

could barely hear yourself and think. right these days when I go to college. campuses and particularly the dining. Halls it's quiet because people are on. their devices they're listening to music. on their iPod they're on their laptops. and one of the most chilling questions. that I got on the college tour again and. again from kids was how are we supposed. to build connection with one another. when the culture isn't for people to. talk to each other anymore just think. about that for a minute yeah they're.

saying the culture is not for people to. talk to each other. anymore we have to rebuild the spaces. where people can talk to each other. where our kids can talk to each other. where they can discover things together. where they can agree and disagree. together but where they can do that in a. way that helps them build healthy. relationships negotiate disagreement and. build. friendships so let's say that Congress. goes along with us and warning labels. start to appear on social media online.

we're now almost 20 years since the. Advent of the smartphone 2007 was the. first iPhone I remember getting in one. entire Generations have formed their. habits around these devices and you know. as we've discussed there have been some. real benefits but also there are some. steep societal costs someone I read. somewhere put it that you know our kids. are now this giant human real time real. life laboratory of what all of this is.

going to. mean so is a label actually going to. unwind that you know is it too late to. unwind this I don't think it's too late. I think about smoking in our country in. 1964 when the first surgeon general's. report on Tobacco was issued at that. time. 42% of Americans smoked there were. advertisements everywhere for smoking. that kids could see it was just seen as.

part of the culture and there were. people at that time who said the notion. that you're going to get people to stop. smoking just seems unrealistic but the. combination of not just a report but all. of the action that that report helped to. promote and unleash Community Education. programs advocacy from parents. legislation from Congress and from state. and local legislatures together over the. years that helped us take us from 42% to. below 12% that helped us save countless.

lives so is it going to be easy to. change and reengineer our relationship. to social media and to make social media. safer no it's not going to be easy it's. going to be complicated but I firmly. believe that as a nation America can do. hard things we've done hard things. before and what better time than on this. issue when what's at stake is the mental. health and well-being of our kids.

[Music]. do your kids know what your job. is my kids now know that I'm the Surgeon. General but I don't know that they know. what that means they know that I wear a. uniform and they know that I do a lot of. interviews and talks but I'm not sure. that they. entirely know what my day job is they. just know it has to do with health and. my house my when you ask who's a doctor.

in the house yeah my kids point to my. wife and we often have to remind them. that hey Daddy's a doctor too so it's. one of the humbling things about being a. parent and I love. it did they know anything about what you. did this. week they know that I was doing a lot of. media because they they saw me on TV. here and there uh when they were walking. past their grandparents television. but they don't really know otherwise um.

they don't really know what really what. social media is at this point but that. is going to change any day now it's. [Music]. coming do you think that potentially. what you're doing now means that they. will be more. protected I hope so. yeah I mean we we do the work we do as. parents I do the work I do as a.

dad not only because I want to serve but. because I want the world to be better. for my. kids and that that's what guides me here. too you know I want my kids to grow up. in a world. where where the technology and the tools. that are in front of them help them and. don't harm them I want them to grow up. in a world. where we are more connected with one. another where they can build friendships. and they can seek out other kids who may. be struggling with loneliness and and.

help them feel less alone and know that. there's somebody who's got their. back if I've learned one thing you know. in my life it's that we really do need. each other my wife and I as much as we. love our kids we can't make sure the. whole world is safe for them by. ourselves we can't make sure that they. grow and encounter healthy levels of. adversity just on our own this is. something we've got to do together as.

parents and so I do hope that the work. that I do will have some small. contribution to making the world better. for them but I also know that to to. fulfill that hope it's going to take all. of us working hand inand and keeping our. North Star clear which is ultimately. taking care of our kids because as a dad. I just don't know what's more important. than. that Dr Mory thank you so much for your. time thank you so much Sabrina I really.

appreciate the chance to talk with you. about. [Music]. this you can hear more discussion of the. Surgeon General social media. recommendation on this week's episode of. hard. [Music]. Fork we'll be right back.

here's what else you should know today. on Thursday the Supreme Court upheld a. tax on foreign income that helped. finance the tax cuts that President. Donald Trump imposed in 2017 in a case. that many experts had cautioned could. undercut the nation's tax system the. vote was 7 to2 with Justice Brett. Kavanaugh writing the majority opinion. he was joined by Chief Justice John. Roberts and by the Court's three. liberals the ruling avoided what many.

feared could have been fiscal chaos by. upholding for now the structure of the. income tax. system and Donald Sutherland the actor. who played a laid-back Battlefield. surgeon in the television series mash. and A Soulful father in the movie. ordinary people died on Thursday in. Miami at the age of 88 Southerland was. known for his wide range he had the. ability to both charm and unsettle to.

reassure and repulse across six decades. starting in the early 1960s he appeared. in nearly 200 films and television shows. some years he was in as many as half a. dozen. [Music]. movies a quick reminder to catch a new. episode of the interview right here. tomorrow this week Lulu Garcia Navaro. talks with Michigan Governor Gretchen.

Whitmer about why she wants to meet one. of the men convicted of plotting to. kidnap her in 2020 I'd like to. understand what drove this group of. people to undergo this exercise to try. to kidnap me and kill me I want to. understand it what is happening you. think there's something to understand. maybe maybe there's not but I'd like to. see.

today's episode was produced by Lindsay. Garrison Rob zipco Alex Stern and Ricky. nety it was edited by Lexi Dia and. Michael benois contains original music. by Dan Powell and Chelsea Daniel and was. engineered by Alyssa Moxley special. thanks to Ellen Berry our theme music is. by Jim brunberg and Ben Lanser of. Wonderland. [Music].

[Music]. that's it for the daily I'm Sabrina. Tavern see you on Monday. [Music].