June 8, 2023
Dr. Naveen Rao, Senior Vice President, Health Initiative at The Rockefeller Foundation: Good morning. We are here for the anniversary of Rockefeller here, and for the last 110 years, our mission has been unchanged, which is the wellbeing of humanity. And what better time to discuss this and what better place? Because New York City has been on the forefront and taken on public health issues. Long strong history, whether it be tobacco control, sugary drinks, nutrition. And this new frontier of the effect of social media on the mental health of children is real.
As a grandfather who has two grandchildren who will be teenagers in the next five years, this is concerning. So I'm really personally grateful all of you have come here to discuss this important, important topic and who better to lead us than Dr. Vasan? Not only is he professionally eminently qualified, but also personally his commitment is clear, as president CEO of the Fountain House. So Vasan, over to you and happy proceedings, and welcome again.
Commissioner Ashwin Vasan, Department of Health and Mental Hygiene: Thanks for the kind words, Naveen. Again, thank you for hosting us here today. I also want to welcome today's speakers as well as our special guests from across the city, the state, and the country. This is truly a national convening. And this is too big a problem to tackle alone. That's why we're joined by representatives from many city, state, and federal agencies along with major health departments, including Boston, Philadelphia, and LA County.
Despite what the industry may want you to believe, let me be clear: there is no doubt that social media is seriously harming our kids. Today, you'll hear from a lot of experts. You'll hear from doctors and lawyers, you'll hear from scholars and philanthropists, you'll hear from leaders of government agencies like me. But the most important experts you'll hear from are those who are affected the most by social media; young people.
There's a reason we scheduled this convening today on a school holiday. There are a lot of other things you could be doing today, but by choosing to be here, you are taking control of your own future. So don't be shy. We invited you here because we want to hear your thoughts, your honest thoughts, your honest perspectives, and your honest experiences. Your voice really matters, today and always.
Okay, let's do an icebreaker. In the spirit of bringing people together, I'd like everyone here to take 20 seconds to introduce themselves to the people on the left and to the right. I'm sorry, deputy mayor, that you are alone in this first row. We did not plan for that. I'm sorry. You can talk to me. Go ahead. 20 seconds, just introduce yourself.
Okay. All right. Very good, very good. Thank you. What a wonderful thing. What a wonderful buzz and a wonderful sound. A sound that's been missing from our lives for the last three years too often, and certainly can't be replicated over Zoom or Teams, or any of these software that we use. That sound of people coming together.
Now, take a moment and consider the time that you spend on social media, and it's far more than 20 seconds for most of us. Does anyone here really wish they spent less time getting to know people like you just did and more time on social media? Can you raise your hand if you believe that? Okay, here's another question, for the adults. If a young person in your life asked, would you advise them to spend more time on social media? Anybody?
So your answers are telling. There's a reason no one raised their hand. From setting dangerously unrealistic expectations of body image, to catalyzing and accelerating bullying and abuse, to causing significant social isolation and exacerbating depression and anxiety, we know that social media is causing harm. It's not that all social media is bad, but we already know that unregulated and unfettered exposure to social media and all of its content isn't good for us, and we already know that it isn't good for young people.
Over the years, as Naveen mentioned, New York City has led the way in reducing harm from various toxins. We've improved the quality of our water and our air, today notwithstanding, [laughter] We've removed.... [laughter.] Yeah, this is what happens when you edit speeches a few days... We've removed pesticides from our parks and our playgrounds. We've taken on big tobacco, and we're dealing with an environmental toxin today.
But what about social media? Until now, we haven't treated it like a toxin. Social media might be digital, but it can be just as damaging to our minds as the toxins in tobacco, lead paint, or in the air are for our bodies. And make no mistake, unregulated, unfettered exposure to social media is an environmental toxin. It's one of our most challenging public health threats, especially for young people at critical moments in their social, emotional and neurological development.
The numbers paint a sobering, sobering picture. We are most certainly in the midst of a youth mental health crisis. In 2021, 38 percent of New York City high schoolers reported feeling so sad or so hopeless during the past 12 months that they stopped doing their usual activities. That rate was significantly higher for Black and Latino children. Over the past 10 years, rates of suicidal thoughts amongst high schoolers in New York have increased by more than 34 percent. And data from our city mirrors national trends, and possibly global trends. By multiple measures, youth mental health began to decline sharply around 2010 or in between 2012. Between 2010 and 2012.
Now, a lot's happened over the last decade and it's impossible to isolate every factor, but it's so hard to ignore that this drastic change corresponds with widespread access to social media, especially on mobile devices. As a doctor and a public health professional, I can tell you that this is the kind of data we see when people encounter a novel environmental widespread toxin. And we owe our children our sustained and collective focus on what these data are telling us, and that starts today.
But my most important job, I'm sorry, deputy mayor and Mr. Mayor who will be here in just a moment, is as a parent of three kids. I can tell you how kids are being conditioned to reach for their phones and devices. This toxin is in my home, and it's in homes throughout our nation, and it's almost certainly in yours. Right now, our children have almost uncontrolled exposure to this toxin, and our response as a society has been largely to let it happen. This will be one of the city's, the nation's, the world's toughest public health challenges to date.
First, while the overall trends are clear, the research is both developing and complicated. Is social media exposure equally harmful to all children, or is it uniquely damaging to those with certain preexisting risk factors such as mental health conditions or trauma? How does race, gender, ethnicity, sexuality, disability factor in? Second, the ways in which we measure exposure and risks are not cut and dry. For social media, should we consider any use of any platform harmful? Is time spent over a certain threshold more damaging? What about certain content such as violent or distorted body images? Third, we haven't defined success.
While toxins like tobacco and lead paint only pose harms, social media can offer some benefits in the right circumstances. Some young people find a profound source of community, connection, and even joy online, but many others become trapped in a cesspool of bullying, body shaming, and violence that can breed isolation and anger. And in any event, social media is not only pervasive, it's part of the fabric of our lives. We use it at the health department and all across our city government to amplify important information and to reach people quickly. In that way, it is a vital conduit for information that people rely on. In fact, we'll probably post these remarks on social media.
There's simply no going backward. It'd be impossible to get rid of social media entirely, and it's not clear that we would want to even if we could. Lastly, we haven't identified, let alone created, all of the tools we need to do this job. The public health threat from social media may not respond to the usual tactics. We need to think about new policies and rules that can set guardrails for the design of these platforms. Wild West no more. And we must hold companies accountable for the harm they're causing, whether it be through legal action or conversation on how we can work together to solve this crisis. We must think about tools that parents, teachers, caregivers, and everyone in the community can use to protect our children.
These are important questions. Answers will not be easy to come by, not least because social media companies will limit our access to information and lobby to remain unregulated.
In fact, the only other industry that I can think of that is so unregulated is the gun industry. Just think about that for a minute. We also have to contend with the reality that social platforms are literally designed to defy any limits on their use. They are designed to foster addiction. Some of the world's most talented engineers are dedicated to keeping you, and you, and you, and especially you, young people, on social media as much as possible, and it works. It's a daunting task, but we have no higher priority than protecting and promoting the health of the city's young people. It's why we prioritized youth mental health as a part of our citywide mental health plan launched in March and entitled, Care, Community, and Action. We care, that's why we're here today. We are a community, that's why we're in this room together. And this is the first step in taking action to protect our kids. We have to start somewhere, and that's why we're all here today. This is a problem that affects everyone and we need all of the perspectives we can to bring us together.
So today, we'll be exploring four avenues, research, policy, public health interventions, and litigation. Our panels will help us set the stage, and we'll transition then into breakout groups. Our incredible lineup of speakers, both on the panels and in the breakout groups, will equip us with the information we need throughout the day. Guys, this is a working meeting. We got to get to work, right? This isn't a talking meeting. This is a working meeting. Today's event is just the start. Today's conversations will translate into actions, and we don't really have a choice. Continuing on our current course will only worsen the crisis young people find themselves in. We can't leave them at the whims of an industry racing to monetize their attention.
I believe that if we face this threat head-on, we can reduce the damage like we have with other toxins. We can make our city safer and our kids healthier. And we might not have all the answers, but I'm certain that public health offers the solutions. It's going to take hard work, it's going to take answering tough questions, and there's no doubt this won't be easy. But I sincerely believe that with our collective attention and immediate action, we have the power to change this trajectory for our kids, and we have no time to waste. Thank you.
Okay, we're going to ad-lib for just a minute because the mayor is not yet here. I was meant to introduce the mayor. He's three minutes out. But I do want to say for just a moment, one of the reasons that I took the role of commissioner of health was because, in the process of looking into the role as I was discussing it with the mayor, it became very clear what his commitments were. His commitment is to making this city as healthy and well as possible. And he understands deeply, in his own life, his own lived experience, as well as in his policies, that mental health is inextricably tied, not only to physical health and well-being, but to the whole health of our city.
And as we recover, as we continue our recovery from the worst public health crisis in a century, as we face a myriad of new challenges, whether it be the needs of thousands, tens of thousands of new New Yorkers arriving to our city, or whether it be unexpected events like today's or the recent days... Centering mental health in our city's agenda could never have been or cannot be more important than it is now, and I'm very proud to work for a mayor and an administration that does so. I'd also like to call out Deputy Mayor Anne Williams-Isom, who leads on this work with exactly the right values, the compassion, the care, and the action that we need. And so, on behalf of the administration, it's just also a real honor to be here today. And I will take a step off the stage and we'll give the mayor just one more minute. I could dance, but I don't think ABC wants to see that. So I'll be back in just a second to introduce the mayor.
Thank you. Very good. Okay. All right, so without further ado, I'm going to introduce the 110th mayor of New York City, Eric Adams. And he's going to come right through that door, I believe, at least I was told. You can meme this, right? You can put this on social media. There we go. Mr. Mayor, welcome.
Mayor Eric Adams: Thank you so much, Dr. Vasan, Deputy Mayor Williams-Isom, First Deputy Mayor Wright, and just the whole team as we deal with this issue. And I think of Norma often. I know she's here somewhere. I think of you often and your amazing son and losing him to subway surfing. And the moment now is, those of us who are lovers of Greek mythology, I believe that this is the Troy War and the Trojan horse. And there was a fortress built around Troy, and the army was able to sneak the Trojan horse inside that fortress. And inside that Trojan horse was the enemy. And they were able to go inside what everyone thought was so well protected.
Social media, in my belief, is our new Trojan horse. As a young person, mom would be able to lock the door and make sure any harm to any of us. She would not allow us to have a television in our bedroom because we would sit down as a family. She would decide what we would watch together as part of the nurturing. But right now, in our bedrooms, in our restrooms, in our kitchens, in our backyards, everywhere our children go, they have this Trojan horse in their hands. A device that was supposed to be used for communication has turned into a device that is being used in a very destructive way. It is teaching our children at a young impressionable age to have those synaptic connections that are part of our brain development where we learn patterns. It is creating these synaptic connections that is really causing those neuron connections to have our children be used to some of these habits that are just so harmful and painful. And just a thought that we are coming together as a team is saying, wait, have we realized what is happening right below our eyes, right below our surface? It has snuck up on us, and it has really captured our young people, almost to a level of addiction that … It is unimaginable. And just the intake of information, I don't think our brains were ever supposed to develop this level of constant bombardment over and over and over again. And sometimes I sit in the room with Jordan and his friends, and we sit down and we'd have dinner, and I would intentionally just sit back for a moment and they're not even communicating with each other. They're just on their devices.
And we would spend a whole hour. They would pick up and nibble on their chicken. And I'd say, "Well, first of all, you should be a vegan, so put that chicken down." And then they would go right back to the devices. But here's the strange part about it. I can't critique Jordan because I find myself doing it. I find myself sitting down with friends and associates and we pick up the device all the time throughout conversations. Something is happening and I don't know an answer. So to have leaders from Boston and Philadelphia and others come in and just examine the first level, to have the surgeon general identify this national, if not international issue, we're having, to have some of these young people who are here, which I'm just really excited about. We met at one of our town halls and they shared, and I said, "Listen, we are getting ready to have this conference, we would need you to come here and talk about it," because it is their peer group that is being allured to do subway surfing that's dangerous. It's their peer group that is finding themselves doing these dangerous challenges.
We are watching in the City of New York and across the country, something called a Kia challenge. It teaches young people how to steal a car, and they challenge each other to steal the vehicle, is putting a criminal record that is going to harm them throughout their lives. Social media is taking the beauty of entertainment and drill music and taking it and now using it as retaliatory actions against other drill artists. So the natural expression of children to entertain themselves is now being used as a tool to create violence against each other. And the social media companies are well aware of the algorithms that attracts you and lure you into what they're doing. And we cannot show a level of ignorance. Profit cannot be over public safety and health, and that is what we are experiencing.
And so Dr. Vasan to make the boldness of saying, "We are going to sit down and not ignore this." This is the same thing we did Deputy Mayor Williams-Isom, when we said we wanted to look at women's health, the same thing when we said we want to look at the environment. That fire in Canada that is clogging our skies here is something that we've been talking about. This administration is going to lean into the discomfort of these conversations that are challenging. We did not become who we are and this administration so we can just go through the motions. We must identify the Trojan horses, not allow them into the fortress of our families and in our city and our country, and we must be honest about what we need to do. That's what this conference is about. It is about identifying the problems and effectively moving in the direction to correct them.
We're not going to solve it today, but we're going to start the process of going back to our various locales, if it's Boston, Philadelphia, if it's [inaudible] going back into the communities, starting the process of getting our assignments, and then executing the plan and getting into our places of medical professions, our schools, our community groups, our organizations, but all of us coming up with a blueprint so that we can really identify one of the number one threats that I believe is going to hurt the development of the minds of our young people as we move forward and hurt the minds of adults. And so I really thank you for the fast turnaround. We spoke with Dr. Vasan, and we said we wanted to do this, all of you responding from the comments from the Surgeon General and your expertise in this area as we find and identify the solution that we need. Thank you for coming out today. Let's try, and we're going to be as productive as possible and really start identifying this crisis that's among us.
Social media should not stop us from being sociable. Human interaction is something that we all need and yearn for. We are a society of communities, and we need to make sure we always hold onto that. Thank you very much.
Commissioner Vasan: Thank you so much, mayor. You missed all the nice things I said about you, but I'll say some of them again. You had a vision. I was saying why I came to become commissioner is because I knew from the beginning that you wanted to center mental health in this city's recovery. You've been bold, you've been brave. We launched our mental health plan in March, and social media, addressing this issue and this convening was in that vision, and I just want to thank you for your leadership on this issue.