2023 US Open Forum on Mental Health and Sport: Why It Matters

on

mental

health

and elite athletes, she also serves as president of the board of directors and president of the US. Naomi Osaka has been ranked number one in the world and is the first Asian player to be ranked number one in singles. Osaka is a four-time Grand Slam singles champion. Her impact is felt far beyond the courtroom in her role as a social justice activist businesswoman and, of course, a mother. Michael Phelps is the most successful and most decorated Olympic athlete of all time with a total of 28 medals, after winning eight gold medals in 2008 he used his performance bonus to establish the Michael Phelps Foundation which promotes

health

and wellness physical and

mental

.

Dr. Vivek H. Murphy is the Surgeon General of the United States as the nation's physician. His mission is to lay the foundation for a healthier country. Dr. Murphy leads a uniform service of more than 6,000 public health officials dedicated to serving the most underserved and vulnerable populations domestically and abroad, abroad, good afternoon everyone and welcome. I really want to start by thanking Michael Naomi again Dr. Vivek Murthy Dr. Murthy for those of you who don't know that he is also a mentor to me, a colleague and a friend, and on stage he will be vague with all of us and thank you for joining us, so this is the

2023

US Open, most importantly, the US Open and the USTA believed that

sport

is a public good that

sport

can and should positively influence society.

Any of you who have been on the ground have seen and heard that we are celebrating 50 years. 50 years ago, the US Open was the first major sporting event in the world to offer equal prize money for men and women, setting an example for society. Well, today we are giving another example to society that mental health

matters

and I want to start by talking about the stigma of seeking mental health care in sport. We are often told to just work hard to hang on, don't let your weaknesses show and we have two great leaders in sport on stage, Michael and Naomi, and you have spoken up, you have been brave and you have said, well, wait a minute , this stigma is not right, we have to do it. talk about mental health we need to talk about mental health care looking for Naomi if I can start with you, what led you on that journey where you really helped shape the world to change the sigma of mental health care looking into sport um, a little selfish.

Like me, I wasn't really thinking too much about others, if we're 100 honest, I was just thinking about how I feel and how I would like to express myself and at that moment I felt like I needed to like the step. back and I like to remember that in the back of my head I was thinking that growing up I was told to tough it out and I was in my head thinking like how athletes are supposed to be, you know, you tough it out and you're actually weak. If you show your emotions and things like that, it was like a very big internal battle, yeah, and Michael, I think he seems to be the most decorated Olympian and maybe it was even shocking when you started talking about the symptoms of maybe feeling detached or depressed. or lonely and so on, and you've shaped the world with that, but what was that journey like?

Well, I mean, I think for me my mental health journey started probably in 2004. I think that's when I experienced the post-Olympic. Depression Um, I came out of this point in the Olympics and, you know, I hit the edge and I was like, what do you do? Where do we go from here? The Olympics are over, so all I did was go back to the pool. I started training again, I put all those things in compartments and over time they got bigger and bigger and bigger and bigger and they kept showing their face, so I kept pushing, pushing, pushing, and I reached the breaking point in 2014 where I don't I don't want to be alive and for me I decided that something had to change so for me I had to become vulnerable for the first time in my life and vulnerable is a very scary word.

Scary change is a scary thing, so for me to become is a scary thing. vulnerable for the first time, it was a process, a learning process, and that process has given me the opportunity to be able to talk now about the things that I have been through and, hopefully, save a life, that is my number one mission in this moment. trying to help people who are suffering like we have, you know, and I'll just tell you since we're sitting here, how you composed your words and posted them on social media. I mean, it gives me chills right now.

Thinking about it because we don't know how many people we are saving with those messages, but I guarantee you that there are people who are reading those things that you are saving and that you saved like I like to this day. It was very touching, so thank you for doing that and thank you for sharing that, Michael in the pool and in your training. Yes, you have ups and downs, but you are in control and now you are talking about this moment of vulnerability and life is different and Vivek as a doctor, a doctor who tweets and now really the position of our country is seen in society, we don't always have control, but how do we really take that and carry a message that mental health?

Attention is seeking okay, maybe we need to show our vulnerabilities and ask for help, yes, well I'm very glad we were having this conversation, to think even 10 years ago of having a discussion like this, maybe would have been unlikely. but one of the things that we are accepting is something that a doctor used to see in the hospital every day and that is that mental health really is Health is no less important than physical health and I think of mental health as the fuel that keeps you it allows you to do everything else in your life show up for your family show up at work show up for your sport show up for your community be there for yourself and when our mental health suffers everyone else's dimensions also suffer, it's like cutting off this vital fuel again If we are not able to talk about it, we are not able to recognize the times when we struggle and talk about how to replenish and support our mental health and well-being. and that's like going through life with one arm tied behind your back not being able to embrace the fullness of who we are, but it also separates us from each other and what's been happening for too long is that so many people are struggling but they're struggling in silence, they're not talking about their mental health issues and that's why they feel like, hey, I'm the only one struggling here, something must be wrong with me, all those other people based on what they post on social media.

The way they talk, you know at parties, the number of parties they go to, they must be having a wonderful life and I'm the only one who's struggling, but that's not true and I had the privilege and opportunity to see it. . As I've talked to patients over the years, I've realized that many of them are really struggling with their mental health and well-being, so I think the pandemic in particular really pulled back the curtain on a lot of mental health struggles. what people were going through. Through many people came face to face with depression and anxiety with the loneliness and isolation that they were facing in their lives and I think this is our opportunity to have a more honest and more

open

conversation about mental health so that Hopefully all of our children can grow up in a world where they realize that if you struggle with your mental health it doesn't mean you are fundamentally flawed, where they also know that if they are struggling there is help available to them.

I just wanted to say I'm sorry, one thing, you know, like always. I love to say that now, like physical and mental health, if we take care of both we can become our own superhero. My kids call me Aquaman, so I guess I'm trying to be one now. It's better for Aquaman to work on both sides of that right and I think it's just that you know that and then another point you made was that asking for help was something that I didn't know how to do and was afraid to do for a long time. time because I was afraid of the response, so for me, when I finally asked for help, it was amazing because there were people who were willing to help and there were people close to me who were willing to help and, again, that's what changed and saved my life, yes, yes, and just a quick reflection on that day.

There is this notion. I think sometimes we have around strength and we define strength in a particular way and society as the person who is not dependent on anyone else and who never expresses any weakness. who never has a bad day and never has a moment of doubt and that's just not real, that's not how people are, right, but in my mind it's strength, strength is really about the courage to be real and authentic. , it's about courage. Being kind is about having the courage to reach out to someone else and give them help and support when you see them struggling, even though that may seem a little awkward or maybe you know if you're not welcome, that's how you really do it.

It's all about strength and I think when you think about not just the current generation, but if you think about the kids that are growing up today, they're learning from our example of how we lead our lives. You know, all three of us have little ones. The kids at home, mine, are five and seven years old, and someone once told me, when I became a parent, that they said to me, "You know your kids sometimes listen to what you say, but often they listen to what you do and That's how we lead." Our Lives, the example that we set around topics like mental health, I think will be really powerful in guiding our children to approach mental health in a healthy way.

I heard a topic here about physical and mental health, physical and mental well-being. and if I hear you correctly we can't separate them and so if you're training Naomi and your knee is really bothering you and you're limping, you're going to get help right away. I'm going to say Hey, you know my knee needs to be fixed or you have severe chest pain and you're having trouble breathing, you go to the emergency room and that's why it's ingrained in us that we seek care for our physical ailments but not for the mental. but you heard something else, I believe about loneliness and what that really means, so Vivek, you wrote a Surgeon General's notice about loneliness and if you haven't read it, I encourage everyone to read it, it's available to the public . but you talk about loneliness as something physical like hunger, like being thirsty or I'll use another example, let's say we're all walking in a park and suddenly something happens, so what happened I guarantee in three thousandths of a second for those Of you who were not asleep and suddenly you were surprised and three thousandths of a second your pupils dilated your muscles contracted your heart started beating faster and only after all that you became aware of the fact that you were afraid, so we have certain core feelings that are so deeply ingrained in us for our survival, fear, hunger, thirst and we like to think that as rational human beings we control that, but we become aware of it and if we don't address it if, say, the Fear is not addressed due to trauma, that physiological expression remains ingrained in the US it leads to post-traumatic stress disorder with physical and mental consequences, if hunger is not addressed it can lead to physical and mental consequences and loneliness in which We don't think that way, but I think Vivek brilliantly captures that, as something so essential to being human, we are meant to be social, to be connected to each other to express our love for each other.

If you wouldn't mind explaining a little more about that concept of loneliness, which is a physical and mental construct and which in some way relates to what we've been talking about already, thank you Brian, and this is not a topic that I ever I thought I would work in public health to be honest with you, but I was really educated by people all over our country and all over the world, you know, as I was traveling and I started to realize that a lot of people were actually struggling with the feeling of loneliness. and isolation and the more I researched I realized two things: one is that loneliness is extremely common in the US, one in two adults report measurable levels of loneliness and the numbers are actually much higher among young people , but the other thing is that I realized how important loneliness was, it was much more than a bad feeling, but when we fight loneliness and isolation, we actually increase the risk of depression, anxiety and suicide, but we also run an increased risk of physical illness, our risk of heart disease increases our risk of dementia increases by 50 percent among older adults our risk of premature death also increases and therefore your biological reasons for this and everything is reduced to the fact that human connection is necessary for the survival that we have developed. for thousands of years in interdependent relationships needing each other, which is why it's so ironic now that we've somehow made it seem like a source of weakness if you need other people in your life, if you're not completely self-sufficient, it's just not how we we develop over time, the reason this is so important right now is because we havebeen dealing with a silent epidemic of loneliness not only in the United States but in many countries around the world, countries like the United Kingdom and Australia, Japan and others have taken Hearing about this, we have started thinking about national efforts that can heading to address loneliness.

When we issued our advisory recently, we established a framework for a national strategy and to address loneliness and isolation in America, but the truth is that if we do not address this it will harm us more than our health, but we will also damage the pillars fundamentals of society when societies are more connected they have lower rates of violence they are more economically prosperous they are more resilient in the face of adversity but when they are not when they are disconnected, they divide more easily than when there is an adverse event, say in a pandemic or other threat that arises, it's harder for people to come together and support each other, it's easier for them to polarize, and for all these reasons.

Tackling loneliness, rebuilding social connection in our lives and knitting together the social fabric of society remains, in my opinion, one of the most pressing social and public health challenges we face today, but I want to thank UV Big for bringing it to our countries and the world's attention because these are profound words um, Naomi and Michael, you have been on the world stage and we can look at you and we could potentially do something harmful to you, we can objectify you that you are this God or a goddess and and you are not human , you don't need this human connection, but what do these words mean?

This concept that we can be on the world stage and feel alone. We can be in a state of loneliness. That? resonates with you and and and how can we accept that you better talk um you know when I think about loneliness I only think about one right feeling is and and when I think about feelings I think that we all have those feelings and we all go through these feelings and emotions, so yeah we're going through something it's just a normal thing you know to me my loneliness feels like a dark room and it's closing in and I feel alone and I felt alone a lot during the pandemic um but through the tools that I got through From my own mental health journey, I was able to get through it and look at me, some of my tools are just talking to people, like texting a friend to check on them. them, whether it's calling my therapist, whether it's reaching out to a best friend, like I have a bunch of groups where we just check on each other because we have to correct them, they're my friends, they're my friends, like these are the people that I love him the most and I just want to make sure that we're all doing this right together because what is it?

It's like one in four people struggle with some form of mental health. How come one in four people don't exactly talk about that? That's for me, that's the only thing I want to change, you know, that's the main reason I

open

ed up and talked about it. I just said why not. I don't remember what the question was, but I said, "Okay, let's go." a journalist asked me a question and I just unloaded and felt amazing. I didn't feel alone anymore. Well, when I think of loneliness. To be honest, I think in time periods, so I think about the last time I felt. and in my case I felt alone during my pregnancy, simply because I felt like I couldn't do a lot of things that I normally could do and I think in a way it's about asking for help too for I, um, I learned a lot like normally.

I think I'm going to be an independent woman and I'm not going to ask anyone for help and stuff like that, and every time something happens, just take it on the chin, but then. I got to a place where I needed to ask for help and I wanted to reach out and talk to people and I think most of the time I have a really good group of people around me and they want to help. but I never ask, so I think it was just the process of asking and the process of I don't know what it was, I don't know if it was Pride or something like that that made me not ask for help and made me feel like I was isolated, but I'm very happy that the people around me just wanted me to ask for help and maybe you talk about wanting to be an independent woman and I think we would all like to say, well, yeah.

I am independent and what is the difference between being an independent woman, being a leader for women in our society and at the same time being interdependent. I think that's what you were talking about, Vivek, that the essence of who we are as human beings is that we are interdependent, we are social. Can we do both and that actually maybe allows us to be even more independent? Oh, that was affirmative, I'm sorry for everyone, but you know, I started to think about it as a team. To me, you see me as the athlete who plays. sport, but actually there is a whole team behind me and I started thinking about it like I think as humans we all care about each other and if someone asks me for help I would automatically help them like there was nothing on my mind and I just thought about it like that, like independence is great, but if I can get to the same goal, in a faster time, like you know, in a better way, that doesn't affect my mental health. a lot I think I'm fine with that too well Michael you in many ways I imagine no I don't want to put words in your mouth but you always had a team but when you're in that group it's you and with your physical discipline, your mental discipline, your independence , but how do you take this concept of independence?

And now you're talking about seeking help, but you're also being a world leader and encouraging others, you're saving lives, so what does it mean? that means to you this independent interdependent um I mean I echo exactly what you know a lot of what Naomi said um it wasn't just me going through everything every day I had a team around me all the time that supported me and and that was the reason why the one that I could do what I did. You know, I think I learned that I couldn't do everything alone no matter how much I wanted to take on absolutely everything in my power that I could think of.

I could stand it, okay, I can't do it. I found out the hard way. I could not do it. So again, yeah, I just asked for help. I think it was a great eye-opening experience for me. You know, being able to have it. Someone said yes, they wanted to help me again, like I felt alone for so long and when someone told me that, I mean you, you just like it, I said, send you back, right? I was very surprised and, um, I guess since then it's like I don't normally keep anything anymore, I just say whatever and leave everything out there, I never compartmentalize, I never carry that stuff with me because, again, I don't want to do things. by I myself am lonely and we are all working together to achieve exactly the same goal.

I've heard you talk before and now your experience with patience. As a great doctor and I've had experience with with patients also with patients not necessarily being patients but taking care of patients no um, but how do we help society? our patients in general in society understand that it is okay to ask for help, there are different ways to ask for help, including the buddy system that you two have talked so well about, but maybe even on another level there is a seeking for medical care professional, but how do you see that and what's the message for all of us here in terms of it's okay to ask for help and sometimes it's okay to ask? to get professional help, well, one good thing is that certainly in the United States in recent years there have been more and more efforts to make help more available, so now there is a 988 crisis line, there are three digits that anyone can call or text if they are having a mental health crisis and can be connected to a trained counselor.

There has also been more investment in telemedicine, using technology to provide care remotely, investing and bringing more counselors into schools, more money in training programs for psychiatrists and psychologists and even more needs to be done because there has been a large gap in provision of care, but all the steps that provide more options for care will not be enough if people do not feel comfortable asking for help and that is where the culture changes. comes into play, can't you legislate or pass some law that says people should feel comfortable asking for help? That has to do with our attitudes and beliefs, and I think that changes when people lead by example and that's one of the reasons why I am deeply appreciative of what Naomi and Michael have done in using their own stories and sharing their own experiences and that, I know, has reached millions of people.

It's also not just about community leaders like Naomi and Michael, it's also about people in communities. themselves moms and dads, who might choose to talk about mental health or get help themselves send a message to their children when teachers or when a boss at work or a co-worker decides they are going to get help send a send a message a message to the people around them saying that it's okay, asking for help and leading by example is powerful, but I also think we need to have more conversations in our schools and in our workplaces about mental health in the same way that we do. we do about any other health issue. right, we could talk about hey, if you get injured, you know, here at work, you know, call someone in this department, they can help you get first aid, etc., we should think about mental health in a similar context again, treating it like physical health and finally, I think from a cultural perspective, I think one thing we can also do is broaden our notion of who can help with mental health, so that it's not just psychologists, therapists and psychiatrists, but that it turns out that each of us has the power to help other people. when it comes to our mental health and well-being now, regardless of our age, regardless of our background, and we provide that help by showing up for other people, checking in on them, listening to how they're doing, so many times they'll ask.

Someone, hey, how are you? and we move on, but if we really pause and listen to how someone is doing, this is what you do when you listen to someone honestly, openly and with your full attention, you are telling them that they are important. I tell them that they are valued and that they are seen, and I have always believed that there are three things that we all need, no matter what country, what culture we come from, as human beings, we all want to be seen and understood just as we are. We all want to know that we matter and we all want to be loved and you can convey all three of those things to another person just by checking in with them and listening to them, being there for them in a time of need, so I know we worry sometimes.

Hey, am I meddling in someone's life? If I ask how she is, am I invading her privacy? But I think this is a time where we need to respectfully take the initiative to check on others because there are too many people out there. struggling on their own wishing someone would just ask them how they are or give them space to be open and instead society too often tells them that they should put on a brave face and do it on their social media posts in their conversation public. and how they present their public image to make it seem like everything is going great even though they are struggling inside.

I just want to say it. I'll put one thing at the end. It is good not to be good. Yes, remember that. maybe you know we talked a little bit about this this morning, um, this latest con, you're almost talking about we're all here for each other, it's a group system, there's a formal term for that, it's called bystander intervention. , so the bystander effect is let's say you're walking through Manhattan and you see something horrible happening on the street, you just keep walking. Bystander intervention is that we learned to be friends with each other, so if I was involved in that, I would learn and we should all learn that, let's say.

Michael is more withdrawn or he doesn't show up to practice or Naomi says something and it worries me or Vivek is suddenly eating differently in a way that I know isn't right and then I think what you're inviting us to do is use the bystander effect in terms of to step in and say Hey, you know how you're doing today or you know me, you want to practice today, you know everything, okay, but when I ask you, I'm present and I'm really waiting for the answer and you understand that I'm waiting for the answer because you matter, I'm validating you or you know Michael, you know where you've been lately and you all have experience too.

Do they have a buddy system and can they? You explain that and its importance. I will say that at the NCAA level it may be the most important thing we are doing with our 500,000 student-athletes. The buddy system. The intervention of the spectators. We know how to take care of each other because we are here in this as a group activity as a human activity together. I mean, I do. I will say. You know, I'll mention one person, Chuck Barkley, and I refer to him and go back and forth randomly in the most awkward way. For hours we just check on each other like he's always checking on me and I have a few friends like that and in a few moments I'll be going through some sort of spell spill spiral as you wish.call it and Bing one. of those phones like my phone goes off a text message comes and I can just relax because you don't feel alone in that moment so I think those things for me are life changing, you know, just being able to have some kind of open communication, that's something for me that was a challenge for a long time.

He was very good at compartmentalizing and probably could have won a few more gold medals, but it's not something to be proud of. saying that in compartmentalization I could have gained more models there, but umYou know, it's just getting things right for me, it's always trying to get things out there because the more you carry it, the heavier the backpack gets on your back, like that that just opens communication, you know, I make the joke. I learned to communicate at the age of 30. um, but at least we got there and I'm trying to do it every day because if I'm putting it out, someone is listening, whether it's my wife, whether it's my therapist, whether it's my friend, whether it's a coach, it doesn't matter, there's someone there and there is always someone who cares as honestly as the two things I always try to remember is to be you and it's okay to not be okay, to be your authentic self, that's what I try to do every single day, what makes the Buddy system is a concept that makes sense to you and how you use it. um, yeah, I mean, I agree with everything you said, but I'm also sorry I laughed a little because, as an example. you said like hey Naomi, yes you said something concerning, but everything I say is a little concerning, I'm not sure if that would work, but um, yeah, yeah, I think for me I definitely like reaching out to my friends, um, every time.

I feel. sad like when I was traveling to play tennis, whenever I have to go abroad and stuff and I feel a little lonely, I discovered that I like to reach out to my friends no matter what time they will answer because they care. for me and I think that's something that's really important and through that I learned to take good care of myself as well and sometimes we learned that strength like we discovered how to surround ourselves with people who listen to us and who listen to us. take care of us and love us, but Michael, you mentioned something that will take this like Segway.

You get a text message in the middle of the night or sometime and it can help you, which is why there is this concept of social media. Well, it's a little more than a concept, I know that well, but social networks are always present. Naomi and Michael, you guys have great social media references and I think you are positively influencing a lot of people with your social media, but it is possible, maybe likely, that I have received some negative social media posts where someone says something hurtful or even worse and and and and being vague and your last notice from the Surgeon General again.

I encourage everyone to read this. It's on social media and youth mental health and it addresses this again. From a public health perspective, yes, social media can be good, but there is a lot we don't know about it and is it possible, especially in our young people, that they are being fundamentally shaped by social media, which on the one hand they believe What are they? They are connected to this vast Universe, on the other hand, they are not really developing human connections, so can you share with us, Vivek, this latest notice and the most recent notice on social media about some of your concerns?

And then I'd like to hear from Michael. and Naomi, if these concerns make sense to you too, sure, Brian, you know that I, uh, am a believer in technology. I spent several years building a technology company before I was in government. I used technology quite a bit and my I think that whether technology is a tool at the end of the day, whether it helps us or hurts us, depends on how it is designed and ultimately and how it is used, and my concern with social media is that what has happened in the last 20 years is that we have released this technology, it has been adopted dramatically and while there have been some positive benefits for some people, I am concerned that many people are actually being harmed by it and that has become a major contributor to the youth mental health crisis that we are seeing in the United States and possibly other countries as well and this is what we are seeing in the data and this is what led me to issue this advisory.

In fact, I'll tell you the biggest thing that led me to issue this notice or conversations with parents everywhere I went, uh, in the United States, the most common question I got from parents was about social media and I was asked if this is safe for my children, if it is harmful to my children, that was the number one question by far, so the data that we found concerning was that people who used three hours or more of social media a day , this is adolescence, they face double the risk of symptoms of anxiety and depression, and that was particularly concerning because the average amount of use in the US is three and a half hours a day in adolescence, so it is an excess of that.

What was also worrying is that almost half of teenagers said that using social media made them feel worse about their body image and many also said that around a third of teenagers watched until midnight or later weekdays using their screens and a lot of that was social media time which kept them up at night and we know that, particularly during adolescence, which is a critical time of brain development, when you're sleep deprived it actually increases the risk of having poor mental health outcomes, so you put all of this together and what I was worried about, what came out to me was actually two things, one is that we didn't really have enough evidence to say from a scientific perspective that social conditions Is social media safe for your children in answer to the question that parents were asking me, but the second thing is that there was increasing evidence that social media use can be harmful for many teenagers, so this has been my point of concern about it and I think that You know, look, clearly there is something good that can happen with social media.

Good messages, positive messages can reach the public. They can be used in ways that can sometimes give people a

forum

for expression and creativity, but what we have to do is. In some ways, what we did with automobiles 20 or 30 years ago, when I was a kid, the motor vehicle death rate was very high in the United States. Now we didn't say, you know what, let's just throw out the cars and get back to the horses. and Buggies, of course, we didn't say that we didn't say that either, you know what, there's nothing we can do, this is just a feature of modern life, let's just put up with all these deaths, we said, you know what we need. to find a way to make this new technology, in this case cars, safer, and we established safety standards that gave us seat belts and air bags and other features that helped reduce motor vehicles, that with the time and here too I think we really need a similar system. approach this technology must be designed in an age-appropriate way it must be designed with the kind of safeguards that reduce the likelihood that people will be exposed to harmful content and harassed, bullied or abused online, which is happening to too many people . people or who will be subject to features that take advantage of people's minds and that are addictive in nature and that ultimately lead to excessive use that then takes away the person's time to sleep and time to exercise, for example so this is a journey that we're on right now and it's an urgent journey because these platforms are widely used and widely available, but I'm concerned about the amount of harm that's accumulating for people and I also think that at the end of the day the In-person time is really valuable, it's weird.

It's been designed for thousands of years to interact with each other in person and a lot of what happens online isn't always a reflection of real life, right, we see people's best days posted online, we see their curated versions of the world. , but there is no substitute for being in person with people, so I think it's important that we recognize that requiring companies to actually share the data they have about the mental health impacts of their platforms because right now researchers They say they can't get full access to that. Data that for me as a parent is very concerning because information is being withheld from me, but we also need these security measures, these security standards and we need them to be enforced, so ultimately, in my opinion, this is how we take a technology. and make sure that ultimately it helps us and not harms us, yes, and your message was loud and clear, another warning we should all read.

Naomi Michael, just to let you know that we are taking on the US Open here along with the rest of the tennis world. steps to find a way to monitor social media to put those safeguards in place, but your active users and that makes you think that it can be potentially harmful um uh well for me my social media is what I am um you'll see me post quotes that sometimes I just needed to see and it means I was having a bad day and that's okay there are times when I post happy faces and that's because I'm actually happy that you get the authentic me every time you're on my site or everyone every time they're on my platforms um I've been harassed um I've had people wishing things on my kids in my family um it's wrong, it's ridiculous and to your point, with three little kids approaching, it scares me um I want them to have the best experiences they can and that then they can also be who they are and not be ashamed of who they are, so yeah, I mean, I agree that it's good and bad, but again, I always try to use it for good, I always try to use it to get my messages across and then I stop.

I don't read comments, I try not to. When I started getting death threats, I basically turned off my phone, so, just because I don't. I don't want to be around it and it makes me feel bored and then my thoughts start racing and I break away Naomi oh um yeah, okay, I don't want it to sound exactly the same but exactly the same um, no I don't know, I feel like at some point definitely I got really scared of social media like, um, I don't know, I felt like there were too many things I didn't know about it, I think the fear of the unknown that I'm still a little worried, you know?

But then I think about the times I use social media, it's to cheer people up or, you know, to show people what I'm doing and look at Beyoncé's outfits or something like that. if you don't want to post like that, just don't post right, yeah, you know, and then I also try not to look at comments like and it makes me sad because like before, people knew who I was, there are people who give me positive. messages, you know, it's a little sad. Sorry to miss that, but I think for my mental health, like if I could see something really bad, it's not worth it.

But yeah, we have three minutes left and I want to use them. part of the three minutes for the four of us on stage we are going to make a promise together and that is what I really believe is to take what you wrote in the last notice on social media and work together with everyone in this room to get the message that we need to understand its impact and we need to understand that we are in a time where we do not know what is happening to our youth, we do not have the science or the medical evidence to understand the negative impact and that is why we can Start working on that's just to help spread the word right when we're spreading the word about mental health.

Good compromise, right? I love it, so maybe we also have one last moment to say, well, how do we end this? I don't even know if we have enough time for all of us to give a final moment, but this morning, Michael, you gave a moment about parenting and, something about the lion's breath, and if you could share that with all of us. As a father, I have three children, seven, five and three, and you know, when they fight with each other and there is a lot of this, there is a lot of yelling and screaming, they sit down and drink. this big deep breath and then they get to roar as loud as they can roar like a lion and usually when they do that their shoulders drop and they can say well Beckett did this or Boomer did this or I was.

I felt this or I was angry and for me, as a parent, you know, for so long I didn't know how to express those things and now he's seven, five and three, they're sitting there doing it right in front of me. from my face it's an incredible thing to see and for any new parent who tries it, it can be very loud, but just give it a spin, well, going back to vacating what you said as a parent, uh, no, it's not like that. Do what I tell you, but you lead by example and I think you're leading by example, so that's one of the hardest things.

Be clear about it. I think many times, as parents, we know what we want. do, but we may not do it and I think part of this broader conversation about mental health has to do with a cultural shift to give ourselves and others more grace and forgiveness and just recognize that we allWe are doing our best. imperfect sometimes we're all going to fall short sometimes we're going to say the wrong thing we use the wrong word but just to recognize that we're all on a journey here and we need the support and help of others, you know.

I've been struggling many times in my own life with my mental health as a child, you know, many times later as an adult as well and as a child I never talked about it because I was ashamed, right? I thought, hey. I'm the only one on this journey and something is wrong with me so there are a lot of people who feel that way and I think if we could approach our lives and other people's lives with a little more grace and forgiveness we would extend the kind of support they need by recognizing that many people are suffering in silence.

I think we can make big steps forward in terms of improving mental health and wellbeing and changing the culture to be more open about it with those words too. of grace and forgiveness. I really want to thank everyone for being here with us today. I really want to give a special thanks to Vivek Naomi.Michael, you are incredible leaders and I hope that you continue this journey with you and everyone here in this room, so thank you all for joining us and thank you all who are watching this broadcast of today.