is head of the OECD New Approaches to Economic Challenges Unit.

William Hynes, DPhil

President Biden’s first State of the Union Address

, he announced a strategy to address the national mental health crisis, which critically includes expanding focus on youth mental health.

 Additionally, in December 2021, the United States Surgeon General Vivek Murthy, MD, MBA, issued a 

 on the urgent need to address the nation’s youth mental health crisis.

 Advisories are reserved for significant public health challenges and have priorly included advisories on opiates and smoking. The recent Surgeon General’s Advisory calls for immediate and coordinated responses to prevent youth mental health from becoming a second pandemic.

While youth have been relatively protected from the lethality of the COVID-19 virus itself, they have been more vulnerable to the psychological impact. Additionally, unlike other physical health conditions, 

three-quarters of mental health disorders

 The combination of these dynamics has created conditions ripe for a secondary pandemic for youth. Similar to the lack of preparedness for the COVID-19 pandemic, we are not prepared to face this second threat. In fact, we were failing, as suicide, depression, and addiction among American youth were at all-time highs before the pandemic worsened them further. For example, at least 4.1 million adolescents—

—had at least 1 major depressive episode in 2020.

Mental health challenges have been particularly hard on young women and youth of color. The pandemic has directly correlated with an 

 in emergency room visits by adolescent girls and young women for suicide, rates of need have grown faster for Black and Hispanic youth, and Black and Hispanic children have experienced grief due to the loss of a parent at rates many times higher than White children.

However, unlike in the early days of COVID-19, there is existing guidance on what to do for youth mental health—guidance that we have too long failed to invest in commensurate with the need. Treatments—including psychotherapy, medication, and care coordination—have been robustly validated and proven safe. Prevention across development phases has also been found to be effective. Youth can also help each other, as social support is an especially beneficial intervention. Additionally, as 7-year-old 

, one of the youngest-ever TED speakers, clearly articulated, we must likewise 

prioritize young children’s healthy brain development

 during the 0- to 5-years-old period, preventing further mental and brain health disorders across the lifespan.

Improving access to screening, detection, and early intervention for children and adolescents is key. Signed into law in mid-2019, 

the Texas Child Mental Health Care Consortium (TCMHCC)

 was formed with the state’s 12 publicly funded medical schools.

 TCMHCC is funded with $118.5 million in state funds to provide universal access to child psychiatry consultation in primary care through the Child Psychiatry Access Network (CPAN), urgent access to psychiatric telehealth care and referrals in Texas schools through the Texas Child Health Access Through Telemedicine (TCHATT) program, and expansion of workforce training and the public psychiatry workforce more broadly. Launched in May 2020, TCMHCC engaged 5000 pediatric primary care providers in CPAN and reached nearly 1.7 million Texas students through TCHATT in less than a year, including 12.5% Black and 34% Latino students—numbers proportionate to the broader child population of Texas. TCMHC provides an infrastructure that can be scaled up or down as needs change. The Texas legislature just took advantage of this by adding $113 million in American Rescue Act funds to ramp up all these programs in response to the ongoing mental health surge.

 over a 5-year period to youth mental health to build capacity for prevention and treatment, help schools cope with the demand, and support families.

 Scaling up investments and sharing best practices between states are key to addressing this national issue.

All the programs mentioned are helping children, young adults, families, and schools across the country cope with the growing youth mental health pandemic. As these initiatives demonstrate, youth mental health is more than health care. Just like all health conditions, mental health is shaped by a variety of factors, including genetics, brain chemistry, trauma and violence, social connections, neighborhood safety, access to food, larger social and economic policies, and more. As such, the recent Surgeon General’s Advisory provides recommendations on how to improve youth mental health to a variety of stakeholders including families, educators, health professionals, entertainment organizations, technology companies, governments, communities, funders, and others.

Students’ ability to engage and connect with their schools is critical to improving emotional well-being and enhancing learning outcomes. Young people must also be directly involved with designing solutions to address the youth mental health crisis. Already, youth are speaking up about their mental health challenges and leading change. 

, ranging from starting nonprofits to campaigning for policies to developing apps, have led to reduced stigma and increased access to care for mental health. It is imperative that government policies, technological solutions, and other initiatives that address youth mental health are designed with young people—not for them.

The youth mental health crisis is a public health imperative with enormous implications for America’s future. Our actions now will determine the future trajectory of our nation and have the potential to prevent a second pandemic. Investing in our youth by building our nation’s human capital, or rather 

, is an ongoing process. Addressing the youth mental health crisis is not only a medical and moral imperative, but it is also key to ensuring we have the next generation of leaders needed to build a prosperous future for our nation and world. As Murthy urges in the 

, by addressing the youth mental health crisis, we have an opportunity to “step up for our children and their families” and “lay the foundation for a healthier, more resilient, and more fulfilled nation.”

 It is this future that we must build together.

 is an Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute.

 is president of the healthcare division of Higher Ed International.

 is president and chief executive officer of the Meadows Mental Health Policy Institute. 

is head of the OECD New Approaches to Economic Challenges Unit. 

 is co-lead of the OECD-PRODEO Institute Neuroscience-inspired Policy Initiative supported by Meadows Institute.

1. Remarks of President Joe Biden – State of the Union Address as prepared for delivery. March 1, 2022. Accessed April 12, 2022. 

https://www.whitehouse.gov/briefing-room/speeches-remarks/2022/03/01/remarks-of-president-joe-biden-state-of-the-union-address-as-delivered/

2. Protecting youth mental health: the U.S. Surgeon General’s Advisory. 2021. Accessed April 12, 2022. 

https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf

3. Kessler RC, Amminger GP, Aguilar-Gaxiola S, et al. 

Age of onset of mental disorders: a review of recent literature.

4. Major depression. National Institute of Mental Health. January 2022. Accessed April 12, 2022. 

https://www.nimh.nih.gov/health/statistics/major-depression

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Emergency department visits for suspected suicide attempts among persons aged 12-25 years before and during the COVID-19 pandemic - United States, January 2019-May 2021.

6. Wright M, TED and Minderoo Foundation. How every child can thrive by five. July 2021. Accessed Arpil 12, 2022. 

https://www.ted.com/talks/molly_wright_how_every_child_can_thrive_by_five?language=en

7. Texas Child Mental Health Care Consortium. 2022. Accessed April 12, 2022. 

8. Wiener J. When children suffer: California to funnel billions into mental health overhaul. March 17, 2022. Accessed April 12, 2022. 

https://calmatters.org/health/2022/03/california-children-mental-health-crisis/

Articles

We must prioritize youth mental health for a flourishing and resilient American future.

Building a Resilient Future: Addressing Youth Mental Health

Violence against women, which can result in traumatic brain injury (TBI) and other acquired brain injuries (ABIs), intensified during the COVID-19 pandemic. A comprehensive and long-term strategy is required to address this issue and to ensure the mental well-being of women.

In July 2021, social media influencer Gabby Petito and her fiancé, Brian Laundrie, embarked on a cross-country road trip captured on Instagram and YouTube.

 In September, Laundrie returned—alone. Weeks later, Petito’s remains were found. It was determined that she died from strangulation, and her case opened a national conversation about intimate partner violence (IPV).

Tragically, Petito’s case is just 1 of many. There has been an increase in IPV, illuminating a shadow pandemic within the 

 Even before COVID-19, 1 in 3 women (approximately 1.27 billion women worldwide) experienced IPV.

 Further, more than one-third (30,000) of the women killed in 2017 in the US died at the hands of their current or former intimate partner.

 In 2020, calls to helplines increased 5-fold in some countries.

 In some nations, there has been a 300% increase in police reports of IPV, likely fueled by COVID-19 mitigation strategies.

 UN Women projected that an additional 15 million women would be affected by IPV for every 3 months of lockdown.

The neurological consequences and IPV-related ABIs, including TBI, are devastating. Despite recent increased focus on sports-related TBI, little attention has been paid to TBI resulting from IPV.

 Yet, up to 90% of IPV survivors report head, neck, and facial injuries, which can result in TBI.

 One study found that 74% of the women who experienced IPV sustained at least 1 IPV-related TBI and 51% suffered repetitive IPV-related TBIs.

 The study also found higher brain injury scores were negatively associated with memory, learning, and cognitive flexibility and positively associated with a number of measures of psychological distress.

IPV-related ABI also includes nontraumatic brain injuries. Research has shown that 1 in 10 women has been choked by an intimate partner,

 with long-term implications. Plus, prior nonfatal strangulation has been associated with greater than 6-fold odds of becoming a victim of attempted homicide and more than 7-fold odds of becoming a victim of completed homicide.

 The high-profile strangulation homicide of Petito underscores femicide in IPV, which remains commonplace.

In addition, women who experience IPV also are more likely to suffer from anxiety, depression, posttraumatic stress disorder, suicidal ideation, and other health problems that can last after the violence has ended.

There is also concern that repeated TBIs from IPV may result in chronic traumatic encephalopathy (CTE), a progressive and fatal neurodegenerative disease that cannot be diagnosed until postmortem.

 For instance, a 1990 report identified a case of a woman who apparently developed CTE from partner abuse.

 In 2021, during a postmortem examination of a young woman who died after a 

, immunohistochemical staining for phosphor-τ revealed evidence of CTE-type pathology.

 This marked the first case of CTE pathology in a young woman who experienced IPV. However, there remains a lack of research investigating the long-term neurological consequences; research is needed to understand the potential for misdiagnosis, nondiagnosis, or the development of 

 The latter is especially important because TBI has been identified as a modifiable risk factor for dementia.

The neurological effects of IPV extend to the family and remain underresearched. A recent Brain Injury Australia report found that of 16,000 survivors of family violence attending Victoria hospitals over a decade’s time, 2 in every 5 had suffered brain injury.

Further, nearly 1 in 3 of the survivors of family violence were children; of those, 1 in 4 had suffered a brain injury. Because this was not a study of IPV but of hospitalizations, it likely represents the tip of the iceberg. Another study across 5 domestic abuse shelters in Arizona found 9 in every 10 individuals reported a head injury with loss of consciousness from family violence in the preceding 12 months.

 Of those, 9 in 10 reported “too many head injuries to quantify.” Yet only 1 in 5 ever sought medical attention. Thus, community rates of IPV ABI remain radically underresearched.

Most domestic violence shelters and emergency department settings do not assess for TBI, nonfatal strangulation, or other brain injuries from IPV.

 Plus, many women do not seek medical care for their IPV-related ABI.

 However, even when women interact with health care and domestic violence advocates, there is a lack of training to adequately screen for and address IPV-related ABI.

Further, a study of women in prison found that 78% had significant head injury; 84% had experienced repeated head injury largely due to domestic abuse.

 are not adequately accounted for in the criminal justice system. The staggering number of women who have experienced abuse and are now in prison also further necessitates development of a trauma-informed criminal justice system.

IPV-related ABI adds yet another injustice to the brain health gap, which highlights and frames the sex and 

 in outcomes for brain health disorders across the life span, with strikingly negative outcomes for women.

 Research institutions are calling for more female participants in preclinical development of medications, clinical trials, and clinical practice, as well as the expansion of research designed to focus on culturally relevant experiences specific to individuals who identify as female. This will enable collection of more robust and representative data. Big data, real-world evidence, and precision medicine approaches should be used to respond to the call to action. Furthermore, investing in public health efforts is imperative to translate these data and perspectives into action. Women remain underrepresented in health care leadership, underlining the lack of gendered consideration in care. These efforts and initiatives are especially important for research, clinical care, and training related to IPV.

Likewise, the world is suffering a global brain capital collapse.

 Brain capital is a novel econometric asset that puts a premium on brain health and skills in our brain economy.

 This is a form of capital relevant to a complex, interconnected, and fragile global economy. Brain capital needs to be integral to a new narrative of growth and progress that puts individuals and their well-being, health, interaction with others, and psychological resilience at the center of our economic system. Female empowerment—which includes preventing and addressing violence against women and better identifying and caring for the neurological effects in survivors—is a public and brain health imperative as well as the most effective way to build brain capital globally.

Addressing gendered violence and related ABIs can be remedied by integrating the social, medical, political, policy, and diplomatic levels. Taking sex and gender into account—including structural and social determinants—is critical for equality in brain health and precision medicine. The Organisation for Economic Co-operation and Development (OECD) New Approaches to Economic Challenges Unit’s Neuroscience-inspired Policy Initiative (NIPI) seeks to tackle this issue.

 We aim to find new ways to reconceptualize and revitalize the economy and how it works, laying the groundwork to identify relevant metrics while building a transdisciplinary network of stakeholders. The effort draws on experts from medicine, neuroscience, gender analysis, economic policy, philanthropy, and business. The initiative will rapidly refine and advance women’s brain health via a series of research projects, seminars, and clear policy analyses and recommendations. We hope to help build a future in which al individuals are equipped with the support, resources, and care they need to thrive and in turn build a more resilient society and world.

is an Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI) (at the University of California, San Francisco and Trinity College Dublin), a Thiel Fellow at Stanford University and Steering Committee member for NIPI (OECD, Meadows Mental Health Policy Institute and the PRODEO Institute). 

 is the CEO of Brain Injury Australia. Dr Valera is an associate professor in psychiatry at Harvard Medical School and a research scientist at Massachusetts General Hospital. Dr Chadha ishead stakeholder, Engagement for Alzheimer disease at Biogen and Pro Bono CEO and cofounder of the Women’s Brain Project. 

is head of the OECD New Approaches to Economic Challenges Unit, senior advisor to the OECD secretary general and colead of OECD NIPI. 

is advisor to the chief of staff and gender advisor at OECD. 

is a senior clinical advisor for Cohen Veterans Bioscience’s trauma research programs. She serves as strategic advisor coleading CVB’s Suicide Strategy Initiative. 

is colead of OECD NIPI, strategic advisor to the HEKA Fund (Newfund Capital and Fondation FondaMental), steering committee member for the Brain Health Nexus at Cohen Veterans Bioscience, and holds adjunct roles with IMPACT at Deakin University, GBHI, and Baylor College of Medicine.

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. October 20, 2021. Accessed November 20, 2021. 

https://www.nytimes.com/2021/09/20/style/gabby-petito-case-tiktok-social-media.html

2. Santucci J. Gabby Petito was strangled. Experts say such an assault is a red flag for intimate partner homicides. 

 October 12, 2021. Updated October 13, 2021. Accessed November 20, 2021. 

https://www.usatoday.com/story/news/nation/2021/10/12/gabby-petito-strangled-experts-say-its-common-intimate-partner-violence/8426282002/

A pandemic within a pandemic - intimate partner violence during Covid-19.

When pandemics clash: gendered violence-related traumatic brain injuries in women since COVID-19.

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Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization—national intimate partner and sexual violence survey, United States, 2011.

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https://www.unodc.org/documents/data-and-analysis/GSH2018/GSH18_Gender-related_killing_of_women_and_girls.pdf

7. Mlambo-Ngcuka P. Gender-based violence: we must flatten the curve of this shadow pandemic. November-December 2020. Accessed November 20, 2021. 

https://www.un.org/africarenewal/magazine/november-december-2020/gender-based-violence-we-must-flatten-curve-shadow-pandemic

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Intimate partner violence and traumatic brain injury: state of the science and next steps.

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Interplay between traumatic brain injury and intimate partner violence: data driven analysis utilizing electronic health records.

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Non-fatal strangulation is an important risk factor for homicide of women.

Adult experience of mental health outcomes as a result of intimate partner violence victimisation: a systematic review.

Intimate partner violence, traumatic brain injury, and social work: moving forward

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Clinical presentation of chronic traumatic encephalopathy.

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Chronic traumatic encephalopathy: neurodegeneration following repetitive concussive and subconcussive brain trauma.

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Chronic traumatic encephalopathy (CTE)-type neuropathology in a young victim of domestic abuse.

Evaluating spousal abuse as a potential risk factor for Alzheimer’s disease: rationale, needs and challenges.

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Dementia prevention, intervention, and care: 2020 report of the Lancet Commission

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Traumatic brain injury in domestic violence victims: a retrospective study at the Barrow Neurological Institute.

Head trauma in a community-based sample of victims of intimate partner violence: prevalence, mechanisms of injury and symptom presentation.

 Published online May 15, 2021;8862605211016362.

Brain injury in women experiencing intimate partner-violence: neural mechanistic evidence of an “invisible” trauma.

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Associations between significant head injury and persisting disability and violent crime in women in prison in Scotland, UK: a cross-sectional study.

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A brain capital grand strategy: toward economic reimagination. 

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Violence against women and resulting traumatic brain injuries increased during the COVID-19 pandemic. 

Violence Against Women and Acquired Brain Injuries

 denial, COVID-19 denial, radicalization creating the 

. If humanity’s susceptibility to mis- and disinformation has you on the brink of despair—take heart! Solutions are on the way. Two sciences—one young, the other embryonic—have begun to deliver actionable insights. Even better, an emerging shift in perspective could rebalance our relationship with the vectors of cognitive contagion.

 It is the study of how bad information spreads through populations, duping and disordering minds.

 Infodemiologists take biological concepts and apply them to the infosphere. They examine salient phenomena—viral memes, moral panics, outbreaks of extremism—and learn how they work. It turns out that infodemics and epidemics happen for similar reasons. Infodemiologists develop a rich understanding of misinformation outbreaks and identify ways to disrupt the transmission of problematic content.

Infodemics are not just a 21st-century phenomenon. They have plagued humanity for thousands of years. Time and again, infectious ideologies have proliferated, polarizing peaceful societies. They have sustained oppressive orthodoxies, too, and toppled magnificent civilizations. Paul P. Harris—the founder of Rotary International—put it well: “Ideas have unhinged the gates of empires.”

The history of infodemics took a strange turn, though, in the early 2000s. Almost overnight, smartphones and 

 became ubiquitous. They hyperconnected our minds, leaving us newly susceptible. Ever since, delusional mindsets have found novel ways to infect and unhinge us.

In 2002, a young public health researcher named Gunther Eysenbach sensed the need for a new discipline.

 He coined the term “infodemiology” and called for its development. Scholars with backgrounds in psychology, epidemiology, and network analysis responded. Together, they fashioned a lens that brings our post-truth predicament into stunning focus.

It is hard to view the world through this lens and not be troubled. Not long ago, 

 companies built apps that were actually 

 They successfully captured a huge swath of human attention (many billions of person-hours a day) and learned how to monetize that capture. Largely unregulated, they became giant, multinational corporations. Facebook conducted a huge mood-manipulation experiment on its users: It adjusted the algorithms that curate content on the platform and found that it could boost “engagement.” And profits. These changes amplified misinformation.

Fake news and inflammatory posts proved adept at propagating.

 Misinformation “super-spreaders” carved out lucrative niches in the attention economy. Foreign actors weaponized disinformation to polarize and weaken democratic societies.

 Duped by intemperate content, many of us became cynical—literally addicted to grievance and outrage.

 In some countries, demagogic politicians emerged and began to radicalize the disaffected. Today, a polluted information environment confuses individuals, destabilizes democracies, and, in some cases, unleashes genocidalfuries.

 ago. Think about that: It means that what scientists call “information disorder syndrome” has advanced with stunning rapidity.

 It is like we are sleepwalking toward a precipice. It is time we woke up.

In 2020, the World Health Organization raised the alarm. It labeled infodemics a serious public health hazard. The international body mobilized a substantial response to 

 and urged immediate action to address our vulnerability to other information pathogens.

 It identified pressing needs for infodemic research and infodemic management. We applaud these efforts. We need to disinfect the information commons. We need to monitor for dangerous disinformation outbreaks and develop our capacity to respond.

NATO has concluded that international alliances must counter disinformation to remain resilient.

 The United Kingdom has launched a Rapid Response Unit to combat fake news.

 Sweden has set up a Psychological Defense Agency.

 Counter-influence campaigns in western countries have begun to “pre-bunk” (or inoculate against) weaponized disinformation, in one case by “tell(ing) the public to anticipate false narratives, but not listen to them.” We need to replicate such programs worldwide.

Yes, the tools of infodemic management can be abused—

 danger should not be overlooked—but a world without them will likely turn dystopian fast.

 of misinformation can easily tread on speech rights, so it is often best to address the problem at the demand end. This is where the second science—the embryonic one—enters the picture. We call it “

 to misinformation. Cognitive immunologists ask why some minds become robustly resistant to (say) divisive ideologies, while others remain more vulnerable.

Since the 1960s, inoculation theorists have been studying the mind’s information-filtration system. William McGuire discovered that it functions like the body’s immune system. The body’s defenses mobilize antibodies to fight infectious microbes; the mind’s defenses mobilize 

antibodies—doubts, questions, evidence, and the like—to fight infectious 

. And exposure to the right inoculant can boost resistance. Cognitive immunologists take the idea of mental immune health seriously; they study the mind’s immune system and find ways to boost its functioning.

Decades ago, enterprising scientists rolled up their sleeves and delivered astonishingly effective protections against biological contagion. The fruits of their efforts—germ theory, hand-hygiene, 

—now protect our bodies from hundreds of debilitating diseases.

Cognitive immunologists want to afford our 

 comparable protections. They study how well-functioning minds spot and remove falsehoods. They catalog types of mental immune 

. They have tested inoculants for extremism, propaganda, and conspiracy thinking, and are working on more systematic ways to strengthen the mind’s defenses.

At the beginning of this article, we alluded to a potentially game-changing shift in perspective. To grasp it, consider this possibility: Mis- and disinformation are actually 

Sounds like the premise of a creepy, low-budget horror flick, right? But here’s the thing: Scientists are taking the idea seriously. Some have analyzed the spread of witchcraft beliefs in early modern Europe and concluded that mind-parasites really do exist.

 Others have concluded that infectious and destructive messages should be thought of as “

”—entities that can behave as agents with their own agendas.

At some level, the claim is unsurprising: Misconceptions, misunderstandings, and false beliefs have always infected minds. Infobugs are not discrete chunks of matter, but they are patterns capable of replicating and causing harm. They are significant entities, and each of us harbors thousands of them.

But isn’t this all just metaphor? Not at all. Metaphorical language frequently morphs into new, literal usages. Not long ago, a meme was just an analogy—a made-up word. But it quickly proved useful: We realized that it designates a phenomenon worth naming, so we dropped the scare quotes. Today, memes are part of the ontology of science—we 

them to be real. Infobugs and mental immune systems are destined to join them.

Now ask this: What if the infobug hypothesis came to be accepted as fact? What if 

 came to grips with it and embraced the consequent epistemic humility? Might this not transform our troubled relationship with information pathogens? A hundred generations of Socratic questioning—a practice known to enhance awareness of ideas’ problematic properties—suggest that the answer may be yes.

Care to boost your immunity? Let these truths sink in: False narratives are everywhere. Some are invasive and proliferate like weeds. They can overrun minds and sink deep roots. And even small concessions to wishful thinking can plant the seeds of delusion.

Grasp this, too: Each of us is blind to our own mind-infections. We need the help of others to spot them. But how do you react when others draw attention to yours? Do you get defensive? Many do. Identify with your beliefs, and corrective information will feel especially threatening: Your mind’s immune system will overreact and prevent you from learning. Belief-based identities create learning traps.

Efforts are underway to design and advance solutions to disinformation.

William Hynes, DPhil

Articles

Building a Resilient Future: Addressing Youth Mental Health

Violence Against Women and Acquired Brain Injuries

Disinformation? There are Remedies for That

Brain Capital Foundry: Accelerating Responsible Innovation

Teleworking—A New Way of Working?

Shedding Light on the Shadow Brain Pandemic: The Devastating Effects of Gendered Violence-Related Acquired Brain Injury