Surgeon General Vivek Murthy and his seven living predecessors joined in a rare panel at Dartmouth on Thursday to discuss ways to address the national mental health crisis.
In a wide-ranging conversation in which several of the participants spoke movingly of the impact of mental illness and addiction in their own families, Murthy—who was appointed by President Joe Biden in 2021 after first serving in the role during the Obama administration—called the growing sense of disconnection, distrust, and loneliness in society “a moral crisis.”
He challenged the audience of more than 1,400 people in Leede Arena or watching via livestream to help cultivate “a world where people feel that they belong—where they know that they matter.”
The historic meeting on the Future of Mental Health and Wellness was the first time in 25 years that all the living surgeons general past and present have convened in one place around a common purpose (David Satcher could not travel but contributed a video statement). The conversation was moderated by CNN Chief Medical Correspondent Sanjay Gupta, a neurosurgeon and associate professor at Emory University Hospital in Atlanta.
In opening remarks, President Sian Leah Beilock welcomed the surgeons general and Gupta to campus and made the case for why she has made a holistic approach to mental health a focal point of her vision for Dartmouth.
“I’ve spent the last 20 years of my career exploring how stress impacts the brain and body, and it’s very clear that in order for our students to succeed academically they need to have appropriate health and wellness skills,” President Beilock said. “How we feel is directly linked to how we perform, and it’s our duty to help our students perform at their best. Our society depends on it.”
A Systemic Challenge
The discussion began with the pre-recorded video message from Satcher, who was appointed surgeon general in 1998 by President Bill Clinton. In that role, he released the first-ever surgeon’s general report on mental health.
Satcher called for the creation of “a balanced community health system”—a system of care that goes beyond treating illness to promoting health, is tailored to the needs of diverse individuals, and that helps remove financial barriers and social stigmas from those seeking mental health care.
Several of the surgeons general on stage described both Satcher and his predecessor, the late C. Everett Koop ’37, as role models and mentors. Koop served as surgeon general under President Ronald Reagan and as the Elizabeth DeCamp McInery Professor of Surgery at the Geisel School of Medicine.
Antonia Coello Novello, a pediatric nephrologist who was appointed by President George H.W. Bush as the first woman to serve as surgeon general, described the mental health crisis among health care providers themselves, which she described as a systemic problem that is driving practitioners from the profession and hampering their ability to give patients the best care.
“We, the ones who are supposed to take care of you, also have a problem, and no one is taking care of us,” she said.
Joycelyn Elders, a pediatrician and public health administrator appointed by Clinton in 1993, spoke about the challenges facing young people, including those in college. “I’m very pleased with the wonderful work that you’re doing here at Dartmouth to really address some of the mental illnesses that our young people are facing,” she said.
As surgeon general appointed by President Barack Obama in 2009, Regina Benjamin, a specialist in family medicine, issued a report on suicide prevention.
“At that time, 150 people were dying of suicide every day, and it hasn’t gotten any better. That’s a small regional jet going down,” said Benjamin, a specialist in family medicine who runs a rural family practice in Alabama. She argued for integrating basic mental health care into primary care and for more community- and peer-based prevention services.
“Health does not occur in the doctor’s office or in a hospital alone. It occurs where we live, where we learn, where we work, where we play, where we pray—everything that we do,” Benjamin said. “And so we have to take our health care where people are.”
The Politics of Mental Health
Calling the bully pulpit the surgeon general’s primary power, Richard Carmona—a surgeon and Vietnam veteran appointed by President George W. Bush in 2006—made the connection between political dysfunction and mental health and well-being.
“The most important thing that we need to deal with today, notwithstanding mental health, is make sure we preserve our democracy, because it’s being tested right now,” he said. “We as surgeons general always have to understand the extraordinary privilege we have to be truth tellers. Often the challenge for us is telling inconvenient truths to politicians.”
Carmona also spoke about the emotional toll of war on individuals and the nation. Describing his own family’s struggle to get treatment for his son, an Iraq war veteran suffering from post-traumatic stress disorder, he called for better systems for providing care to soldiers, veterans, and their families.
See the full recording of the surgeons general panel.
Jerome Adams, an anesthesiologist appointed by President Donald Trump in 2017, connected the conversation to the problem of substance abuse, which he said had affected his own family.
“We have this chicken-and-the-egg phenomenon where people are causing mental health disorders because of substance misuse,” Adams said. “But we also know that in many cases people are self-medicating their pain away because we don’t have enough resources out there to treat their addiction, to treat their anxiety, and so they turn to substances. We have to really look at this entire spectrum and ask ourselves how can we build resilience?”
Asked about the relationship between political polarization and mental health, Adams said, “The media often wants to stir up that hatred and frame things as binary, and you have to resist that.”
One way to resist is to travel and to engage with people different from oneself, he said. “There’s more that aligns us and that we share in common.”
Kenneth Moritsugu, a specialist in preventative medicine who twice served as acting surgeon general under President George W. Bush, spoke about the “meta message” of bringing “decades of surgeons general,” from across the political spectrum, onto the same stage.
“Each one of us is bringing a different perspective, but I think one thing that we all do is we have a consistency in terms of the arc that we are taking,” Moritsugu said. “We’re all focused on the science and the evidence and dedicated to improving the health and the well-being of our nation.”
The approach to the issue of mental health should be “to apply the principles of public health to the whole problem,” Moritsugu said, by using the surgeon general’s platform to raise awareness, to use data to target interventions with the populations most in need, and to bring national policy to the level of states, communities, and individuals.
Community and Connection
Concluding the panel, Murthy brought the conversation back to the challenge of community and connection.
“For a lot of us this issue is very personal,” he said, asking the audience in Leede Arena to raise their hands if they or someone in their lives had struggled with mental health or loneliness.
Almost everyone raised their hand.
With that in mind, he called on those present to cultivate empathy and the “the small moments of human connection that make a huge difference in how we feel and in how the people around us feel.”
He continued: “For those of you who are in medical school or in nursing school or in training to be a health care professional, the most important tools you need to be a healer are the ones that you had before you came to school. It’s that ability to be kind, to be generous, to give and to receive love. That is the moral reawakening that we have to engineer together in our country. It’s how we stitch together the social fabric of our nation, and on that foundation we can build healthy institutions.”
A Collective and Ongoing Effort
In her opening remarks, Beilock thanked the front-line health care providers and elected officials and public servants present, and recognized Koop’s widow, Cora Koop, who was in the audience.
Beilock also thanked the student mental health organizations on campus for their “continued advocacy and commitment to helping build a campus culture in which mental health is not just openly discussed, but effectively improved.”
And she acknowledged Geisel Dean Duane Compton, Dartmouth Health President and CEO Joanne Conroy ’77, and Lisa McBride, Geisel’s associate dean for diversity, equity, and inclusion, whom Beilock called “the driving force behind bringing the surgeons general together on our campus today.”
At the end of the panel, Beilock presented McBride and each of the surgeons general with the C. Everett Koop Legacy Medal for their distinguished contributions to public health.
A Needed Event
Following the event, students were enthusiastic about what they had heard.
“This is an event that needed to happen,” said Peggy-ita Obeng-Nyarkoh, a first-year medical student at Geisel. “In medicine you are going on your own—the focus is on serving others without serving yourself. I’m glad to see the university and the people in positions of power recognize the challenges of young people and physicians in training.”
Avi Singh ’26 said Murthy’s comments about a world fueled by love and human connections resonated with him.
“I’m not usually a very emotional person, but I felt like I could be moved to tears by what he said at the end, and that is going to stick with me for the rest of my time at Dartmouth—just to be a force of love in the world instead of being a force of powerfulness, because that’s not what’s really going to move our community,” Singh said.
Mental Health and Wellness at Dartmouth
Next month Dartmouth will roll out a strategic plan for student mental health and well-being that includes, among other initiatives, previously announced updates to the policy governing students taking time away for medical reasons.
In the past three years, the institution has more than doubled clinical counseling staff, and all students have access to teletherapy services through the mental health provider Uwill. Geisel has committed nearly $6 million to Healthy Students, Healthy Physicians, a mental health and wellness program for medical students launched in 2019.
In addition to Thursday’s discussion, the surgeons general will be participating in a Friday roundtable on The Future of Health Care 2023, hosted at Dartmouth Hitchcock Medical Center by Dartmouth Health, the Geisel School of Medicine, and the C. Everett Koop Institute at Dartmouth.
On Wednesday, four former surgeons general—Carmona, Elders, Moritsugu, and Novello—met with undergraduate, graduate, and professional school student leaders at the Hanover Inn.
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Mental health support is available through Dartmouth 24/7 for students, faculty, and staff. Students experiencing a mental health crisis can call the Counseling Center at 603-646-9442.
If you or someone you know is in crisis, you can call or text the nationwide Suicide & Crisis Lifeline at 988 or use the online chat at 988lifeline.org/chat.