James Donaldson on Mental Health – Loneliness, suicide and the crisis facing young men

By David J. Canepa

California Gov. Gavin Newsom's executive order addressing the mental health crisis among young men and boys speaks to something many of us see every day, even if we don't always say it out loud.

Too many young men are struggling with isolation, anxiety and a loss of purpose and those struggles often remain hidden behind silence.

The data explains why this matters. In California, men ages 15 to 44 die by suicide at three to four times the rate of women, making suicide one of the leading causes of death for young men. Annually, about 3,300 men kill themselves a year in California compared to approximately 1,000 women. Firearms account for a significant share of those deaths. At the same time, men are far less likely to seek mental health care, often because stigma and outdated expectations tell them they should handle problems on their own.

In San Mateo County, we recognized this reality early. In January 2024, we became the first county in the nation to formally declare loneliness a public health crisis, because we could see how disconnection was showing up in emergency rooms, classrooms, workplaces and homes.

Before loneliness became part of a broader national conversation during the COVID pandemic, our county chose to name it and invest in solutions. A Behavioral Health and Recovery Services survey conducted nearly five years ago found that nearly 50% of San Mateo County residents were lonely. Gov. Newsom's executive order, issued in July 2025, now brings that same urgency and clarity to the state level.

Loneliness is a major driver of this crisis. Nearly one in four men under 30 reports having no close friends, a fivefold increase since 1990. Isolation increases the risk of depression, substance use and early death. Loneliness is not simply an emotional experience, it is a serious public health risk with long-term consequences. The U.S. surgeon general has warned that chronic loneliness can be as harmful to health as smoking a pack of cigarettes a day.

There is also a strong economic connection. Labor force participation among men without a college degree is at historic lows, leaving many disconnected not only from community, but from opportunity and purpose. Over the past decade, college enrollment and completion rates for men have declined, leaving too many young men without a clear path forward.

Newsom's executive order recognizes that mental health, education and workforce participation are deeply interconnected. It directs state agencies to coordinate suicide prevention, behavioral health access, service opportunities and pathways to work, reflecting the reality that these challenges cannot be solved in isolation.

In San Mateo County, we have been moving in this direction for years. Through our 'Loneliness to Light' initiative, we bring people together to talk openly about isolation, grief and connection. These gatherings reduce stigma and create space for honest conversations, particularly for men and young people who might otherwise suffer in silence. The message is simple but powerful — you are not alone.

The county has also invested in peer support, recognizing that some of the most effective help comes from people with lived experience. Peer specialists play a critical role in our behavioral health system, helping individuals navigate crisis, recovery and reentry into school or work.

Supporting men's mental health is not only compassionate, but also preventative. Stronger connections lead to healthier families, safer communities and better outcomes for everyone.

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 988 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.