April 27, 2023 | Interview
By guest authors Kana Enomoto and Nicole Carroll.
Nicole Carroll is editor in chief of USA Today. Kana Enomoto is director of brain health and a McKinsey Health Institute coleader in McKinsey’s Washington, DC, office.
Comments and opinions expressed by interviewees are their own and do not represent or reflect the opinions, policies, or positions of McKinsey & Company or have its endorsement.
USA Today’s top editor discusses mental health, the media’s role and responsibility, and how she draws from her own experiences to make a professional impact.
Journalists are often wary of becoming part of the story. Nicole Carroll is no different. But when it comes to childhood trauma and mental health, her story is part of that story.
USA Today’s editor in chief opened up in recent years about her adverse childhood experiences and how those experiences—and the adults who stepped in to help—affected her trajectory, both personally and professionally.
As part of the McKinsey Health Institute’s (MHI’s) Conversations on Health series, Carroll sat down with Kana Enomoto, coleader and director of brain health at MHI, to discuss a range of topics including children, trauma, and the media’s coverage of mental health issues. The following is an edited version of their conversation. [Editor’s note: It was recorded prior to the April 16 announcement that Carroll would be leaving USA Today on May 1.]
The importance of positive mental health
Kana Enomoto: Today we’re going to talk about mental health and well-being, its role in the workplace and society, and, particularly, its impact on children and their life trajectories. To start, where do you see mental health and mental health promotion for kids today?
Nicole Carroll: It’s so incredibly important. Luckily, we know a lot more about it now. The past two decades of research on adverse childhood experiences really shows the impact of stress and trauma on children and the lifelong consequences of that. So I think, as a society, we’re more prepared to deal with it; we just need to deal with it.
There are ten [widely recognized adverse childhood] experiences that kids can have that will impact them later in life: anything from poverty to an incarcerated parent to mental, physical, or sexual abuse—ten things that can happen in your childhood that will have a long-lasting impact. And it’s proven that this impact isn’t just on mental health. It can affect you physically—you can have diabetes, asthma, heart issues as a result of these adverse childhood experiences. What has also been proven is that one caring adult can change that trajectory. We can all look for that opportunity to help young people in our communities, our families, our churches, or our synagogues. It’s not any one person’s responsibility; it’s something we all can do.
I look back on my own childhood experiences and realize that I had those people. I had a grandparent who looked out for me. I had an advisor who pulled me aside, who saw something in me, and I know it made a difference.
I also think schools should be teaching children about brain health the same way they do physical health. It shouldn’t be something we discover as adults when we’re in the middle of a panic attack.
Kana Enomoto: As you mentioned, there is a role everyone can play to promote positive mental health, and you sit in this wonderful position as editor in chief of USA Today, reaching 100 million people a month. As an omnichannel media entity, what role does USA Today play in addressing these issues and promoting awareness?
Nicole Carroll: I think about that all the time. I think about the huge responsibility and the privilege we have to touch that many people, and I truly think every morning when I go to work, “How can I help someone today? How can we explain something or inform or empower someone to make their life better?”
Number one, we can normalize talking about mental health. It should be just as common as talking about getting a physical checkup or disclosing a diabetes diagnosis. When Senator John Fetterman (Democrat, Pennsylvania) announced he was getting treatment for depression, we wrote a front-page story thanking him for doing so. Depression is no different than any other health ailment; there’s no embarrassment or stigma. It’s something he’s dealing with, and good for him for being transparent about it.
Kana Enomoto: That is exactly how we think about it at the McKinsey Health Institute—all dimensions of health are equal and important. We consider physical, mental, social, and spiritual health in our work, including physical well-being, relationships, and a sense of purpose. Tell me more about your personal sense of purpose and how a sense of purpose plays out for the health and well-being of others.
Nicole Carroll: I want to reach out to other kids and say, “I get it. I’ve been there, and there is a path forward.” And I want to reach educators and community leaders and talk about the importance of preventative care. I’m from Arizona, where there are 14,000 kids in foster care. We spend a lot of time talking about those 14,000 kids and how to help them. But we’ve also got to talk about what happens when those 14,000 kids age out [of foster care] and become adults. The needs they have aren’t going to stop when they hit 18. They’re going to need [ongoing] help with psychotherapy or physical-health issues and resiliency. And protective factors can balance out risks that kids experience—for example, how well we are engaged with school, our social relationships, and our ability to earn a livelihood. Anyone can make a difference—when we have that loving person, that connection, that therapist, or that confidential person to talk to, we can make a difference just by being there for people. It’s so powerful to realize the impact you can have on a person’s life.
The importance of trauma-informed journalism
Kana Enomoto: Journalists do so much for our society in translating the experiences of these kids, and they also see some of the hardest things that happen in the world—natural disasters, man-made disasters. That can be traumatic. How do you support journalists in navigating their mental health and the stresses they experience on the job?
Nicole Carroll: Before we even launch into, “Tell me about your story,” it’s “How are you doing?” In our morning news meetings, before we jump into the news of the day, we have a moment of open mic—anything anybody wants to talk about. Because as a newsroom, we collectively go through this trauma, and sometimes we just need to talk about it.
But I think we need to be more intentional as well. Our newsroom created a mental health committee made up primarily of reporters. They came back with some fantastic recommendations, such as, “We need to pay more attention to who we’re assigning to these stories; if it’s the same person who’s covered five mass shootings, they need a break.” On top of just checking in, we need to be very direct about the help we’re offering our journalists. We’re asking them to go do this work, so we need to take care of that whole person.
It’s also important that we train our journalists on how to interview people affected by trauma. You first approach them without a pen or a tape recorder. You approach them as a person: “How are you doing? I’m so sorry you’re going through this.” It’s okay to empathise with somebody who’s gone through something terrible. And once you build that trust, you can ask, “Would you like to talk about this?” It’s their choice; they have the control. And we’re really careful to make sure they know exactly what’s going to happen with it—that it’s going in the paper, online, on social.
When we’re able to train journalists to do that, they feel good about it because they’re giving that person an opportunity to speak. And sometimes that helps them heal. So we can feel good about the job we’re doing and not like we’re compounding the trauma.
It’s trauma-informed journalism, but it’s also just good journalism.
Covering ‘death by suicide’
Kana Enomoto: We’ve talked about how USA Today covers traumatic events. A particular kind of traumatic event is when someone dies by suicide. How has your approach to that changed over time?
Nicole Carroll: Not that long ago, we just didn’t talk about it. The rule of the newsroom was you don’t write about suicide unless it’s a public figure or a very public occurrence. But suicide is one of the leading causes of death. We have to talk about it. It’s a national crisis. We went to experts. We learned the responsible way to talk about it: don’t get into details that could lead to contagion; don’t assign motives. The thing that helps most, we’ve found, is when you interview survivors or people who have attempted suicide or thought about it but then got help. People need to see that; they need to see there’s hope.
Recently, I wrote about my grandfather’s suicide, something we hadn’t really talked about in my family. We all knew it happened but didn’t talk about it. My nephew died by suicide—something we’re just beginning to talk about. Even our lingo has changed—you hear me saying “died by suicide.” Back in the day, it was “committed suicide,” but that sounds more like “committed an offense.” As media, we have to cover it, but we need to do it responsibly. It’s sometimes a fine line, but we’re learning as we go and are always checking in with experts to make sure we are helping and not hurting.
And I love the  hotline. Every time we write a story [relating to suicide], we put the hotline in there to tell people there’s hope and help.
Kana Enomoto: Thank you so much for doing that and for sharing your story.
Supporting workers across generations
Kana Enomoto: We spoke earlier about children and youth, but USA Today reaches individuals across the lifespan and considers topics relevant to young and old. When you think about the workforce, how do you see the role of the older worker as we look ahead to the workplace of 2030?
Nicole Carroll: I am particular to journalism, and I think it is really important to connect generations to each other at work. Some of our older journalists love working with the younger journalists because they can help them, but they’re also learning at the same time. It’s very important that we honor their experience and the wisdom they bring to the job and share. I remember when I was an intern just starting out, I sat next to the courts reporter, and I would just listen to her all day on the phone—calling people, doing interviews—and then when a court decision would come in, she’d grab me and say, “Let’s go to the courthouse.” I’d just tag along, and we’d interview jurors. What an amazing experience that was. She was training me in the best way possible, and we need that. Something’s lost when you don’t have that intergenerational support on both sides.
What we can do for all of our employees is really treat them as humans first and make sure we’re offering the flexibility for whatever they need. You might be taking care of a spouse or taking care of a daughter or son or, if you’re a younger person, taking care of your parents. Luckily, journalism’s very flexible, right? It’s 24/7. I tell people all the time, “I don’t care when or where you work as long as you’re getting the work done.” Make the schedule work for your life. We’re going to get talent for a lot longer if we can be flexible to let them take care of their life needs and also have a fulfilling career.
Our jobs are stressful. We’ve got a lot on our shoulders. I’m really pleased that so many young women look at me and say, “She has three kids, and she’s a top editor. I can do it too.” Many times, they’ll come and talk to me about my career and how I did it, and then they’ll get kind of quiet and ask, “Okay, how did you do it with kids? How did you make that work?” I’m just so grateful I can be there for them and have that conversation. And now, as I became the editor, I make a point, when I’m taking my kid to the doctor or I’m leaving early to go to my son’s baseball game, to say I’ll check in with the team afterwards. I also reinforce this with everyone on the team—not just women.
Balancing bad tidings with a glimmer of hope
Kana Enomoto: Much of our discussion has focused on telling stories in the right ways, and one of the newest methods of sharing stories is TikTok. Tell me about your use of TikTok. You’re not just a passive fan, you actually have your own channel.
Nicole Carroll: We have more than a million followers on TikTok. And I love it because it’s a way to reach a whole different audience with the news. We put current events up there; we also put up silly videos. I’ve also used it to help explain decisions we make. Last year, before the election, I did a TikTok where I talked to the readers about how we were going to cover the election and why results may not come immediately.
Kana Enomoto: Context is so important, as well as the balance of positive and negative stories. There’s a bit of weariness, a sense of doom and gloom out there, particularly among our young people. What do you think about the media’s role in protecting people’s well-being while also being transparent about what’s happening in the world?
Nicole Carroll: We have a responsibility to bring the news to the public. We also have a responsibility to bring solutions and how you can help. So we’re going to talk about the earthquake but also how you can be part of the recovery or relief effort. We’re going to talk about a hurricane, but then we might do a series on climate change and give people information about how the choices they make add to that.
We have a responsibility to bring the news to the public. We also have a responsibility to bring solutions and how you can help.
I also think about our balance of news. Sometimes I look at the paper, the scroll, and I’ll say, “Let’s get some good news out there; let’s share the joy in life; let’s share [stories of] those who are overcoming.” When there is a tragedy, one of the first stories we look for is [that of] the heroes, and we show the people who tried to help or stopped the bad guy or saved a life. Let’s give that glimmer of hope.
This article was edited by Hannah Buchdahl, an associate editor in the Washington, DC, office.