Do We Talk Too Much About Mental Health?

Do We Talk Too Much About Mental Health?

In “Are We Talking Too Much About Mental Health?” Ellen Barry writes about recent studies that have cast doubt on whether large-scale mental health interventions are making young people better. Some even suggest they can be harmful. The article begins:

In recent years, mental health has become a central subject in childhood and adolescence. Teenagers narrate their psychiatric diagnosis and treatment on TikTok and Instagram. School systems, alarmed by rising levels of distress and self-harm, are introducing preventive coursework in emotional self-regulation and mindfulness.

Now, some researchers warn that we are in danger of overdoing it. Mental health awareness campaigns, they argue, help some young people identify disorders that badly need treatment — but they have a negative effect on others, leading them to over-interpret their symptoms and see themselves as more troubled than they are.

The researchers point to unexpected results in trials of school-based mental health interventions in the United Kingdom and Australia: Students who underwent training in the basics of mindfulness, cognitive behavioral therapy and dialectical behavior therapy did not emerge healthier than peers who did not participate, and some were worse off, at least for a while.

And new research from the United States shows that among young people, “self-labeling” as having depression or anxiety is associated with poor coping skills, like avoidance or rumination.

In a paper published last year, two research psychologists at the University of Oxford, Lucy Foulkes and Jack Andrews, coined the term “prevalence inflation” — driven by the reporting of mild or transient symptoms as mental health disorders — and suggested that awareness campaigns were contributing to it.

“It’s creating this message that teenagers are vulnerable, they’re likely to have problems, and the solution is to outsource them to a professional,” said Dr. Foulkes, a Prudence Trust Research Fellow in Oxford’s department of experimental psychology, who has written two books on mental health and adolescence.

Until high-quality research has clarified these unexpected negative effects, they argue, school systems should proceed cautiously with large-scale mental health interventions.

“It’s not that we need to go back to square one, but it’s that we need to press pause and reroute potentially,” Dr. Foulkes said. “It’s possible that something very well-intended has overshot a bit and needs to be brought back in.”

This remains a minority view among specialists in adolescent mental health, who mostly agree that the far more urgent problem is lack of access to treatment.

About 60 percent of young Americans with severe depression receive no treatment, according to Mental Health America, a nonprofit research group. In crisis, desperate families fall back on emergency rooms, where teens often remain for days before a psychiatric bed opens up. There is good reason to embrace a preventive approach, teaching schoolchildren basic skills that might forestall crises later, experts say.

Dr. Foulkes said she understood that her argument runs counter to that consensus, and when she began to present it, she braced for a backlash. To her surprise, she said, many educators reached out to express quiet agreement.

“There’s definitely a fear about being the one to say it,” she said.

  • What do you think about the current focus — from parents, schools, social media influencers, even the surgeon general — on young people’s mental health? Is it an important issue that you are glad is being addressed? Or have we crossed a line into talking about mental health too much?

  • Is social and emotional learning a part of your school’s curriculum, or have you participated in a mental health program at school, like one of those described in the article? If so, what was the program like? What kinds of things did you learn? Did you think the program or curriculum was helpful? If so, in what ways? If not, why not?

  • What, if any, benefits have you experienced from learning more about mental health? How has that knowledge improved your life?

  • Have you ever experienced any of the negative effects that were described in the article? For example, have you ever diagnosed yourself with a condition that might not have been accurate? Or felt as if you were learning only about problems and not about solutions, leading you to feel hopeless about a situation? Do you see young people glorifying mental health disorders?

  • Lucy Foulkes, one of the research psychologists interviewed in the article, suggested that schools should “press pause” on mental health programs because of the potential negative effects they may have. But Lucy Kim, a Yale senior who has lobbied for better mental health support on campus, said that stigma and barriers to treatment remain the bigger problem. With whom do you agree more and why? When it comes to the mental health of young people in your community, what do you see as the most pressing issue?

  • What suggestions do you have for how schools might approach mental health education, if you think they should address it at all? For example, is mental health education something that all students should get? Or should mental health education be targeted to those who need it most? What, if anything, would you be interested in learning about?