No, we aren’t talking too much about mental health
A recent New York Times piece raises questions about youth mental health awareness efforts; the truth is we aren’t talking enough about this important issue
By Gillian Katz Lamon, Law Clerk at the National Center for Youth Law
We aren’t talking too much about mental health.
In May, the New York Times published an article headlined “Are We Talking Too Much About Mental Health?” The article, by Ellen Barry, draws its title question from the work of Lucy Foulkes and Jack Andrews, researchers who argue that mental health awareness efforts among youth are not advancing health, but rather are contributing to the reported increase in mental health problems.
To quickly answer that headline: No. The truth is that we aren’t talking enough about mental health.
Frankly, Foulkes’ and Andrews’ “prevalence inflation” theory is misguided, and mental health care for young people should be prioritized more than it already is, not less. Let’s dive in.
False and harmful message
The NYT piece, in addition to the aforementioned researchers, also points to research in the UK and Australia which found that students who underwent training in mindfulness, as well as certain behavioral therapies, did not emerge healthier than their peers who did not participate. These small studies go against the majority of research and data that has shown that social emotional learning (SEL) leads to students being better off, both in terms of mental well-being and academic achievement.
To be sure, pathologizing developmentally appropriate youth emotions and experiences as mental illness is problematic. All youth, and all people, experience emotional ups and downs in their lives. Only some have experiences that rise to the level of a medical mental health diagnosis. But the notion that mental health programs — in education settings or otherwise — are “creating this message that teenagers are vulnerable” is false and harmful.
Given the challenges of the world that young people are inheriting, and natural patterns of growth and development, young people are at high risk of experiencing unmet mental health needs. The data is clear and concerning: Youth suicides rose 62% between 2007 and 2021. Hospital admissions for pediatric suicidal behavior rose 163% in the 10 years before the pandemic. Suicide is the second leading cause of death for children ages 10 to 14, and the fourth for young people 15 to 29.
Moreover, the majority of young people who die by suicide in the U.S. don’t have a previously diagnosed mental health condition, suggesting inadequate access to screening, identification, and treatment.
“By everything that we measure, the mental health of young people is deteriorating.” — Alex Briscoe, Principal at the California Children’s Trust, in a July 30 speech at The White House Convening on Child Welfare Transformation.
Despite these unmistakable indicators of crisis, the NYT article frames the issue as due in part to programs improving mental health literacy. The headline “Are We Talking Too Much About Mental Health?” alone is eerily reminiscent of those who suggest we shouldn’t be honest in education, that racism will disappear if we simply stop talking about it, or that talking about racism produces racism.
Burying our heads in the sand will never be the answer. The suggestion that we should stop talking about mental health stokes the fires of stigma around mental health in general, and will only further entrench existing barriers to getting help.
Disconnected from reality
There are many contributing causes to the rise in unmet youth mental health needs. Examples are violence on school campuses, climate change, increased use of social media, intergenerational trauma, poverty, and isolation during the pandemic. “Talking too much about mental health” — whether through mental health education in schools, student-led initiatives, or expansion in school-based and school-linked mental health services — is not among them.
The picture painted in the NYT article is wildly disconnected from the reality of mental health education in the U.S. In the states that provide mental health education for students, it is usually integrated into existing health curricula as a “dimension of health.” Age-appropriate instruction for young students includes topics like identifying emotions, self-management, developing a positive sense of self-image, and building coping skills — basic information and tools that every child should have access to, and that can help serve as protective factors against the impact of mental health issues.
Some states require instruction on stress, anxiety, and depression awareness for older students, but there are no mandates that this instruction be delivered through a rigid medical lens. For states that have included mental health in their learning standards, the purpose is to promote a holistic and well-rounded understanding of health overall. This is in contrast to the characterization in the article (along with the cited research) of mental health as a binary — failing to consider that the state of one’s mental health and well-being is more complex than “has” or “has not” and that we could all benefit from efforts to promote positive mental health.
Perhaps most importantly, mental health education is something that young people are asking for. This is evident even from the NYT’s own follow-up to this article, which included an open call for young people to share their thoughts. Of the 74 comments posted in response to this call, the vast majority expressed a desire to learn more about mental health in schools. Here are a couple examples:
“I think students need to learn about mental health to stay emotionally healthy. If they don’t understand their own feelings, they won’t understand themselves or others. Teaching mental health in schools can reduce conflicts and help students focus on their work. A healthy mind is important, so schools should focus on their student’s mental health.” — Chris, Minnesota
“I am involved in the national speech and debate program, where I hear multiple stories about teens’ experiences with their mental health. It’s enlightening to see different mental illnesses highlighted and shared with teenagers and adults alike. There is no judgment or stigma in the speech world, which allows us to share raw stories that spread awareness through different communities. Even outside of speech, there is tons of awareness everywhere we go, but there is a huge lack of acceptance. This is what can make it difficult for older generations to understand, as they didn’t have much awareness of mental problems in their eras, so they repressed it and kept silent. This is what is negatively affecting youth because they aren’t getting the help or comfort that they need. We may talk about it a lot, but the people who hear about it may not be willing to take it seriously. Acceptance doesn’t come easy. It is scary because you are exploring a topic that you were told not to. Though as we begin to move into the future and newer generations begin to normalize mental health discussions into adulthood, acceptance will become more spread throughout America.” — Sky, Texas
Undoubtedly, instruction needs to be age-appropriate, holistic, and delivered in a manner that equips youth to talk about mental health, understand their own, and ask for help if they need it. In the face of the greatest youth mental health crisis that we have ever seen, at least one thing is clear: “Doing nothing,” as recommended by Dr. Andrews in Barry’s article, is not an option.
Instead, here are some things we can and must do:
- Listen to what young people are saying about mental health education.
- Equip schools with knowledge, tools, and curriculum that is holistic, age-appropriate and culturally competent.
- Support advocacy and legislation that advances mental health education and support in child-serving systems.
- Keep the conversation about mental health going — in schools, homes, and communities.
Gillian Katz Lamon is a Summer Law Clerk with the National Center for Youth Law’s Mental Health Team and a rising third-year student at UC Law San Francisco.
