Are we talking too much about mental health (and racism)?

I’ve been meaning to write a post about the subjective experience of racism, but before I got to it, there was this NYT story that I think is actually quite related, “Are We Talking Too Much About Mental Health?”

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.

It may be a minority view, but it sounds pretty damn right to me. Not to mention, I think we can both work to increase access and destigmatize while also trying to avoid prevalence inflation (then again, maybe we can’t).

As for the racism angle, Verasight conducted a poll on behalf of the MPSA conference I attend annually and this result really stuck out to me:

Of course the older a Black person gets, the more likely they are to have had negative experiences with racism.  Yet, that’s the opposite of what we see here.  But, the answer is in the question wording and the emphasis on the subjectivity of the experience, “experiences with racism that have negatively affected them behaviorally and psychologically in the long term.”  Now, when you put it that way, it’s not surprising– especially in light of the first part of this post– that this negative subjective experience is far more common among the youngest cohort.  And, obviously, racism remains a serious problem that we as a society need to continue to work hard on.  But, I also think it is not great that the youngest generation believes they are the most likely to suffer psychological harm from it.