August 11, 2024 - 5:00pm
The federal agency for mental illness, SAMHSA, published the results of a major annual survey last week, the National Survey on Drug Use and Health. It estimated one in three adolescents received medical and professional services for treating mental disorders last year.
SAMHSA officials consider this increase a positive development from efforts to normalise and destigmatise seeking out mental health treatment. Unfortunately, though, it is not. For one, the estimate does not reflect how many adolescents have mental disorders, which is a key overlooked factor. The survey, which interviews Americans older than 11 on their self-perceived mental health, use of drugs and alcohol, and related treatment received in the past year provides vivid testimony to that fact. It estimates that nearly 32% of all adolescents aged 12 to 17 — not just those reporting a diagnosis or abnormal distress — received prescription medication, treatment, and/or counselling for mental health in various inpatient and outpatient settings in 2023.
This rate is worryingly high. For most people, mental disorders associated with chronic and serious impairment don’t develop until late teens and early twenties, suggesting many kids are being unnecessarily treated. Around 8.3 million were treated last year, but according to the survey, only about half that number (between 3.4 and 4.5 million) might have enough distress to consider treatment.
The industry-pushed narrative is that therapy is good for everyone, but mental health treatment has limitations and can be actively harmful. Studies show that such treatment is less effective for youth than adults, and established guidelines are often not followed. Many young people therefore end up receiving low-quality care, which is associated with increased self-harm and hospitalisation.
The survey also excludes individuals in group settings, like juvenile justice centres, residential treatment facilities, and mental hospitals — where those with the most severe emotional distress are disproportionately represented. Americans surveyed, by inclusionary definition, stand to benefit less from treatment.
For those on the margin, a mental diagnosis increases future likelihood of death, being sick from work, and unemployment, while reducing one’s sense of control and probability of being married. Stimulant overuse can induce psychosis — troubling given how many young people are prescribed for ADHD. Symptoms of many common diagnoses, like depression, are transitory and often get better on their own. As a prominent psychiatrist puts it: no treatment should be the prescription of choice.
Rather than expressing concern, the Assistant Secretary for Mental Health and Substance Use declared SAMHSA was “pleased to see” the number treated grow by half a million from 2022.
This is, unfortunately, unsurprising: federal policy has bought into the unsubstantiated idea that mental illness can be prevented by improving “emotional health” across society. Tens of billions of taxpayer dollars annually thus go to programmes and services that indiscriminately push people toward treatment or directly provide it.
More than a half-century of this policy approach has legitimised widespread mental health treatment and medicalised social problems. Most crucially, it has not reduced prevalence rates of mental disorders.
To be sure, some youth (and adults) with severe emotional distress and disorders can benefit from high-quality services when the benefits of such services clearly outweigh the risks. But we do not universally support more knee surgeries and physical therapy for youth with ambiguous growing pains. Greater indiscriminate use of mental health treatment shouldn’t be applauded, either.
Join the discussion
Join like minded readers that support our journalism by becoming a paid subscriber
To join the discussion in the comments, become a paid subscriber.
Join like minded readers that support our journalism, read unlimited articles and enjoy other subscriber-only benefits.
SubscribeIf you don’t experience some form of cognitive dissonance with the world around you whilst in your teens, you’re not trying hard enough. By that, i mean you’re not someone who’s willing and able to reflect upon the world in which you’re growing up.
The experience of this type of dissonance will result in occasional feelings of depression and anxiety. Should these feelings become medicalised? Absolutely not. They should be worked through by the individual, as part of their journey into adulthood.
If such feelings become so overwhelming that they lead to dysfunction i.e. inability to go about everyday life, then for sure, help is needed. Otherwise: leave those kids alone!
Agree and would add that tantrums are normal for pre-schoolers (knew a couple who had their kid diagnosed with autism for “having major meltdowns” as a toddler, indistinguishable from other kids by school age). Daydreaming (“attention deficit”), stubborness (“obstructive behaviour”) and hyperactivity are utterly typical for primary school kids.
The original meaning of the term “gaslighting” referred to making a person believe they were mad…
What Phillip Rieff long ago identified as “the triumph of the therapeutic” has produced concept-creep whereby what might once have been regarded as issues of character building or just self development are, rather, medicalized; and this drives a full-employment programme on the part of the Helping Professions. Why for instance do the letters O & C need to be followed by the letter D? We used to refer to this simply as The Protestant Ethic.
‘Daydreaming (“attention deficit”), stubborness (“obstructive behaviour”) and hyperactivity’ are now used whereas we might otherwise just say ‘utterly typical for primary school kids.’
Great comment, completely agree. Emotional spikes during your teens are normal, and a normal healthy part of growing up.
But painful — in a society that has made a fetish of avoiding painful things.
The problem is that kids used to work through difficult times and feelings by talking with friends. That doesn’t happen as much these days, where they can find support and diagnoses online, and where they’re instead encouraged to work through feelings with a total stranger.
I worked as a volunteer for 5 years at a military hospital in the pharmacy. I was amazed at how many children were getting Adderall. Then I started noticing how many of their parents appeared to have ADHD themselves. I don’t know if the children were getting it from their parents. There did seem to be some correlation though.
Kids who are prescribed Aderall often sell the pills. College students are often their best customers. Do they make you high if you don’t have ADHD?
ADHD is a broad umbrella term used to describe energetic, excitable people. It’s a normal variance of human behavior that’s been medicalised to excuse poor outcomes for people that can’t pay attention to things that bore them.
ADHD is a genuine medical condition for some people. I used to teach in special schools and know it is real. It is unmistakable when you see a genuine case. To dismiss it off hand shows both arrogance and ignorance.
Tell me why are males so much more likely to be diagnosed than females?
I read that it presents slightly differently in girls than boys and is therefore harder to spot.
In the UK it’s quite closely monitored by the prescriber, parents and school’s with a health care plan and school nursing involvement if the child needs to take them during school hours.
It’s widely recognised as HIGHLY HERITABLE, so much that questions about parents and siblings are part of a standard ADHD workup. So you would expect this correlation. And it makes a lot of sense: in milder versions, or at the point when it doesn’t even qualify as disorder, it’s basically a temperamental/ personality characteristics, and these are mostly genetic.
I worry that the people with serious mental health problems will find it difficult to find a really good therapist — because the good ones are all treating teenagers for the trouble of being a teenager.
Sure. Easier, more profitable, and the parents are more likely to pay up.
Children need to face adversity, grapple with it and come out stronger. Many of the issues we see today IMO are related to our fragility as a society.
And don’t forget the iron rule of bureaucracy. The Substance Abuse and Mental Health Services Administration will find ways to make itself relevant and expand. So much of govt overreach is related to the growth in govt itself.
Of course they were “pleased to see” the number grow. More grants, more staffers, more money, and the Assistant Secretary goes up a couple of GS levels. I’d be “pleased,” too.
So true. Gotta pay those salaries and keep growing!
I’ve lived with severe enough OCD to be considered disabled for almost 20 years, and let me tell you that the push to ‘de-stigmatize’ mental illness by focusing on the nebulous idea of ‘mental health’ has done *nothing* but trivialize actual serious diseases and encourage and reward narcissism and sociopathy. Now, I admit that I’m a bitter and resentful person, and that that’s not good and I try my best not to be, but there is very little in this world that inspires more bitterness and resentment in me than seeing how much social clout some vapid 20-something can harvest by cloaking themselves in the latest fashionable illness all while people like me are left to rot in the margins, where we’re often actively maligned by the very people who loudly trumpet that they speak for the marginalized. I’ve learned the hard way that the louder someone proclaims their virtue, the less they often actually have, and caring for the mentally ill is no exception.
Wow. Great comment.
Spot on. It’s troubling how many young people have been schooled to be sociopaths – narcissism is endemic now. We have a whole generation bleating about their mental health while not caring about the people around them that they are harming by their self-absorption.
It’s worse than that. Everyone without a serious condition who’s demanding help and support is taking the very limited help and support available from those who desperately need it.
I quite agree – those who are most in real pain and need are usually suffering in silence and not broadcasting about it.
Meanwhile, those of us without chronic conditions (I can’t resist tidying up messy supermaket shelves) should just be grateful and not get in the way of people who need help for conditions that are not their fault and sadly not really curable today.
And you’re not coming across as bitter and resentful here.
I’m curious, how does the increased focus on mental care for others affect you? Has your treatment over the last 20 years gotten worse? I can understand being bitter, being angry at people using mental health to boost themselves (something people have done for a long time, see claiming insanity at a trial, etc), but your admitted bitterness and resentfulness might be blinding you a bit here.
Just a few years ago, I had a social worker who, after spending 3 months hearing my medical history and seeing what I struggle with on a daily basis, said to me quite incredulously that I couldn’t possibly have suffered as much as ‘a person of colour’. As terrible as the treatment options were 20 years ago when I was diagnosed, I wouldn’t have had a blonde white lady with a university degree lecture me about how my problems don’t matter as much because of my whiteness. I’m sure being a straight man didn’t help either. And this is far from an isolated incident. CAMH, the Centre for Addiction and Mental Health, is the biggest mental hospital in Canada and one of the best in the world, and yet almost all of their recent announcements and initiatives have focused on various DEI mantras, to the utter exclusion of people like me, who I imagine comprise the bulk of those with mental illnesses in this country because we comprise the bulk of the population. Their ‘no one left behind’ ad campaign was actually pretty offensive to me, seeing as I was quite literally left behind. 20 years ago it was because of apathy. Today it’s deliberate exclusion.
My bitterness and resentment might exacerbate how I feel about this, but that’s only because they’re latching onto something very real. After all, those feelings didn’t just spring out of nowhere.
That is sophistry.
When we have 5 doctors who can handle 10 patients properly, we do well.
When we take otherwise healthy people and say they are not, the 10 becomes 25 and suddenly nobody gets the care they need.
It is not about you being faux kind. It’s about people who assume resources are unlimited…until they need to wait.
Evolve your mind.
Any academic realm with “science” in its name is usually not science, especially “behavioral sciences”. Psychologists long ago donned lab coats in a pretense designed to invest them with the respect due real scientists like physicists and chemists. The witless masses were duped by this and have suffered under the quack remedies inflicted upon them. Fully 50% of all “research” in psychology cannot be replicated and much of it is outright fraud. Somehow, few seem to notice–until massive harm is done–that the latest rounds of fad diagnoses and treatments are no better than the catastrophes of electroshock therapy, insulin comas, and frontal lobotomies, all of which were innovated during the scientific era of psychology and the last of which even earned a Nobel prize for its originator. No psychological treatment has ever begun to approach the revolutionary success of interventions such as antibiotics or MRI scanning or most vaccines. And yet, despite failure upon failure, we keep heeding the latest advice of psychologists and never ask “why are all mental health issues always growing worse in the face of such widespread application?” So now we have unleashed quackery and snake oil upon our children. As if we needed another way to poison their future.
And now kids going through normal puberty are encouraged to question their gender and mutilate their bodies preventing them from experiencing a normal sex life when they get over their confusion. Right up there with a lobotomy for medical care. Will we ever learn?
My heart goes out to parents who are obliged to hand their children over to therapeutically-empowered educational systems that have massive exposure opportunities, no respect for the values of the parents, and no accountability for their ghoulish psychological tinkering, not to mention the poor quality of education.
Social emotional learning was the main reason I removed my children from school and home educated them. Best decision I ever made. I read a white paper which stated that social emotional learning was responsible for increased narcissism in young people, it added those that need it pay no attention, and those that don’t need it, do pay attention and are damaged by it. I’d say that white paper was right on the money!
My two are now out of education, which is fortunate because Labour have never made a secret about their dislike of home education. They want to damage ALL of our children!
It was 61% that failed to replicate!
In general agree. Medicalising elements of adolescence isn’t smart.
But we have the first generations that were exposed to smart technology, the addictive marketing and algorithms of social media and the blight of over-protective parenting in itself fuelled by ‘it bleeds it leads’ media. We still do too little in these areas.
Future likelihood of death can’t be increased beyond the normal 100%.
Or reduced by any known process. One death to a person, the number that has always existed and probably always will.
These are great obvious points and would have made for a good edit — the study cited via link in text finds that diagnosis increases morbidity between age 18 and 30.
I have found this recent rise in an overly therapeutic approach to children to be fascinating (and sad), and highly recommend Abigail Shrier’s recent book. The relationship with the full on requirement to learn parenting from the experts (frequently childless themselves) is of particular relevance I suspect.
However, despite this I was not prepared for it to actually happen in my own little world. Took my four year old in for a speech pathology screening of a mild speech issue. Surprise, it was actually an entire behavioural assessment. Walked out with slight speech issue BUT ALSO may have autism/ADHD. Why? Because he showed repetitive play, moves around while sitting in a chair, and flicks his ear. The actual reason for these things: the assessor would respond by laughing at his silly play antics, he is a four year old boy, and he needs a haircut. He had no issues when asked to perform the actual screening tasks and we have not had any concern ourselves or from his teachers. Who knew how easy it was to find yourself on such a precipice!
Shrier is my hero! It’s rare to see such a combination of intelligence, bravery, and tenaciousness. If our culture survives, future generations will look back on what we did to our children via these “therapeutic” interventions with the same distain and contempt we have for yesteryear’s frontal lobotomies.
Social psychologist Jonathan Haidt explains it brilliantly ‘we changed childhood’ there’s a great podcast between him and Bari Weiss on Honestly and he’s written a couple of books, published research articles etc.
‘The Coddling of the American Mind: How Good Intentions and Bad Ideas Are Setting Up a Generation for Failure’ being one and ‘The Anxious Generation: How the great rewiring of childhood is causing an epidemic of mental illness’
Maybe we’ve forgotten how to be adults for our children.
I think one aspect of adulting (imo the most important part), is an ability to accept responsibility for our actions. Many adults today can’t do that themselves and they are passing this on to their children. Grasping for excuses is all part of this. It’s always something else and mental health provides an unquestionable excuse. I can’t because (insert mental health issue here). There was a time no one would dare because of attached stigmas, now it’s a free for all!
A key problem is the distinction in mental health care between therapy that encourages healing and finding a way to overcome unhappiness and the toxic version that encourages unhappiness and the need for ongoing “help” from a near-priestly class of therapists. Guess which group has the official endorsement of Woke culture and is mercilessly targeted at young people. It’s a natural outgrowth of the Left’s insistence that all of Western culture/economy/government is pathological.
In America the problem originates in the public school system. Abigail Shrier’s book, “Bad Therapy”, carefully details the rise of mental health services now administered in public schools. Poorly trained teachers are expected to encourage children to identify as having any number of mental health and emotional problems. School nurses now give out diagnoses for a host of purported mental health problems more often than band-aids.
The Health industry and the LGBT+++++ community cooperate with progressive teachers’ union members to encourage children to declare themselves as having any number of issues from gender dysphoria to sexual orientation to depression and anxiety, with extra points for being diagnosed with multiple issues.
It’s not surprising that so many children participate. After all, boys who are told about toxic masculinity can find shelter, acceptance, and accolades by deciding they’re bisexual or gay. Girls can stand out by declaring themselves any one of a number of sexual orientations, and be congratulated for their courage in speaking out. At earlier stages those who haven’t reached puberty are supported in deciding they’re something they’re not.
As always it’s cui bono. The pharmaceutical industry and the health industrial complex benefit financially, while the pubic school systems increase their budgets–and influence–because they find they have to hire more counselors to help the children.
What’s not to like?
It isn’t as though the next generation needs to be prepared for the responsibilities of adulthood with all the traps and snares that entails. How much better to infantilize all children so that they are forever in the thrall of health services and a cornucopia of medications.
It’s all perfectly ghastly.
Entitlement and not being able to handle the word no, nor handle any uncomfortable feeling is not a mental illness.
As my PhD (Psychology) supervisor once said to me regarding psychological disorders; “If we name it, they will come.”