When Mental Health Education Makes us Sick

The first quarter of the present century will be marked by the steep rise in poor mental health diagnoses. At every turn, there seems to be another report, or statistic, or warning about Australia’s “silent” problem of poor mental health. Except that it is not so silent. For the last decade, governments around the globe have thrown well-intentioned taxpayer funds towards psychoeducation, namely early intervention and prevention programs, to slow the rate of mental health diagnoses. Instead, the reporting seems so bleak about the current state of the human mind that it appears that we are losing both the battle and the war. With one in five Australians experiencing a mental or behavioural condition each year according to the Bureau of Statistics, young people (aged 16–34) account for almost double the reporting of mental distress than the elderly (aged 65–85).

History is a storyboard for the vastness and complexity of the human experience. Shakespeare’s portrayal of the human condition drew richly from a palette dripping with love, hate, vengeance, pride, and depression. Contemporary novelists and filmmakers like Jhumpa Lahiri, John Updike, and Joan Didion explore similar themes. Negative emotions and distress are a constant in the human experience. Why is it, then, that we have begun champing at the bit to write them off as medical conditions?

Older generations have always lamented the fragility of youth, hearkening back to their own glory days of true grit and resilience. Perhaps the difference now is that we have not only armed the next generation with the language for self-diagnosis but have also stripped them of individual empowerment to look within and create meaningful change.

The noble roots of the journey in Australia towards educating the layperson about mental health conditions began to appear in the 1990s when the very first murmurings of reducing the stigma around anxiety and depression were voiced. As momentum grew, a crusade to “normalise” seeking help when struggling emotionally morphed into an emphasis on early intervention and the inclusion of psychology services in the national Medicare scheme. But somewhere along the line, we have turned from promoting acceptance of poor mental health conditions to the normalisation of the very diagnoses themselves.

Do we really want to live in a society where poor mental health is considered “normal”? Furthermore, if it is the norm, then surely that calls for a recalibration by the medical fraternity of what we regard as a disorder or pathology.

Through the National Mental Health and Suicide Prevention Plan, the Australian Federal Government invested an eye-watering A$2.3 billion in the 2021–22 Budget. This money has been thrown around to various initiatives including Beyond Blue, headspace, Lifeline, and multiple school-based programs. These well-intentioned initiatives are often run by qualified mental health clinicians delivering high-quality interventions in the form of school-based education, individual and family therapy, case coordination, and crisis support. But what are the measures we use to assess the efficacy of these programs? Perhaps their legacy is the increased detection of mental illness that already exists in the community, but surely we can’t measure their success based simply on increased rates of diagnosis?

Still, supporters of mental health awareness campaigns in our education system insist that the issue is “silenced” and argue that we must continue to have “the conversation” with very young children about mental health, insisting that it will encourage them to speak up about and seek help with issues that they are experiencing. The problem with that is, as the American psychologist Abraham Maslow stated, “If all you have is a hammer, everything looks like a nail.”

In that regard, there must be more in our toolkit than the language and mechanisms for self-diagnosis. Even the children’s television show institution Sesame Street aired an episode in which the word of the day was “Anxious” and offered up suggestions (prompts) for situations that may elicit worry in their viewers. We need to reflect on the balance between creating a space for the inflicted to confidently step forward without fear of judgement and not encasing the “emotionally well” with a sensitive instrument that allows them to view the trials and tribulations of their lives as medical disorders outside of their control.

We also live in a society where inclusiveness is next to godliness and, in some perverted way, the initial ambition of acceptance of an outlier, or those suffering ailments, has turned into the vehicle through which many young people now identify and connect with each other. This phenomenon has been able to easily take root and flourish due to the explosion of technology, moulding a generation that wants an instant hit in the form of a label and an answer to their feelings of discomfort.

The teenage years are marked by a drive to move away from parental control and authority and seek acceptance and inclusion from peers. For this reason, the movement of mental health education has provided a fertile ground in which struggling adolescents can identify, connect, and lament together their hardships and adversities. Compounding this is the sound-bite nature of social media, with its insidious and persistent messaging providing children with vindications of their emotions and struggles. With a natural and innate drive to “fit in,” young people will have a tendency to self-analyse, self-flagellate, and, ultimately, identify as mentally unwell, reinforcing not only their belonging to a community but also their own deficiencies.

Pushing our relationship with poor mental health further than mere acceptance, in recent years we have seen sportspeople, celebrities, and “influencers” praised for outing their own diagnoses. In mid-2021, the world watched and was divided over the decision by American gymnast Simone Biles to pull out mid-event at the Tokyo Olympics, citing the need to put her mental health first. Accolades came in instantly from people around the world who applauded her bravery in such an act, establishing her as the poster child for how we should all approach the adversities in life that push us to our limits and beyond. Concurrently, there were unfavourable whispers that Biles’s actions demonstrated a lack of resilience and the egotism typical of her generation.

Perhaps it was the revelation of real vulnerability in a cult-like sports hero that, disappointingly, brought her back to being just a fallible human. But the Biles affair also pushes us to question which message we are now supposed to be imparting to young children. Is the characteristic of persistence more important than quitting? Or should the message be that signs of emotional fragility are to be prioritised and that quitting is both essential and admirable?

One day we’ll discuss mental health just as we do sprained ankles today. Until then, sharing a mental health challenge is heroic. Be a hero, so future generations don’t have to. @Simone_Biles @naomiosaka @MichaelPhelps @kevinlove @NAMINYCMetro @MentalHealthAm @WeTheUrban pic.twitter.com/olLqaVE2K7— mitul desai (@mitulidesai) August 4, 2021

In the weeks immediately prior to Biles’s action dividing the sporting world, tennis star Naomi Osaka withdrew from the French Open to focus on her mental health. These close events appeared to signal a decisive shift from the days of Michael Jordan, who is commonly known to have said that “If you quit once, it becomes a habit,” to an embracing of vulnerability and fault, letting fans know that it is okay to not be okay.

Humans have always needed to categorise and label the world around them. Categorisation is a well-documented short-cut phenomenon employed to reduce the complexity of our experiences and environment to a simplistic form to conserve cognitive resources. In this manner, the potential over-labelling of undesirable childhood behaviours in the classroom has, for some time, been increasing exponentially in parallel with the rise in emotional neuroses.

Five-year-old Australian children with an inability to sit still, attend, and respond appropriately to instruction as required have resulted in an explosion of paediatric assessments and “therapy.” Defiance, like melancholy or stress, presents with a slippery slope for a quick diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) or, worse, Oppositional Defiant Disorder (ODD), to explain away any obstacles faced by children and their parents and teachers. In a similar vein to the mental health movement, the noble objective to de-stigmatise neurological conditions that impact functioning in the classroom has created a hyperalert environment in which no child will fall through the cracks and all difficulties are seen through the lens of a potentially undetected diagnosis.

One of the many problems associated with this medicalisation of broader human presentations is a watering-down of serious neurological disorders which, at best, can impact some element of daily functioning and, at worst, can be lifelong and debilitating. One such diagnosis is Complex Trauma, which is said to develop after a person has been repeatedly exposed to a situation that elicits feelings of anxiety, fear, hopelessness, or powerlessness. The difficulty in such a theory is that young people are increasingly identifying and reporting such feelings during seemingly “normal” but challenging periods of their life, such as end-of-school exams and navigating their first jobs. When they are given a formal diagnosis of trauma, the young person is not only validated in their experience but also stripped of an opportunity to look at their situation with a fresh perspective and uncover their own faculty to bring about change.

The steep rise in youth mental health diagnoses undoubtedly reaches its peak among the middle classes. They are the children of the educated whose parents have been flooded with messages of early detection, the need for constant communication, and the dangers of not seeking help early—the youth self-harm rate alone is enough to frighten any helicopter parent. The latest figures from the Australian Institute of Family Studies (AIFS) reveal that 30 percent of young people aged 14 to 17 had considered intentional self-injury and 18 percent had engaged in actual self-harm. Parents are armed with an overabundance of knowledge to ensure that their child has well-developed self-esteem, a worthy emotional IQ, an ability for self-reflection, and a toolbox of self-care strategies at their disposal.

This is all before they even begin to consider nurturing concepts of gender and identity. Of course, this demographic also has the most access to mental health services, which usually confirm and entrench their self-diagnosed ailments. Amongst these middle-class students there is an obvious growth in disability provisions awarded for mental health reasons during exam periods. These usually consist of regular breaks, extra time, and smaller rooms for those students who cannot cope with the ordeal of the standard examination experience.

As a psychologist, I applaud our acceptance of those that are suffering from mental health conditions and believe that we still have work to do to ensure the message is loud and clear—seeking help in times of need is not a weakness. Poor mental health should be an accepted medical condition along with physical ailments, and the path to treatment unobstructed and without persecution.

However, a society that wallows in a culture of self-flagellation and diagnosis of emotional neurosis should never be held up as an ideal, just as we should not strive to normalize poor physical health. Mislabelling many of these emotions as mental illnesses may serve to ignore the great resilience and problem-solving ability humans have within themselves for overcoming adversity, and that can only be both a shame and loss to future generations.


This is a companion discussion topic for the original entry at https://quillette.com/2022/06/07/when-mental-health-education-just-makes-us-sick/
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Indeed, the pathologizing of normal human experiences must be called out as it happens. I am a psychologist in private practice. I have made it a point to use the words worried and sad instead of anxious and depressed and to encourage that use as a self-descriptor amongst my client group when appropriate. I have also noticed that the term narcissistic is bandied about when people may more accurately mean selfish. Trauma is another word becoming made almost meaningless by overuse. but don’t get me started.
Good article Clare

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I sometimes wonder if this medicalization of so much psychology, descends from the 1950s culture of psychoanalysis in New York. Although other incentives may contribute too, like the opportunity to sell drugs (“meds”) to lots of people, and the addition of new clients to the welfare state. And perhaps there is also some structural change to the lifeworld of modern people which promotes it too (information overload? neoliberal atomization?).

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Fortunately for us all, the strong normally overtake the weak. Even if the effort requires time. Many of these people may come around in adulthood and gain a bit of stoicism. Those that do not will produce fewer and fewer progeny. Other, stronger, more resilient, or simply more belligerent cultures will overtake them. Darwin will keep winning…

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This is an issue I have thought about quite a bit lately.

  1. Stress: Stress is considered a “pathological state” that “must be addressed”. But stress is just really an internal pressure to meet deadlines, obligations, job needs, family needs. When you are stressed, you need to function at a higher level, meet those deadlines, and solve the problem. Stress is not a problem - it is a simple indication that stuff needs to be done

Put another way, stress is a natural reaction to responsibility. When someone has hired you and pays you to do a job, you will feel stress because you need to meet the obligations. Stress is part of work.

  1. The pathologizing of puberty is a terrible scandal. People are told, over and over, that puberty is this terrible event. Perhaps you are not a boy but a girl with a dick? Escape puberty by drugging the body, and making yourself a permanent child. This is not a solution to puberty. Of course, a normal event that EVERY adult has gone thru is not a pathology. It’s just a developmental stage.

  2. Anxiety: Anxiety means that you are worried about something. While there can be pathological anxiety, it’s more often a stress-reaction. If there are some stimuli which actually cause paralyzing anxiety, psychologists have actually done quite well with systematic desensitization in this area. Normal anxiety, normal worry, is part of life.

Those who are anxious should practice stoic thinking, which reduces anxiety by parceling and partitioning experience into the sphere of control (where you can do something) and the sphere of other (where you have no control). You cannot control the thoughts of others, so their thoughts should not make you anxious.

Converting normal human experience into pathology makes all of life a pathology. We improve ourselves by finding ways to address our stress, our anxiety.

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I feel the same; it’s the SJW’s favorite word.

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The change in “your personal state” from a model of “improve yourself” vs “cure yourself” vs “get others to cure an internal problem” is a huge change. In human experience, much thought has been devoted to “self-improvement”, which includes “problems of your thinking”.

Let’s say you have a problem with alcohol, in that you drink too much. “Improve yourself” means that you should find a way to control your drinking, which can be difficult. But converting the “alcohol dependency” to a medical condition removes agency from the person. A person should improve himself, but if he is ill with “pathological alcohol dependency”, a professional must assist.

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(Scroll down to The Back Pages, “How to Raise Weird Kids” – not with online culture and self-diagnosis.)

Let’s do an Ike and make this analysis bigger. And let us use the method of Nazi jurist Carl Schmitt.

Schmitt says that the political is the distinction between friend and enemy. So when you have government schools in the mental health biz you are going to get people trying to eliminate the enemy – gnerally, in the modern school mostly taught and administered by women, boys – and shovel money at their friends.

Then the moral is the distinction between good and evil. Morality, of course, is a precipitate from a religion, whether the god is immortal or secular. What is a good child and what is a bad child, and what do “we,” the government or the community, secular or religious, do about it? And, incidentally what right do “we” have to correct the child unless the child has committed something that all can agree is nasty.

Then there is medicine, with the distinction between sick and healthy. You tell me, you mental health experts, what is sick behavior and what is healthy behavior. Obviously, in a government school, there will be a tendency for lifer bureaucrats to avoid responsibility and hand the sick kids over to the experts.

And don’t get me started on the law, where the distinction is between legal and illegal.

My problem with “mental health” is that it carelessly uses various religious concepts of good and evil borrowed from who knows where without really thinking about what it is doing. It imagoines itself a science when it is really a hodgepodge of science, philosophy, religion, law, and politics.

I prophesy a cockup on the mental health front and that things will get worse before they get better.

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If there’s going to be any kind of meaningful comparison between the mental health of the past & present a much more comprehensive analysis is required that isn’t just limited to the advent of the internet or psychological approaches. Huge social shifts that include an emphasis on materialism instead of spirituality, meritocracy, big city living, loss of community & extended family support networks, time poor less engaged parents, lack of contact with nature, hyper scheduled living to name a few are all possible contributors to a sense instability, anxiousness & anome. Our ancient lizard brains weren’t exactly designed for modern living.

Let’s also not forget who these recent generations are the products of & that’s those who have grown up on a steady diet of hyper media fear via the six o clock news at dinner time. Helicopter parents didn’t emerge out of a vacuum whose anxiety & coddling are likely consequences from their own upbringing that no doubt form part of their offsprings inheritance. Monkey see, monkey do.

Raising children might be physically easier these days because of access to material comforts but it’s much more psychologically precarious given all the additional pitfalls that at the minimum require selfless laser focused engagement, commitment & sacrifice from parents whose priorities these days can be very questionable even with the best intentions. If kids are less resistant the buck stops at their parents & societies inability to provide the necessary tools to develop it. Bootstraps don’t work if they aren’t modelled.

It’s ironic that in an article on fragility there’s no self reflection or responsibility taken on the world previous generations have shaped for the future ones only defensive finger pointing at superficial causes. Language is the least of it but a convenient scapegoat & certainly on political ‘woke grooming’ narrative trend with a nice serving of conservative bootstraps on the side as a solution. Sounds exactly like another in a long line of ‘but what about the children’ trojan horse where faux concern is all the rage for the purposes of political point scoring.

If exorbitant funds have been spent & yet the problem persists perhaps it’s because the root causes are not being genuinely addressed?

Is it any wonder mental health problems are on the increase when such superficial ignorant assumptions are made by those who are supposedly required to know something about the field they are expert in? Simone Biles had an extraordinary difficult childhood including a drug addict mother who lost custody of her, was raised by her grand parents, separated from her siblings & was sexually abused by a sports doctor all while attending one of the most arduous elite athletic training programs coached by one of the worlds most notoriously disciplined gymnastics coach. Most of us would ‘crack’ at much less….

And anyone who knows anything about elite sports would know that often ‘training’ methods these days are a little more extreme than days gone by & certainly not conducive to healthy outcomes especially if the the individuals concerned have compounding psychological issues. National Australian swimmers do very well career wise but an alarming amount of them suffer serious mental health issues. One can hardly say these kinds of individuals lack discipline or resilience but one thing they all share is an absence of a healthy childhood/ lifestyle & a society that highly rewards whatever it takes….

Spare me the whining, honestly. Biles was on her third Olympics. All that crap is in the past. She’s a whiner, unfortunately, and other whiners like you have enabled her cowardly withdrawal.

It’s not just that she chickened out during the games. She is and was, at this point, unfit for high-level competition.

She stole a slot from another, more deserving, woman.

So, the whining about her “bravery” is just so disgusting. She’s a coward, period. And if she was going to coward-out, she should have withdrawn BEFORE the games. You don’t coward-out during the game. Not if you are a big girl.

When boys and girls grow up, they learn that FINISHING THE JOB is the key thing. Not whining. Not quitting.

I hope her useless “victory tour” goes bankrupt. She doesn’t deserve the victory lap. Because she didn’t get the victory. She’s a coward and a loser, but so representative of cowards and losers out there today.

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You obviously don’t know much about elite sports. Athletes often go into periods where they get the ‘yips’ or performance anxiety & if you are doing very dangerous manoeuvres it can be very health/life threatening. Also it’s quite possible a history of anxiety or other mental health stressors can act as a trigger or make someone more susceptible to future bouts. Biles was a very talented gymnast from a young age but often missed selection due to her mental instability.

Had she gone to a physician and found that there was a balance issue due to an infection or something, I might have a different opinion. But, no, in the Olympics, you are not allowed to make such whining excuses.

I hear you. What sets me off is the ice skating. "How can they possibly fall? “They must of landed that jump a gazillion times!” But fall they do all the time. How 'bout that russian chick Kamila Valieva eh?

What’s frustrating with Biles is she could have taken the easy way out & faked an injury but because she told the truth got tarred & feathered. She obviously hoped she could overcome the ‘block’ & kept trying. Do you really believe she would put herself upto such humiliation if she knew she was past it? She got the yips, it happens….& always in the most inopportune circumstances.

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The falling is not a problem. I agree - the moves are high risk. The ones that amaze me are the pairs where the guy tosses the girl and she ends up, 99% of the time, skating backwards. It’s not even that they land the trick. It’s that they probably did not land it a bunch of times, and came back to work it over and over.

The issue is not failure. God knows I have failed at a bunch of things. The issue is NOT TRYING and PULLING OUT. Let the record show that I can do a backflip off the diving board, but not standing on a gym floor - so the issue of the “performance difficulty” is not one that I have experience with, in that I have never tried a flip on a balance beam.

This was her 2nd olympics, and there are multiple high-level competitions in which she excelled at a level that normal people cannot understand. If you make the O team, others did not make it. By pulling out during the competition and not before, she not only deprived them of the spot and opportunity, but gave cover to those who do not continue in a competition.

No one should excuse her.

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The twisties appears to be something that’s quite unpredictable so she may not have had notice as well as appropriate facilities to correct it. Gymnastics is not the kind of sport you can carry on with when not in form. The responsible action was to drop out.

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That was a pleasure to read. When you put down the bullhorn and moderate your language you are not less effective, but more.

Indeed, and since your tribe is in charge perhaps you should look to your own assumptions rather than accuse those of us who disagree with you of ‘faux concern’.

You’re trying to turn the thing into some grand moral lapse George. Above you are quite matter of fact that every elite athlete hits the wall at some point. It isn’t realistic to expect anyone to drop out ahead of time, that’s just not how the elite roll – you go until you crash and burn and that’s what Biles did. True, all the ‘mental health’ talk was a bit cloying, but at bottom, she just lost her nerve just like almost all of them do at some point. I remember one skater, who just couldn’t step onto the ice, she’d hit the wall, that’s how it goes. Give Biles a break, she’s neither a hero nor a villain she’s just a thoroughbred who’s ran her last race.

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True. Well said.

But, personally, I think the largest factor for young people right now is in fact the internet, specifically social media. Social media immerses kids in a machine-gun environment of validation and peer inspection - at an early age, and for huge numbers of hours daily. They are constantly under a microscope. It’s a trap, because without the validation part you’re a nobody.

The younger the kid, the more they’ve been raised in this boiling pressure cooker. It inhibits healthy emotional development. I think, for millions of them, they now simply lack the tools to deal confidently with the real world.

I don’t see this getting better. It makes me sad.

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T

I agree but I often think of social media as a tell of insecurities that were already there to begin with, a symptom that’s a barometer of a malady as well as exacerbating of those insecurities in various ways not to mention highly addictive. Yes it’s a sad & unhealthy thing to get caught up in but it can also expose one’s psychological weaknesses. If self reflection can be something that’s more instilled perhaps at least there’s a learning & growth opportunity that can be utilised . We are so accustomed to looking outward rather than inward we often miss the opportunities to be had. “What does my reaction here teach me about myself that I might need to work on?” mentality certainly would help.

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