The latest on teenage mental health concerns a program called WISE that was supposed to teach high school students "social-emotional skills":
Last month, the journal Behavior Research and Therapy published a study of 1,071 Australian teenagers who were observed from 2017 to 2018: One group participated in WISE Teens; another group participated in a standard health-class curriculum. Compared with the teenagers who got the standard education, the students in WISE Teens reported more depression, more anxiety, more difficulty managing their emotions and worse relationships with their parents.
As to why that would be, maybe
by focusing teenagers’ attention on mental health issues, these interventions may have unwittingly exacerbated their problems. Lucy Foulkes, an Oxford psychologist, calls this phenomenon “prevalence inflation” — when greater awareness of mental illness leads people to talk of normal life struggles in terms of “symptoms” and “diagnoses.” These sorts of labels begin to dictate how people view themselves, in ways that can become self-fulfilling.
I find this depressingly predictable. So far as I can see, the trend over the past century has been that the more we talk about mental health problems, the worse they get. The more we talk about PTSD, the more soldiers suffer from it. The more mental health care we offer to students, the more they need it.
Which is not to say that mental health problems are not real, and ancient. But so far as we can measure, the mental health of young people now is worse than it has ever been. Our lives keep getting better, but how we feel about them does not. Depression is more common among young Americans today than it was among young Germans or Russians who came of age during World War II.
Some people are crazy and can't make it without help. Some are fine. But there seems to be a vast middle ground of people who have issues that might be manageable or might lead to crisis, depending on – well, depending on all sorts of things, in ways I don't think we understand. But for many of them, it seems that worrying too much about themselves makes things worse, and that the best thing would be to stop looking inward and get on with life instead.
There is a model of our youth mental health crisis that goes like this: what kids need is activity, to be busy, to be around their peers, to be around adults, to work and play and look outward into the world. But we keep telling them to look inward. To look into their souls and figure out who they are, what their passions are, to explore their dreams, to find their identities. Worrying too much about who you are, in this model, leads to anxiety and depression.
Some of that is, as people have been pointing out since Kierkegaard, a consequence of freedom. The more choices we have, the more we worry about them; the more freedom we have to choose our own identities, the more we wonder who we are; the more we wonder who we are, the more depressed we become. Your identity used to be something you inherited, a place in a system of family, clan, tribe and nation that mostly determined what you would be. In many ways, that sucked, but so, it seems, does freedom.
One possible issue is that our society is now full of mental health talk, but at a level that raises more questions than it answers. It may be that some of the kids who were depressed by a fairly trivial intervention like WISE would get better after prolonged therapy or some other serious care. But I'm not really sure about that.
I feel like we have fallen into an uncanny valley where we know enough about mental health problems to see how real and common they are, but not nearly enough about how to treat them. I linked here a few years ago to a study that claimed almost every area of medical care had gotten better over the past 20 years, except mental health care, which has not improved at all.
But if that is true, it raises a serious question about how to respond. The thing is, we really do have a lot of freedom. We live in a world with a hundred different possible educational paths and ten thousand different careers. Advice to "get busy" just raises the question: get busy at what? In our world, you have to make choices; that is the real glory of our world. But maybe it is also our curse.
4 comments:
@John
It is worth pointing out that the author of the column does argue for the idea that WISE and programs like it were superficial and too much trying to do mental health on the cheap, easy, and quick. Exposure to mental health talk in such a context is possibly more harmful than helpful (esp. in the context of a lot of it proliferating among influencers, TikTok, and suchlike). But done in a different way, it may not be so harmful (as you do acknowledge, though only to doubt it). Saxby recommends *more* old-fashioned, long-term, and (yes) expensive type therapy, the training and hiring of more therapists, etc. They also recommend smaller class sizes, as part of a general approach of giving young people more chances for developed relationships with more adults not their parents (which they only mention by-the-by, but I think may be very important).
As you know, I'm skeptical that people were all that much happier in the past. This is NOT because I'm philosophically devoted to freedom of the sort we're talking about. Obivously I grew up in our age of freedom and am completely shaped by it as a person as much as any other secular middle class westerner--but, yes I can imagine and have seen examples that, say, arranged marriages can produce happy families (although I do esteem M. Toulmouche's painting, for better or worse (heh)). And so on. But my studies of the past and encounters with people who were old when I was growing up (especially my relatives on both sides) convince me that there was also quite a lot of misery, and that much of it was more interpersonal and simply human than about larger structures of oppression. I'm convinced, I think in good faith, that we hear a lot of the misery we hear today because people in the past were too ashamed to talk about it, or they had learned that, if they called attention to themselves, a beating or social humiliation and ostracism, with risk of consequent vagabondage and pauperization or worse, was the likely result.
This is obviously not my only source, but I've long been haunted by the little passage in Fisher's Albion's Seed about what happened to those who lost in the fierce world of Appalachian social competition. He depicts them lurking off alone on the margin, furtive, despised, old before their time. My memory is he has examples, and is not just fantasizing.
Then there is the interview I heard with a historian who had written a book on the history of tobacco. The journalist asked him, "Why do people smoke?" The historian exclaimed, as though it were the most obvious thing in the world, "Because human life is miserable!"
(One also remembers, of course, the old joke: "And it's all over so quickly!")
I would like to double down on Saxby's suggestion about relationships with adults not their parents. Saxby also mentions changing school schedules to promote more sleep--one might add that cutting off screens at, say, 10pm, might help sleep as well (I think I once saw that linked to on this blog).
I think these two are the most potentially productive suggestions re this problem that I've seen.
Thinking about it, I have to admit that, for some, a relationship with an adult who plays the coach/drill instructor/Doktorvater role and teaches toughguyism will be helpful to some/many adolescents. A lot of the athletes I taught--and no, I didn't scorn or spurn my athlete students--clearly revered their coaches and had built promising-seeming psychological structures around what the coaches were teaching them. Even an adult who teaches Andreeson values might be helpful to some. Of course, I wouldn't want to watch. But I have to admit, some might benefit--even if they would probably have to learn to tone it down in order to live with everyone else.
But a lot of adolescents might respond productively to something a bit more mensch-like and even handholding. That was obviously my comfort zone as a college teacher; as a friend of mine said, I was "nice uncle David." Even tough-guy athletes who were not good writers appreciated my patient, word-by-word going over their papers with them, asking them, "okay, read this sentence. Do you see a problem?"
I think John recently said something like, in education, nothing beats a relationship between a student and an adult who cares. I think one could extend that to growth at the age we're talking about, in general.
The old ways of preset work paths, arranged marriages, churchgoing as just what one does, and so forth, are not going to come back, I think we all can agree, and it's probably not worth debating them in this context (though as an academic, historical topic I'm all for it!).
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