The Substance Abuse and Mental Health Services Administration (SAMHSA) recently released its National Survey on Drug Use and Health, revealing that one in three adolescents received professional mental health services in 2023. While SAMHSA officials view this as progress in normalizing and destigmatizing mental health treatment, the findings raise concerns about the potential over-treatment of youth.
The survey, which includes data from Americans aged 12 and older, indicates that nearly 32% of adolescents received some form of mental health care last year, including prescription medications, counseling, or treatment in various settings. However, this statistic does not necessarily reflect the actual prevalence of mental disorders among adolescents, suggesting that many young people may be receiving treatment they do not need.
Mental disorders that cause chronic and severe impairment typically develop in late adolescence or early adulthood. Yet, the survey shows that approximately 8.3 million adolescents received treatment last year, while only 3.4 to 4.5 million may have experienced sufficient distress to warrant it. This discrepancy raises questions about the appropriateness and necessity of such widespread treatment.
The prevailing belief that therapy benefits everyone overlooks the limitations and potential harms of mental health treatment, particularly for youth. Studies indicate that treatment is less effective for adolescents than for adults, and the quality of care often falls short of established guidelines. This can lead to inadequate care, which has been linked to increased self-harm and hospitalizations among young people.
Moreover, the survey excludes data from individuals in group settings like juvenile justice centers, residential treatment facilities, and mental hospitals, where those with the most severe emotional distress are overrepresented. As a result, the survey may not fully capture the needs of those who could benefit most from high-quality mental health care.
For those on the margins, a mental health diagnosis can have lasting negative effects, including increased risk of death, chronic illness, unemployment, and a diminished sense of control over one’s life. The over-prescription of stimulants, particularly for conditions like ADHD, can induce psychosis, adding to the potential risks associated with treatment. Many symptoms of common mental health issues, such as depression, are often temporary and may resolve without intervention.
Despite these concerns, federal policy continues to support the notion that mental illness can be prevented by improving emotional health across society. This has led to the allocation of tens of billions of taxpayer dollars annually to programs that promote widespread mental health treatment. However, after more than 50 years of this approach, the prevalence of mental disorders has not decreased.
While some adolescents with severe emotional distress can indeed benefit from high-quality mental health services, the indiscriminate promotion and use of such treatment should be reconsidered. Just as we do not universally advocate for more knee surgeries and physical therapy for youth with vague growing pains, we should be cautious about broadly endorsing mental health treatment for adolescents without clear indications of need.