Teaching depression: Mental health programs can make students feel worse

Mental health awareness campaigns aimed at teenagers may backfire, writes Ellen Barry in the New York Times. While the truly troubled may benefit, others will "over-interpret their symptoms and see themselves as more troubled than they are," researchers warn.

Photo: Emre Keshavarz/Pexels

In Britain and Australia, "students who underwent training in the basics of mindfulness, cognitive behavioral therapy and dialectical behavior therapy did not emerge healthier" than the control group, and some did worse.

Young people who are told mental health problems are common may be decide the normal challenges of growing up are signs of mental illness, says two Oxford psychologists, Lucy Foulkes and Jack Andrews, who coined the term "prevalence inflation."

"In the summer of 2022, the results of a landmark study on mindfulness training in British classrooms landed — like a lead balloon," writes Barry.

My Resilience in Adolescence, or MYRIAD, followed about 28,000 teenagers over eight years.

Half of the teenagers were trained by their teachers to direct their attention to the present moment — breathing, physical sensations or everyday activities — in 10 lessons of 30 to 50 minutes apiece. The results were disappointing. The authors reported “no support for our hypothesis” that mindfulness training would improve students’ mental health. In fact, students at highest risk for mental health problems did somewhat worse after receiving the training, the authors concluded.

But, by the time the results were in, schools had committed to mindfulness programs, says Dr. Foulkes. They weren't interested in the evidence.

Researchers speculated that making kids aware of troubling thoughts -- but providing no solutions -- doesn't help teenagers. Mindfulness training can encourage group brooding, known as co-rumination.

Australian students observed cartoon characters dealing with mental health concerns in the Climate Schools study. Dr. Andrews found that "higher levels of depression and anxiety symptoms six months and 12 months later." Girls were more likely to exhibit co-rumination, he found. “It might be that they kind of get together and make things a little bit worse for each other.”

There's evidence that social-emotional learning can help students, writes Barry. "A 2023 meta-analysis of 252 classroom programs in 53 countries, found that students who participated performed better academically, displayed better social skills and had lower levels of emotional distress or behavioral problems."

The rise in depression among teenage girls may be partially a diagnosis issue, writes David Wallace-Wells in the New York Times.

The smartphone kicked off the selfie era in 2010, argues social psychologist Jonathan Haidt. Suicide attempts by girls and young women rose sharply, and reports of anxiety and depression skyrocketed.

But something else happened, Wallace-Wells writes. In 2011, new federal guidelines urged doctors to screen teenage girls for depression annually, and required that insurance providers cover such screenings. In 2015, a coding change required hospitals to record whether an injury was self-inflicted or accidental . It "nearly doubled rates for self-harm across all demographic groups." In New Jersey, "researchers have found that the changes explain nearly all of the state’s apparent upward trend in suicide-related hospital visits."

Both explanations could be true, he concludes. "Emotional distress among teenagers may be genuinely growing while simultaneous bureaucratic and cultural changes — more focus on mental health, destigmatization, growing comfort with therapy and medication — exaggerate the underlying trends."