Bidding Farewell to Mental Health Awareness Month

With May, the month of Mental Health Awareness, coming to a close, it may be time to rethink whether “emotional awareness,” the superficial approach to U.S. mental health policy over the past decade, is actually effective. “It’s okay to not be okay” and acknowledge it, says the U.S. Substance Abuse and Mental Health Services Administration, or SAMHSA, the federal agency on mental illness. But this public-health style attempt to prevent mental illness by promoting “wellness” for all isn't working. What warrants attention is the desperate need for treatment and services targeted at serious mental illness and serious emotional distress in youth.

Universal mental health initiatives like awareness, often targeted to kids, encourage regular attention to emotions, talking about them when bad, and learning the names and symptoms of mental disorders, all to more frequently identify possible problems so mental health intervention can be sought. Taxpayer-funded, commercially packaged programs are doled out through public schools and workplace mandates. Examples include universal screenings, pseudo-therapeutic social emotional learning, Mental Health First Aid, Mental Health Awareness training, and most programs peddling “prevention.”

In SAMHSA’s 2025 budget proposal, funding requests for four awareness and prevention initiatives alone ballooned to nearly $1 billion, from $207 million in 2021.

What can we expect? Decades of rigorous research finds no evidence universal mental health programs prevent mental illness, nor suicide. They can make things worse.

Excessive attention can glamorize mental illness, incentivize seeking coveted diagnoses, and normalize extreme behavior. Ruminating can induce depression. Depression can be contagious, as can suicide, self-harm, and even violence. TikTok videos increasing awareness of Tourette’s syndrome produced a rise in adolescent tic-like behaviors.

Policy failures are clear among youth. Gen Z are strikingly open about mental health. But their feeling anxious and depressed has gotten significantly worse—not so for older generations, less indoctrinated into thinking about how they feel all the time. Kids self-proclaim disorders in school and on dating apps. The proportion of adolescents meeting diagnostic criteria for a disorder is so high that questions have been raised about their clinical significance.

 Preoccupation with awareness helped create the largest pool of kids ever seeking mental health services while simultaneously diverting resources from providing needed services. Most U.S. counties don’t have a mental health provider. Psychiatric residential treatment for youth—an intermediate setting between more-intensive inpatient hospitalization and less-restrictive outpatient treatment—has seen massive declines over the past decade.

Residential treatment is particularly important for kids at risk of suicide, who sometimes need more oversight than can safely be provided at home. While capacity declined, the youth suicide rate has gone up. More restrictive inpatient hospitalization (where stays can be longer if residential care is not available) increased significantly for youth with depressive disorders.

Boarding at emergency departments has increased disproportionately for youth mental health compared to all other types of visits. Almost 99 percent of acute care hospitals have had to board youth since the pandemic. Accounts have been reported of child abandonment in EDs, by parents feeling they can no longer manage “increasingly ill” behavior and have no other options.

We’ve seen this all before. For adults, insufficient psychiatric bed capacity has been associated with increased risk of suicide and rates of boarding, too.

Targeting effective, high-quality mental health services to those with mental health needs—as opposed to dousing everyone with ineffective programs pre-emptively—will itself help all.

With so much attention, mental health has been normalized. What warrants awareness now is how bad it’s left us.

Carolyn D. Gorman is a Paulson Policy Analyst at the Manhattan Institute.