Let’s discuss 3 of the biggest myths/problems with discussions on youth mental health.

MYTH #1: One size fits all

Nope! Historically we have designed interventions, programs even apps that generally fail to account for the rich, diverse and unique experiences of People of Color and people with marginalized identities. My field of mental health (psychology, social work, counseling, psychiatry, etc.) has historically treated mental health as a one size fits all game, if we build one approach, develop a single shared understanding of the origins of mental illness and how to treat it, we can take care of everyone. But up until the early 70s, our field actively and openly told People of Color and anyone with a marginalized identity that our issues were not so unique. In fact, much of what we were taught about how to understand and treat mental illness was built with no consideration for welcoming inclusion and that it was all easily solvable by conducting studies, even if the studies had no PoC in them, no people with disabilities and few, if any openly LGBTQIA+ people. Obviously, this was flawed logic and has had some significant negative impacts on diverse people and our mental health. Further, a lack of diversity in research studies also means that everyone suffers because we do not get the benefit of truly generalizable knowledge and approaches. Fortunately, with a lot of good will and hard work, this is a treatable problem.

MYTH #2: The ONLY way to treat mental illness is through psychotherapy

This is also false, some people do not want psychotherapy, others benefit from a few sessions and still others require long term care. ALL of this is ok, all of it is correct. Rather than look at this issue as right or wrong, I encourage us to look at it on a continuum. Everyone falls somewhere on the continuum and my book, Rise and Thrive, is designed to help you develop coping skills wherever you are on that continuum.

MYTH #3: Kids and teens have nothing to worry about, they need to just grow up and get over these small problems

This is not something I hear every day, but I have heard it enough in my 30-year career that I know some people still believe it. The idea that young people have no worries is by far one of the most common and hurtful myths about mental illness, especially in racially and culturally marginalized communities. Story time; I once chaperoned a field trip to see a hit Broadway play, Dear Evan Hansen, with about 200 kids from a mentoring program. If you are unfamiliar, it was a hit play, then movie, about a kid really struggling with mental illness and it includes themes of suicidality. We had a huge group discussion at the end of the play and there was a Filipina in the student group. She said something I’ll never forget. 

I asked the group how the adults in their lives felt about mental illness, how was it discussed in their homes. She said something that sticks with me to this day, because it is so universal. The Filipina student told our group that day, that in her culture, people call mental illness “First World Problems”. I’ve heard the same myth from different cultural groups in many different parts of the world as well. Once, I was with Representative Ilhan Omar at a public hearing. In that hearing, we were discussing suicide and depression in Black youth. She shared that when she was a child, in her country of origin Somalia, they did not have a word for mental illness and that people often used the C-word (e.g., crazy). In other communities, I have heard things like, “mental illness is for rich people”, “it costs too much to have a mental illness, so I’ll just choose to not have one”, “mental illness is made up because people just don’t want to develop mental toughness”, etc. etc.

Let me say clearly, I do not judge older generations who minimize the significance of mental illness, I believe that I owe my elders respect and grace, so I regularly talk to older generations (my own GenX included) about the signs and symptoms of mental illness. Further, given the time I spent in my career studying, learning, collaborating with and listening to diverse youth, young adults, families and communities, I am uniquely equipped to teach at an even deeper level. I appeal to adults’ sense of love (and care for younger generations) to ask them to just take a step back and empathize. Then I ask my elders to remember things they went through as children that they wished they’d had some support in navigating. So often, at this stage of the conversation adults get quiet, reflective, some even cry. And I believe it is because they remember times when they wished someone safe had taken just a moment to help them in their time of emotional need.  

But so many adults never got the help they needed and instead got pushback and scolding for not being tough enough. I find that once I help older adults connect the dots, many can see that their own misperceptions of mental illness inform how they respond to the needs of their children. Some adults don’t get the connection immediately, others feel pushed to silence, then sorrow, then curiosity, then slow, creeping acceptance. And that is often all the space I need to make a difference in a young person’s life, helping their loved ones understand youth mental health struggles just a tiny bit better.

I never call the lack of awareness ignorance, because that word (ignorance) has been wielded like a sword against People of Color for centuries. Instead, I teach people to frame lack of awareness as a natural response to centuries of PoC being made to feel unwelcome — into national conversations on mental health, into leadership on mental health studies and into the development of interventions that benefit the widest range of people.

— Dr. Alfiee