A fourteen-year-old girl lies in bed unable to get up for school, not because she is lazy or defiant but because the thought of facing another day of existing makes getting out of bed feel impossible. Her mother stands in the doorway not knowing whether to push or comfort, whether this is typical teenage moodiness or something more serious, whether making her go to school is the right thing or the worst thing. The girl does not have words for what she feels, just a heaviness that settled in sometime last year and has not lifted since. A sixteen-year-old boy excuses himself to the bathroom three times during dinner because his heart is racing and his chest feels tight and he cannot breathe properly, and he does not know why this keeps happening or how to make it stop, only that something is wrong with him that he cannot explain to parents who would worry and friends who would not understand. A twelve-year-old stops eating lunch at school because eating in front of other people makes her anxious, then stops eating breakfast because mornings are when the anxiety is worst, and her parents do not notice until her clothes hang loose and the school counsellor calls to express concern. A fifteen-year-old who has always been a good student starts failing classes, not because the work is too hard but because he cannot concentrate, cannot find the point, cannot remember why any of it matters, and when his parents ask what is wrong he says nothing because nothing is a safer answer than the truth. A seventeen-year-old scrolls through social media at three in the morning unable to sleep, comparing herself to curated images of peers who seem happy and confident and together, each comparison confirming what she already believes about her own inadequacy, the phone both companion in her insomnia and contributor to it. These are not rare stories. They are everyday stories, playing out in homes and schools across the country, in a generation experiencing anxiety and depression at rates that have alarm bells ringing across the mental health system. Whether what we are seeing represents a crisis requiring urgent response or normal developmental challenges that have always existed but are newly medicalized remains debated, but the suffering of young people caught in its grip is not in question.
The Case for Treating a Mental Health Crisis
Advocates for treating current rates of youth anxiety and depression as a crisis requiring urgent response point to data showing significant increases in mental health challenges among young people. From this view, something has changed, and the response must match the scale of the problem.
Survey data consistently shows increases in youth reporting anxiety and depression symptoms. Emergency department visits for youth mental health crises have increased substantially. Self-harm and suicidal ideation have increased. The trends are clear and concerning across multiple data sources. These are not normal variations but significant shifts requiring attention.
Young people are suffering in ways that affect their development, education, relationships, and futures. Mental health challenges during adolescence can have lasting impacts. Early intervention can prevent problems from becoming entrenched. The argument for action does not rest solely on statistics but on the lived experience of young people in distress.
The systems meant to help young people are overwhelmed. Wait times for youth mental health services often exceed those for adults. Schools lack adequate counsellors. Parents struggle to find help for children in crisis. The gap between need and service availability demonstrates system failure requiring investment.
From this perspective, addressing youth mental health requires: major investment in expanding youth mental health services; school-based mental health programs reaching young people where they are; reduced wait times for clinical services; parent education and support; addressing social factors including social media that may contribute to youth distress; and treating youth mental health as a system priority.
The Case for Caution About Pathologizing Adolescence
Others argue that framing normal adolescent challenges as mental health crises may do more harm than good, medicalizing developmental experiences that have always existed and creating problems through the very lens meant to address them. From this view, caution is warranted before declaring crisis.
Adolescence has always been difficult. Identity formation, social challenges, academic pressure, and emotional volatility are normal parts of development. Previous generations experienced similar challenges without labeling them mental illness. The increased rates we see may reflect increased awareness and willingness to report rather than actual increases in disorder.
Labeling normal distress as mental illness may create self-fulfilling prophecies. Young people taught to interpret their feelings as symptoms may develop identities centered on illness rather than resilience. The expectation of fragility may undermine the development of coping capacity. Sometimes the most helpful response to difficulty is not treatment but the message that difficulty is normal and manageable.
The mental health industry has incentives to expand its reach. Pharmaceutical companies, therapists, and mental health advocates all benefit from broader definitions of disorder. Screening programs that pathologize normal variation create patients who might otherwise have muddled through without professional intervention. Not everyone who struggles needs clinical help.
From this perspective, addressing youth mental health requires: distinguishing clinical disorders from normal developmental challenges; building resilience rather than assuming fragility; being cautious about pathologizing normal adolescent distress; questioning whether more treatment is always better; and recognizing that not all suffering requires professional intervention.
The Social Media Question
Social media use correlates with increased anxiety and depression in young people, but the nature and direction of this relationship remains contested.
From one view, social media is a primary driver of youth mental health decline. Constant social comparison, cyberbullying, disrupted sleep, and engineered addictiveness damage developing minds. The timing of mental health increases corresponds to smartphone and social media adoption. Restricting youth social media use should be a public health priority.
From another view, the relationship between social media and mental health is more complex than simple causation. Correlations do not prove causation. Young people with existing mental health challenges may use social media more, reversing assumed causality. Social media also provides connection and support for isolated youth. Restricting access may not improve mental health and may have unintended consequences.
Whether social media is cause or correlate of youth mental health challenges shapes policy responses and parental guidance.
The School's Role
Schools are where young people spend most of their time and where mental health challenges often first become visible. Schools' role in mental health response is debated.
From one perspective, schools should be primary sites of mental health intervention. School-based counsellors, mental health curriculum, and early identification programs can reach young people before problems become severe. Schools are accessible, non-stigmatizing environments for mental health support. Investment in school mental health infrastructure is investment in youth mental health.
From another perspective, schools are educational institutions being asked to solve problems beyond their expertise and capacity. Teachers are not therapists. Mental health curriculum may not be effective and takes time from academic instruction. Schools identifying mental health problems cannot necessarily address them, creating referrals to services that do not exist. Schools can support mental health but cannot be the mental health system.
Whether schools should be primary mental health intervention sites or should focus on education while connecting students to external services shapes school policy and resource allocation.
The Medication Debate
Medications can be effective for youth anxiety and depression, but their use in young people raises specific concerns.
From one view, evidence-based medications should be available to young people whose symptoms warrant them. Withholding effective treatment because of age-based stigma around medication harms young people who could be helped. Medication combined with therapy is often more effective than either alone. Clinical decisions should be based on individual need, not blanket reluctance to prescribe to young people.
From another view, medicating developing brains requires particular caution. Long-term effects of psychiatric medications on youth development are not fully understood. Medication may be prescribed too readily as alternative to addressing underlying causes. Non-pharmacological interventions should be tried first for most youth with anxiety and depression.
Whether medication should be readily available for youth mental health treatment or approached with special caution shapes clinical practice.
The Therapy Access Problem
Evidence-based therapy including cognitive behavioural therapy is effective for youth anxiety and depression, but access is limited.
From one perspective, therapy access is primarily a coverage and capacity issue. Most young people who could benefit from therapy cannot access it because of cost and waitlists. Expanding publicly funded therapy, training more youth-focused therapists, and reducing barriers to access would help more young people.
From another perspective, the therapy access problem cannot be solved by expanding one-on-one professional treatment alone. There will never be enough therapists for every young person who might benefit. Scalable interventions including digital therapeutics, group programs, and guided self-help may reach more young people than traditional therapy ever could.
Whether therapy access should focus on expanding traditional services or developing scalable alternatives shapes investment in youth mental health.
The Parent Factor
Parents play crucial roles in youth mental health, both as risk factors and protective factors, and as those most likely to notice problems and seek help.
From one view, supporting parents is central to supporting youth mental health. Parent education about youth mental health, guidance on when to worry and when to seek help, and involving parents in treatment improves outcomes. Family-based approaches may be more effective than individual treatment for young people who live within family systems.
From another view, parent involvement in adolescent mental health must respect adolescent developmental needs for autonomy and privacy. Some family environments contribute to rather than protect against mental health challenges. Young people may not seek help if parent involvement is required. Confidential access to services independent of parents should be available.
Whether parent involvement should be central or balanced against adolescent autonomy shapes how youth mental health services are structured.
The Prevention Possibility
Preventing youth anxiety and depression may be more effective than treating it, but whether prevention is achievable and what it requires remains uncertain.
From one perspective, prevention programming can reduce rates of youth anxiety and depression. School-based programs teaching emotional skills, mindfulness, and cognitive techniques show evidence of effectiveness. Universal prevention reaching all young people may be more efficient than waiting to treat those who develop problems.
From another perspective, prevention programs often show modest effects that may not justify their costs. Universal programs dilute resources across many who do not need them to reach the few who might benefit. Targeted intervention for high-risk youth may be more efficient than universal prevention. Prevention is harder to achieve than treatment advocates suggest.
Whether prevention should be prioritized over treatment shapes investment in youth mental health.
The Diagnostic Question
When does youth distress cross the line into clinical disorder, and does that line matter?
From one view, clinical diagnosis is important because it identifies young people who need and can benefit from treatment. Diagnosis enables access to services, justifies insurance coverage, and provides frameworks for understanding and addressing problems. Young people meeting diagnostic criteria for anxiety or depression should receive appropriate treatment.
From another view, diagnostic categories drawn from adult psychiatry may not fit the fluid nature of adolescent emotional experience. Labels may stick and shape identity in unhelpful ways. Dimensional approaches recognizing degrees of distress rather than categorical presence or absence of disorder may better serve young people.
Whether clinical diagnosis should guide youth mental health response or whether other frameworks are more appropriate shapes assessment and intervention approaches.
The Canadian Context
Canada has recognized youth mental health as a priority, with federal and provincial investments in youth mental health infrastructure including Integrated Youth Services hubs, school mental health programs, and crisis services. The Kids Help Phone provides national crisis support. Yet wait times for services remain long and access remains uneven across regions.
From one perspective, Canada should accelerate investment in youth mental health, building on promising models to create comprehensive, accessible services for all young people.
From another perspective, investment should be guided by evidence of what actually works rather than assumptions that more services necessarily mean better outcomes.
How Canada develops its youth mental health system shapes whether the next generation receives the support it needs.
The Question
If young people today report more anxiety and depression than previous generations, if emergency rooms see more youth in crisis, if wait times for youth mental health services stretch months while young people suffer now, if parents watch their children struggle without knowing whether to worry or wait, whether to push or protect, whether to seek help or let time heal - are we witnessing a mental health crisis requiring urgent systemic response, or are we pathologizing normal adolescent challenges in ways that may make things worse? When a fourteen-year-old cannot get out of bed, is she sick or is she struggling? When a sixteen-year-old cannot breathe from anxiety, does he need treatment or does he need someone to tell him this will pass? And if we cannot answer these questions with certainty, how do we build systems that help young people who need help without convincing young people who would be fine that they are broken? If the line between normal distress and clinical disorder is unclear, who decides where it falls, and what are the consequences of drawing it in the wrong place?