Isaac L. Ahuvia

The journal's recent debate series (‘are we overpathologising young people's mental health?’) featured compelling articles regarding the pathologisation of emotional distress in young people. Much of the concern over overpathologising is that young people are overpathologising their own mental health (i.e. identifying as having mental illnesses when they are actually experiencing normative, non‐clinical levels of emotional distress; Foulkes & Andrews, New Ideas Psychol ., 69 , 2023, 101010). I wish to briefly share a relevant finding from a recent study (on mental illness self‐labelling in late adolescence) and highlight ways that new empirical work can move this debate forward.

Self-labeling with a mental illness, for example, deciding that one “has depression,” has the potential to affect clinical outcomes through multiple cognitive and behavioral pathways. Despite such possibilities, little empirical research has examined these pathways. We propose a conceptual model, which we call the “Mental Illness Self-Labeling Model,” that can be used to study the clinical consequences of mental-illness self-labeling. We begin by reviewing existing literature on self-labeling, including sociological research on modified labeling theory, and how it can be leveraged to support the conceptual approach we propose. We then outline the proposed model, articulating how self-labeling can cause beliefs about mental illnesses to be internalized and how subsequent changes in psychological mediators (e.g., perceived control, self-blame, and others) can have downstream effects on clinical outcomes. Our model provides a conceptual framework and methodological tool kit for researchers interested in investigating the clinical consequences of mental-illness self-labeling.

Depression is the leading cause of disability among adolescents. Fewer than 50% of youth with depression access mental healthcare services. Leveraging a mixed‐methods approach, this pre‐registered study characterized youths' self‐reported barriers to accessing mental healthcare in a socio‐demographically diverse sample of 123 United States adolescents (ages 13–16, identifying as Asian (n = 19), Hispanic (n = 23), Black (n = 7), White (n = 65), or other race (n = 9); man (n = 9), woman (n = 58), or gender minority (n = 56); heterosexual (n = 19) or sexual orientation minority (n = 104)). All participants were experiencing elevated depression symptoms (Patient Health Questionnaire‐2 score of ≥2) and endorsed wanting mental health support but being unable to access it. We asked participants an open‐ended question gauging perceived barriers to accessing care (“what has kept you from getting support when you wanted it?”), and a binary item gauging perceived current need for mental health support (“right now, do you feel that you need support for emotional or mental health problems?”). Via thematic analysis of responses to the perceived barriers question, we identified a total of 13 categories of barriers. Across all participants, 42.48% (n = 52) endorsed family‐related barriers and 31.71% (n = 39) endorsed financerelated concerns. We conducted Chi‐square analyses, examining rates of endorsing specific barriers as a function of (a) perceived current support need and (b) demographic variables (e.g. race/ethnicity, gender). In the current study, all adolescents endorsed similar categories of treatment access barriers, regardless of race/ethnicity, gender, sexual orientation, and level of depression. Implications for increasing mental healthcare access for adolescents with elevated depression symptoms are discussed.

The goal of the present study was to better understand adolescents’ beliefs about what causes depression and how these beliefs relate to other clinical constructs. This study explored the causal beliefs about depression held by a diverse sample of U.S. adolescents with elevated depression symptoms ( N = 281; 55% White non-Hispanic; 53% cisgender girl; 78% LGBQ*). Qualitative methods were used to identify causal beliefs from open-ended survey responses. Quantitative methods compared the perceived causes of one’s own depression versus others’ depression, compared causal beliefs across groups, and measured the association between causal beliefs and additional clinical constructs. The most common causal beliefs were dysfunctional home and family relationships (52%) and stress from school (42%). Several causal beliefs were expressed more in regard to one’s own depression than others’ depression (e.g., adverse childhood events, 11% vs. 3%, p = .004) and vice versa (e.g., social media use, 12% vs. 2%, p < .001). Few significant relationships emerged between causal beliefs and demographic and clinical variables. Adolescents’ causal beliefs about depression are diverse and multifaceted, and their causal beliefs endorsed about their own depression differ substantially from those endorsed about depression generally. However, associations between adolescents’ causal beliefs and clinical variables appear limited.

Objective: The COVID-19 pandemic has simultaneously exacerbated mental health concerns among college students and made it more challenging for many students to access mental health support. However, little is known about the extent of mental health support loss among college students, or which students have lost support. Participants: 415 undergraduate students who reported receiving mental health support prior to the pandemic participated. Methods: Students completed an online questionnaire between March and May of 2020. Researchers examined the extent of support loss and how support loss differed by demographic and mental health variables. Methods pre-registered at https://osf.io/m83hz. Results: 62% of respondents reported loss of mental health support. Loss of support was associated with more severe depressive symptoms (p < .001), more severe anxiety symptoms (p < .001), suicidal ideation (p < .001), and sexual minority identity (p = .017). Conclusions: Loss of support was common, especially among more vulnerable students.