Should We Provide Mental Health Support to Kids Who Don't Need It?
In this video, Dr. Justin Baeder discusses Abigail Shrier's argument that universal mental health screening and intervention may actually increase anxiety and distress in children who were doing fine.
Key Takeaways
- Universal screening can create problems - Identifying 'mental health needs' in children who are functioning normally may pathologize normal development
- Shrier's argument deserves consideration - The idea that intervention can cause harm is counterintuitive but supported by evidence
- Target services to those who need them - Intensive mental health support should go to students with genuine needs, not applied to the entire population
Transcript
What if SEL instruction and any other type of mental health support that schools attempt to provide to all students was harmful?
Abigail Schreier has a provocative new book out today called Bad Therapy.
And her argument begins with the idea that all medical care has the risk of harm.
There's what's called iatrogenesis, the idea that when you treat someone, the treatment is not without risk.
And if we're treating people who are healthy, then we risk causing a great deal more harm than if we don't do anything at all and allow treatment to happen outside of school and only for the people who need it.
And that makes a certain amount of sense to me.
I'm not finished with the book.
It just came out today.
But it makes a certain amount of sense to me because, you know, think about Band-Aids.
Like a Band-Aid is great if you get a cut.
It's great to have a Band-Aid to help that heal.
But if you put band-aids all over your body when you don't need them, you're going to get like, you know, skin problems, you know, probably some infections that come from something that's supposed to prevent infection and help you heal.
And certainly that gets even more extreme when the treatment is more severe, right?
Like if you look at any kind of cancer treatment, if you give that cancer treatment to someone who does not have cancer, it is almost certainly going to harm them.
And I think SEL interventions are more on the band-aid end of the spectrum, just to kind of keep things in proportion.
But there's a very real risk that perhaps we are making things worse.
So let me know what you think about this.
I'll keep you posted as I get all the way through the book and have more of a sense of where she's going with this argument.
But I think if we take psychiatry, if we take mental health, if we take counseling, if we take therapy seriously as medical treatment, which I believe it is, then it makes sense to me that that kind of fundamental argument that there is a risk of harm in doing kind of innocuous sounding things to everybody including many kids who are not suffering, then we may be causing harm.
Let me know what you think.