Blaming overdiagnosis fails to confront the deeper causes of children’s distress

An upcoming UK review1 into the possible “overdiagnosis” of mental health and neurodevelopmental conditions in children risks overshadowing another crisis: a generation being made ill by deprivation. As a paediatrician and inequality researcher in some of the UK’s most deprived areas, I see children whose health is deteriorating through poor living conditions and lack of support.2 I meet teenagers whose anxiety began when food ran out at home, children whose “behaviour problems” followed yet another move into temporary accommodation, and young people unable to sleep after years of community violence or racial bullying. Their distress is not mysterious; it maps directly onto their lives. Yet public discussion of the “youth mental health crisis” often treats these problems as if they arise de novo, detached from the material and political conditions of young people’s lives.3 Children from more materially advantaged backgrounds are also experiencing rising distress linked to academic pressure, performance culture, social media, and wider uncertainty about the future.4 Declining mental health is not confined to any one group, but its burden is unequal. Social and economic disadvantage still shapes who …