I already raised this on my blog before: when we talk about the increase in mental health problems among young people, these seem to be rising mainly among children from more advantaged backgrounds. At the same time, it remains true, as it has for decades, that young people from lower socioeconomic backgrounds are on average more vulnerable. That may sound contradictory, but it actually isn’t. It mainly depends on what exactly you are looking at.
Levels versus trends
If you take a snapshot, little changes in the classic picture. Young people from families with fewer resources report more mental health problems on average. That finding is robust and well supported. But if you look at developments over time rather than levels, you start to see something else. In some studies, mental health problems have increased more quickly among young people from higher socioeconomic groups. Not because they are suddenly worse off than other groups, but because their numbers are rising faster. As a result, especially during the pandemic, social inequalities in mental health became smaller, although those inequalities may well increase again after the pandemic.
That difference between levels and developments matters. The first tells you who is worse off. The second tells you where change is happening. If you mix those up, you risk drawing the wrong conclusions.
A question of visibility
And then there is something else. More advantaged groups often have better access to care, diagnosis and the language to express what they are experiencing. That makes problems more visible. In other groups, similar problems may remain underreported or unnoticed for longer. So part of what appears to be an increase may also be a matter of visibility.
What you then get is not a simple story of an “elite problem”, but a more layered picture. On the one hand, there is a persistent inequality. On the other hand, there are shifts in how mental health problems evolve across groups.
Is inequality the driver?
What is sometimes put forward as an explanation is inequality itself. The idea is that growing income inequality leads to more mental health problems among young people.
But when you test that idea more strictly, it turns out to be less convincing. A recent large-scale, preregistered study by Nilsen and colleagues, involving more than half a million Norwegian adolescents, did not examine differences between regions but rather changes within municipalities over time. The reasoning is straightforward: if inequality really is a cause, then increases in inequality should go hand in hand with increases in mental health problems.
That was hardly the case. The study found no meaningful association between changes in income inequality and depressive symptoms among young people. Small differences were sometimes statistically visible, but practically negligible. That does not mean that regions with more inequality do not have higher average levels of problems, but it does mean that changes in inequality do not explain those developments well. Also noteworthy: differences between boys and girls, where a small effect did appear, as is often the case to the disadvantage of girls, remained limited.
A note of caution is needed here. This does not mean that context does not matter. Norway, for instance, is not the United States. But it does raise questions about the idea that inequality is by definition the main driver behind the recent increase in mental health problems. Once again, the story is less straightforward.
Holding both perspectives
If you bring these two insights together, a more interesting picture emerges. Yes, social differences remain important. Young people in more vulnerable situations have more problems on average. But the recent increases cannot be reduced to that classic gap. And broader macro-level explanations, such as income inequality, appear to be less predictive than is often assumed.
To be clear, this is not a myth-busting post. It does not mean that earlier insights are wrong, but that they become incomplete once you look at change rather than at a snapshot. Anyone who wants to understand what is happening with young people today will have to accept that the story is both social and broader at the same time. That there is no single factor that explains everything. And that nuance here is not a weakness, but a necessary condition if you want to avoid missing the point.