Rethinking child mental health diagnoses amid social and cultural shifts

As debates grow over child mental health diagnoses, experts call for a re-evaluation of social, cultural, and medical factors shaping perceptions and treatment, highlighting potential risks of overdiagnosis and stigma.

Child mental health is now a subject of public debate not only after shocking incidents, such as a child suicide or serious violence by young people, but also because modern life places a premium on traits that schools, employers and institutions reward. According to Anica Mikuš Kos, a child psychiatrist and philanthropist whose essay appeared in Mladina, those traits include strong cognitive ability, social skills, quick responses, adaptability and resilience, all of which are increasingly linked to social success and self-image.

Mikuš Kos argues that the growing use of mental health labels reflects more than a rise in distress. She says children are increasingly assessed against demanding social and institutional standards, while shifts in family life, digital habits, consumer culture and weaker social ties all feed the sense that more children are falling outside the norm. The result, she suggests, is that more children are being classified as having mental disorders even when their differences may also be understood as variations in temperament, pace or style.

Her central point is that the boundary between health and disorder is not fixed. Diagnostic systems change over time, and what counts as a disorder depends heavily on professional agreement and social values. The article points to ADHD as an example: in the US, the CDC says about 7 million children aged 3 to 17 have ever been diagnosed with the condition, while a review in the National Library of Medicine says around 10% of US children have received a clinical diagnosis. Mikuš Kos notes that changes in criteria can widen the pool of children who qualify for a label.

The debate is not only about classification but also about meaning and consequence. Mikuš Kos says diagnosis can protect children from punishment, unlock support in school and make sense of behaviour that otherwise looks like failure or defiance. It can also help parents understand their child better and reduce guilt, while schools may find it easier to frame difficulties as medical rather than educational or social. For many families, she argues, the label can bring relief and practical help.

But diagnosis can also carry costs. Mikuš Kos warns that children may internalise stigma, see themselves as deficient and become less willing to participate fully in school or later work. She argues that labels can also let education systems avoid harder questions about teaching methods, classroom pressure and the treatment of children who learn or behave differently. In her view, the wider social effect is to reinforce a narrow ideal of the successful, psychologically intact child.

Research cited in the related material shows why ADHD has become such a contested diagnosis. The CDC says treatment often includes medication and behavioural therapy, but access and use vary. A review in the National Library of Medicine says accurate diagnosis matters because both under- and over-identification can harm children. A Cato Institute commentary argues that subjective criteria and financial incentives may be driving overdiagnosis, while a Penn State study found white children were especially likely to be overdiagnosed and overtreated in elementary school. Separate research on four US communities found medication was often not paired with broader psychosocial or school-based support.

Mikuš Kos does not dismiss medicine. She says it remains essential for children whose difficulties stem from brain injury, neurological illness or other physical causes. But she argues that most current labels, interventions and preventive strategies need rethinking. Rather than expanding diagnosis alone, she calls for more attention to the social conditions shaping child development, stronger support in families and schools, greater acceptance of diversity and a broader role for mental health professions in protecting children’s wellbeing as a whole.