Rising rates of depression, anxiety, and chronic school absenteeism suggest that many young people are struggling. While the Covid-19 pandemic intensified the crisis, these troubling trends were already underway. After working with more than 1,000 children as a clinical psychologist, Dr. Ross W. Greene argues that these issues are best understood not simply as disorders, but as distress signals.
Like infants who cry when they’re hungry or uncomfortable, children communicate emotional strain through behavior. The key, he says, is to ask what is driving that distress.
In his book, The Kids Who Aren’t Okay, Greene points to sweeping societal shifts that have made childhood more complicated. Among them:
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School shootings: Since the 1999 massacre at Columbine High School, there have been more than 400 school shootings in the U.S., creating an ongoing atmosphere of fear for students and educators.
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High-stakes testing: Uniform academic benchmarks often fail to account for developmental differences, while tying teacher evaluations to test scores increases pressure on classrooms. Greene suggests measuring growth from each child’s starting point instead.
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Social media and smartphones: While sometimes dismissed as distractions, excessive use has been linked to declining mental health, exposing children to mature and often troubling content at younger ages.
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A shortage of mental health providers: In many regions, children face long waiting lists for care, and those in crisis can spend days or even weeks in emergency rooms without proper treatment.
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Political polarization: The nation’s deeply divided climate filters down to children, who absorb the tension around them.
Greene echoes psychiatrist Thomas Szasz’s 1960s argument that mental illness can often be viewed as “problems in living.” Diagnoses may describe symptoms, but they rarely explain the root causes. Reframing children’s struggles this way shifts the focus toward identifying — and solving — the underlying problems.
While large societal forces are beyond any one parent’s control, caregivers can address everyday stressors in a child’s life, including bullying, academic challenges, family conflicts over screen time or sleep, and unresolved learning difficulties.
Greene advocates for a collaborative model of problem-solving. Rather than imposing unilateral decisions, adults should involve children in developing solutions. Kids are more invested in plans they help create, and collaboration strengthens trust and communication.
He also urges parents to be proactive rather than reactive, addressing predictable challenges before they escalate. Instead of concentrating on behaviors such as defiance or withdrawal, adults should focus on the problems driving those responses.
Punishments and rewards, Greene argues, are motivational tools — not long-term solutions for depression, anxiety, suicidal thoughts, or chronic absenteeism. Most children want to do well. What they need is not more pressure, but understanding and partnership.
After decades of working with families, Greene says power-and-control parenting often backfires, especially for children who are already struggling. If traditional strategies aren’t working, he advises, it’s time to try something different — centered on empathy, listening, and shared problem-solving.
Dr. Greene previously served on the faculty at Harvard Medical School for more than 20 years. He is currently an adjunct professor at Virginia Tech and at University of Technology Sydney.
