Understanding Mental Health: The Bootstraps of a Generation

The Changing Landscape of Mental Health

A recent article in The Globe and Mail described the experience of a young woman in her twenties living in Fredericton. She earns just under $50,000 a year, which she considers reasonable for her location. However, approximately $500 each month goes toward therapy and medication related to her mental health. She explained that without these supports, she struggles with sleeping, eating properly, and functioning well enough to work. For her, mental health care is not an optional expense; it is essential for maintaining her everyday life.

What intrigued me was her observation about the difference between her generation and previous ones. Older generations often encouraged the idea of pulling oneself up by the bootstraps. For her and her peers, therapy and medication have become the bootstraps of their generation. This simple observation raises important questions about our understanding of mental health, resilience, and personal responsibility.

Are younger people genuinely experiencing more mental health difficulties than previous generations? Or are they simply more willing to recognize those difficulties and seek help? Are the circumstances in which young adults begin their working lives different enough to expect a different experience of stress? Most importantly, what does it signify when more people view professional mental health support as essential for functioning? These questions are complex, and I suspect there is no single answer. Several factors may be at play simultaneously.

The Positive Systems Approach

One central idea of the Positive Systems Approach is that human behavior and emotional well-being do not develop in isolation. Individuals continuously interact with the systems around them. These systems include family relationships, friendships, schools, workplaces, communities, physical environments, economic circumstances, and the broader social environment. Biological and developmental factors also play a role, as do personal history, temperament, coping skills, and previous experiences.

When someone experiences anxiety, depression, emotional dysregulation, or another mental health difficulty, our natural tendency is often to look inward. We may ask what diagnosis best describes the difficulty, what treatment might be appropriate, or whether medication or psychotherapy could help. While these are important questions, they only provide part of the picture.

The Positive Systems Approach encourages us to widen our lens and become curious about what is happening around the individual. What pressures exist in their environment? What relationships can provide support? How predictable is their daily life? Are there opportunities for meaningful activity and social connection? Is the workplace supportive or stressful? Are financial pressures creating persistent uncertainty? Are there family or community resources that could help but are currently unavailable?

None of these questions suggest that the individual has no responsibility for their well-being. Instead, they recognize that individual responsibility operates within a larger context. The ability to cope with stress depends partly on the skills and resources a person brings to a situation. However, it also depends on the demands placed upon them and the resources available in their environment.

Resilience and Support Systems

This is why I am cautious when I hear discussions suggesting that younger generations have simply become less resilient. Some young people may struggle with coping skills, emotional regulation, or tolerance for frustration, just as people have at every point in history. However, we should be careful about assuming that an increased willingness to seek help represents a reduction in resilience. In fact, it may indicate the opposite.

Previous generations faced anxiety, depression, trauma, and relationship difficulties, but the language used to describe these experiences was often different. Many families and communities pressured individuals to keep emotional difficulties private. Seeking psychological help could be associated with stigma or the belief that one should manage their problems independently. A young adult's willingness to say, “I am struggling and I need help,” may represent a significant shift in our understanding of mental health. It does not necessarily mean that younger people are less capable of coping. Instead, it may indicate that they are more comfortable recognizing when their existing coping strategies are insufficient.

At the same time, it would be overly simplistic to conclude that nothing has changed except our willingness to talk about mental health.

The Broader Context of Young Adults' Lives

The broader environment in which many young adults begin their adult lives is also different in significant ways. Housing costs have risen substantially in many communities, and the cost of everyday necessities has placed additional pressure on household budgets. Student debt complicates financial independence, and employment can be uncertain, especially for those trying to establish themselves early in their careers.

These circumstances do not affect everyone equally, and many young adults navigate these challenges successfully. However, they represent part of the environmental context in which development and adult functioning occur.

From a systems perspective, chronic background stress can influence many aspects of functioning. A person uncertain about their living situation, financial stability, or job security may carry a cognitive and emotional load invisible to others. This does not mean that financial difficulties inevitably lead to mental health disorders, nor does it explain every instance of psychological distress. It is simply one factor among many that can influence how a person experiences the world.

This becomes particularly interesting when we consider two individuals with similar personal characteristics but living in different circumstances. Both may be intelligent, motivated, and psychologically healthy. Yet, one may have stable housing, supportive relationships, predictable employment, and a sense of financial security, while the other may face uncertainty in several areas simultaneously.

We could ask which person has better coping skills, but the Positive Systems Approach encourages us to ask another question: what is each person's environment asking them to cope with?

The Importance of Context in Mental Health

This distinction has been crucial throughout my clinical work. When we focus exclusively on the individual, it can be tempting to assume that the solution must also reside entirely within that individual. We teach coping skills, recommend strategies for managing anxiety, prescribe medication when appropriate, or provide psychotherapy. All these interventions can be valuable. However, sometimes the difficulty is maintained by external factors. Unless we understand the broader context, we may find ourselves repeatedly treating the consequences without fully grasping the conditions contributing to them.

The Globe and Mail article also raised concerns about how some employee benefit plans provide significantly greater coverage for medication than for psychotherapy or psychological services. The reasons for this difference are complex, and medication and psychotherapy are not interchangeable forms of treatment. For some, medication may be essential for maintaining psychological stability. For others, psychotherapy may be particularly helpful in developing coping strategies, understanding behavior patterns, working through difficult experiences, improving relationships, and learning to respond differently to stress.

The systems issue is not whether medication or psychotherapy is the “right” approach. It is whether people have access to the combination of supports appropriate for their circumstances.

The Interconnected Nature of Mental Health

Mental health rarely rests on a single intervention. Just as physical health is influenced by many interconnected factors, psychological well-being is often supported by a network of relationships, routines, activities, skills, and environmental conditions. Sleep, nutrition, physical activity, social connection, meaningful work, financial stability, relationships, recreation, and access to appropriate professional care all contribute to a person's ability to remain psychologically well.

The young woman described in the article seemed to recognize this herself. Alongside therapy and medication, she spoke about maintaining a healthy diet, caring for her pet, and structuring her life to help her remain balanced. These details may seem ordinary, but they illustrate something we sometimes overlook when discussing mental health. Stability is often created by many small and interconnected supports rather than by a single treatment.

Rethinking Resilience

This is where our understanding of resilience deserves reconsideration. Resilience is sometimes described as an individual's capacity to withstand adversity and continue functioning despite difficult circumstances. There is certainly a place for developing personal coping skills, emotional regulation, problem-solving abilities, and confidence. However, resilience does not necessarily mean doing everything alone.

Children are often more resilient when they have supportive adults around them. Students tend to manage challenges more successfully when schools provide predictable environments and meaningful relationships. Adults facing difficult circumstances frequently cope better when they have emotional or practical support. In each of these situations, resilience is partly an individual characteristic but is also supported by the systems in which the person lives.

This is why I would hesitate to describe therapy or medication as evidence that someone is not resilient. For some, accessing professional support may represent a thoughtful recognition of what they need to function well. Knowing when to seek assistance can itself be an important coping skill.

We should also be cautious not to assume that every increase in mental health treatment represents an increase in psychological health. Greater openness about mental health is generally positive, but there is another possibility worth considering. If family connections, community relationships, workplace supports, and other informal sources of support become less available, professional mental health services may increasingly fill roles that once belonged to the broader social environment.

In this case, the growth in mental health care may reflect not only individual needs but also the systems surrounding them. This distinction changes the questions we ask. Instead of simply asking, “Why are so many young people struggling?” we might also ask, “What is happening in the environments where young people are trying to establish their lives?”

The Complexity of Mental Health

This question does not imply that society is responsible for every difficulty an individual experiences. Nor does it mean that psychological disorders are merely products of social circumstances. Mental health is influenced by biology, development, personality, relationships, life experiences, and many other factors. A systems perspective does not attempt to replace one simple explanation with another. It seeks to recognize the complexity that already exists.

Perhaps this is why the idea of therapy and medication as the “bootstraps” of a generation is so intriguing. It suggests that our understanding of coping may be evolving.

Throughout my career, I have seen how easily we can fall into the habit of looking for the problem within the individual. When a child behaves in a concerning way, we may ask what is wrong with them. When an adult struggles emotionally, we may ask what disorder they have or what treatment they require. While these questions can be clinically useful, they can also narrow our perspective if they become the only questions we ask.

The Positive Systems Approach encourages a different starting point. We still examine the individual, including strengths, developmental factors, coping skills, communication, and individual needs. Simultaneously, we assess the systems surrounding that person and consider how relationships, routines, expectations, environments, and available supports may influence what we observe.

Sometimes, the most meaningful change comes from helping the individual develop a new skill. Other times, it comes from changing the environment in which that skill is expected to be used. Often, it comes from doing both. This perspective helps us move away from the idea that resilience is something people either possess or lack. Resilience can be strengthened by supportive relationships, meaningful experiences, opportunities for success, predictable environments, effective coping skills, and access to appropriate assistance. In other words, resilience itself can be understood as something that develops within a system.

A New Understanding of Personal Responsibility

Perhaps, then, the generational conversation about “bootstraps” needs reconsideration. The issue may not be that one generation believed in personal responsibility while another has abandoned it. Instead, we may be developing a more complete understanding of what personal responsibility looks like. Taking responsibility for one's mental health can include learning coping skills, seeking professional help, taking medication when appropriate, maintaining healthy routines, developing supportive relationships, and recognizing when circumstances need to change.

It can also mean acknowledging that people do not create their lives entirely on their own. Families, workplaces, schools, communities, health-care systems, and public policies all contribute to the environments in which people attempt to function. Some systems facilitate healthy coping, while others can make it considerably more challenging. When we understand this, the goal of mental health care expands beyond helping individuals manage symptoms. It also encompasses creating conditions that allow people to develop and maintain well-being.

This does not mean we can create a world without stress, anxiety, disappointment, or psychological difficulty. We cannot—and perhaps we should not try. Struggle is part of being human, and learning to navigate adversity is crucial for development.

What we can do, however, is pay greater attention to the conditions in which that development occurs. If young adults increasingly turn to therapy and medication as essential supports, perhaps the most useful response is neither to criticize them for doing so nor to assume that every difficulty reflects a societal failure. Instead, we might become curious about what their experiences reveal about the interaction between individuals and the systems around them.

The young woman in the Globe and Mail article may have made a practical observation when she described therapy and medication as her generation's bootstraps. Perhaps she was highlighting an evolving understanding that maintaining psychological well-being sometimes requires support, just as maintaining physical health often does.

The Positive Systems Approach takes that idea further. It reminds us that those supports do not have to come solely from professional services. They can arise from relationships, families, workplaces, communities, meaningful activities, predictable routines, healthy environments, personal strengths, and the many other systems that surround us.

Conclusion: Building Supportive Environments

In the end, perhaps resilience is not solely about how strongly an individual can pull themselves upward when life becomes difficult. It may also involve whether something solid exists beneath them from which they can begin to stand. This perspective offers hope. Instead of asking only how we can make individuals stronger, we can also ask how we can create families, workplaces, communities, and systems that facilitate healthy functioning.

We may never eliminate the need for personal resilience or professional mental health care. However, we can create environments where people do not have to be exceptionally strong simply to remain well.

In this journey, we can embrace the Positive Systems Approach, recognizing that we are all part of a larger tapestry of support and understanding. Together, we can foster environments that nurture resilience and well-being for everyone.