Not only do I have a dim view of the efficacy of mental health interventions in general and see pretty much zero evidence they have done anything positive in the last quarter century, scholastic mental health seems particularly devoid of evidence-based medicine, and involves a lot more of people just winging it. There's perverse incentives by parents (who get more government support, or preferential treatment for their children) and schools (who get more funding, and lower standards in examinations). There is also a systemic bias towards deterministically blaming children's permanent unchanging nature without actual concrete proof this is the case, because that absolves the school and parents of any blame or responsibility for failure or disappointment. Diagnosis's made based on subjective criteria once during a child's development by a single practitioner are treated as ironclad lifelong unquestionable truths and prophecies.
Children are told from early childhood that people who act a certain way are mentally ill, are delayed behind others, are disordered. They are not told neutrally or positively some medial terms that describe their true selves, look into the diagnostic criteria's used, they are resoundingly negative and frequently use words like "Defect" and "Dysfunction". Why pathologize people so? Well because it's politically necessary if you're going to show favouritism towards this group of people with tax breaks, government support, social leeway, insurance coverage, and so on. Then as more and more resources allocated to these people, we discover the children we haven't allocated resources to are struggling. Whatever child is struggling most is clearly just a person with unidentified mental illness, and once they've identified or self-identified as such, they may as well buy into the system since they already are facing the stigma. The support they get is nominally evidence-based but often the intervention was often tested on a very different child in very different circumstances than who is getting the treatment (if at all), even if they're diagnosed with the same pathology.
I see the biggest fundamental problems being out of control pathologization, and the usual absence of any up-to-date objective measurement of the value of mental health interventions (except in this case).
1: https://www.amazon.com/Bad-Therapy-Kids-Arent-Growing/dp/059...
