Ask a teenager to discuss what it means to be mentally healthy with their peers.
Would you have thought to have defined it as having “grit,” or “golden retriever energy?”
Associate Professor Theda Rose, PhD, MSW
Those are just some of the insights a focus group of ninth through 12th graders from a Baltimore City Public School shared with University of Maryland, Baltimore researchers. Their voices add valuable perspectives on adolescent mental health.
Led by University of Maryland School of Social Work (UMSSW) Associate Professor Theda Rose, PhD, MSW, this research was published in the November 2024 edition of Youth & Society.
It was co-authored by UMSSW alumnae Judith Leitch, PhD ’17, LCSW, assistant professor at California State University, Sacramento; Patrice Forrester, PhD ’21, LCSW-C, and Ariya Hayes-Lawson, LMSW ’24.
The research was part of a larger project for Rose that explored how to define and assess mental health among adolescents. One takeaway so far is that defining and measuring mental health is a complex process that is often problem-focused and minimally considers well-being.
Rose sat down for a Q-and-A about what she learned from these Baltimore teens. The interview has been edited and condensed for clarity.
Most research on mental health is based on what adults think. Your study focused on teens’ own views. Why does that matter?
Theda Rose: Adolescents are the best reporters of their thoughts and their feelings. They’re the ones who can tell us what’s going on with them. My experience working with them directly for years confirms this.
We as adults tend to project onto them what we think is best, which is valid — we gain insights from experience, scholarly knowledge, and research — but their perspectives and lived experiences are unique to them. If we don’t hear from them, we’re missing a big piece of the conversation.
Even though definitions of mental health have evolved over time, they’re still largely adult-driven. Most of the widely accepted definitions of mental health were developed by adults. Applying those definitions to adolescents without collaborating with them risks misalignment. That misalignment can affect how we develop programs, services, and interventions.
It’s important to give young people opportunities to lead conversations around mental health to ensure that we have a stronger foundation for designing services and programs.
Your study found that teens don’t see mental health as something you either have or don’t have. Can you explain how they described it instead?
Theda Rose: We asked them to describe mental health and being mentally healthy separately. Some teens described mental health as neutral, while others gave more conventional definitions, that were problem-based. But when they discussed what it means to be mentally healthy, they saw it as a dynamic state. They used more positive descriptions and framed it as a range of emotions that fluctuate over time.
One of the quotes was, “It’s healthy to be sad sometimes, and mad sometimes.” In other words, mental health isn’t just about being happy all the time — it includes a full spectrum of emotions. They normalized that fluctuation, seeing it as a natural part of life.
Many teens in the study said being mentally healthy means having confidence and staying strong through tough times. What stood out to you the most about how they defined it?
Their use of the word "grit." That was interesting to me because grit is a concept we often associate with sports, but they consistently applied it to mental health. One participant described mentally healthy as having "golden retriever energy" — a persistent optimism.
They saw mentally healthy as tied to perseverance, confidence, and resilience. It wasn’t just about feeling good — it was about the ability to push through difficult experiences. I thought it was interesting to hear that perspective from them about being mentally healthy.
How did teens view the impact of their environment on mental health?
When discussing school and neighborhood environments, an interesting perspective emerged about grit and resilience. Some teens expressed that having fewer resources could make achievement more difficult, but it could also build resilience. One participant put it this way: "I think if you have less resources, you are more likely to be more persistent”
They acknowledged that limited resources presented challenges, but they also believed it fostered a sense of determination. This perspective was interesting because it highlighted a different way that they looked at economic disadvantage — not just as a barrier but also as a potential driver of perseverance.
That connects to a quote from a participant who said, "Some people from the suburbs can go downhill because they always had everything handed to them. They don’t know responsibility because their parents did everything for them. So the people who don’t really have it are going to try harder because they have responsibilities."
Theda Rose: Exactly. They saw responsibility and perseverance as crucial traits. It was enlightening to hear them articulate that not having resources didn’t mean they couldn’t succeed. Instead, they viewed it as an added challenge they had to navigate, reinforcing their sense of grit.
One participant distinguished between being mentally healthy and mentally stable. Can you explain that distinction?
Theda Rose: That was an insightful discussion. I never introduced the term "mentally stable" — it came up organically in their conversation. They debated whether someone who appeared fine on the outside but was struggling internally could be considered mentally healthy. One participant concluded that such a person might be "mentally stable" but not truly mentally healthy. This highlighted the importance of acknowledging internal struggles rather than just outward appearances. And also emphasized their nuanced and sophisticated understanding of what mental health means to them.
What advice would you give to teachers or mental health professionals working with teens?
Theda Rose: Youth can contribute ideas about how to focus on intervention components, so they are more relevant to their lived experiences. This can be for schools and mental health professionals. Schools can implement universal wide interventions to support positive mental health based on youths’ conceptualizations. For more targeted services screening can be for problem symptoms as well as wellbeing, so both reduction of symptoms and improvement of emotional and psychological wellbeing can be addressed.
Outside of the article they also mention wanting more tailored guidance to the unique needs of the student, as some interventions have come across as generic.
How can parents and families help nurture those positive aspects of mental health?
Theda Rose: Families can open doors of communication with youth about mental health to normalize the conversation. Both listening to youth’s perspectives and sharing their own including how they have dealt with mental health challenges would be a good start.
One way to engage youth may be asking what good mental health looks like to them (which somewhat mirrors what we did in the study) and talking about ways to foster good mental health based on their response.
Looking at your broader research, are you seeing major themes emerging about teen mental health?
Theda Rose: Across multiple studies, a recurring theme is that teens have a strong sense of self-awareness. They understand their needs and challenges, and they consider how their mental health impacts their future. They also exhibit a sense of perseverance, whether we call it grit, resilience, or coping skills. My takeaway is that we have a responsibility to help them strengthen this inner resilience while also addressing any challenges they face.