Children’s Mental Health in the US: Notes from a Recent Arrival

I had been planning this move for a long time. And then it finally happened. My wife and I packed our bags, three children, and made our way to the United States.

Anyone who has moved countries with children knows this already: no matter how prepared you think you are, the transition is hard. New routines. New schools. New expectations. The supermarket is so different. Everything feels slightly off-balance, but also exciting.

What I didn’t expect was how quickly everyday moments would begin to reveal something deeper about how children and families are supported here. And from my view, how child mental health challenges are formed.

What follows is not an indictment. It is a set of observations that slowly accumulated, until they formed a question I could no longer ignore: why does supporting children’s mental health sometimes feel so effortful in the US, even when everyone involved is clearly well-intentioned?

Polite Language, Absent Responsibility

One of the first moments that stayed with me was a short conversation about my teen’s math placement test. I asked, quite simply, what content the exam would include, so my child could prepare. The response I received was calm, respectful, and firm: the content doesn’t really matter. What matters is his current level.

This was said a week before the test. During summer time.

What made the exchange unsettling was not the tone, but the assumption behind it. Other children taking the same test already knew what to expect. They had learned the material within the system. My child, coming from another country, had not. Preparation, in this context, was not about pressure. It was about orientation. What remained mostly unspoken were the future implications, as if this placement is not truly relevant to anything.

I began to notice this pattern. Advice is often framed as preference rather than guidance. Decisions are presented without a sense of downstream consequences. Responsibility dissolves into politeness.

The Missing Social Unit

Another difference revealed itself more slowly: the absence of a stable social unit.

From middle school onward, children do not seem to belong to a “class” in any meaningful sense. They move continuously, from subject to subject, room to room, teacher to teacher. There is extensive discourse around respect, equity, and inclusion at the declarative level. But there is remarkably little structured attention to the actual social life of the group. Well, there isn’t any group.

There is only one recess in school. Little time for unstructured interaction. Almost no shared space in which conflicts, alliances, exclusions, or misunderstandings can be noticed and worked through together. Even birthdays celebrations after school, small but symbolically important social events, are treated as entirely private matters, with no shared norms to prevent children from being left out.

Belonging feels fragmented. And fragmentation is rarely neutral for children.

School Ends, and So Does Community

In other countries I’ve visited or lived in, school does not end when the bell rings. Children flow, almost frictionlessly, into after-school frameworks that preserve the social group: sports, activities, shared spaces populated by the same peers.

Here, everything fragments again. Soccer here. Basketball there. Each child transported individually (or with few friends). Social continuity becomes another parental responsibility, rather than a property of the system.

Community has to be actively constructed, or it disappears.

When Equity Requires Parental Time

Parental involvement is explicitly required for a child to succeed.

Homework, projects, preparation between school days – these are often impossible to manage without significant adult support. Equity is not only about access to opportunity, but about protection from failure. A system that assumes time, energy, and cognitive bandwidth at home will inevitably widen gaps between families who can provide those resources and those who cannot.

Equity, in practice, begins with ensuring that most learning happens within school walls.

Therapy without Nuance

Coming from systems where therapist training is long, centralized, and highly standardized, I was unprepared for how difficult it would be to find deeply trained child therapists.

If you are looking for manualized treatment, CBT for anxiety or depression, you will likely find someone, at list at a private clinic. But once you are looking for something more subtle, emotion regulation through embodied play, relational repair through shared challenge, therapy that moves outside the room, the options narrow quickly.

This is not about dedication. Many therapists are caring and hardworking. It is about training depth, supervision culture, and what the system is designed to produce.

A Necessary Caveat

None of this diminishes the professionalism of teachers, counselors, and school staff. On the contrary, I was hugely impressed by how much effort and thoughtfulness they put into caring and helping their students, much more than other countries I've visited. The tailoring and sensitivity I have seen at the individual level is very impressive.

What feels misaligned is not intention, but infrastructure.

And infrastructure, more than attitude, shapes children’s mental health.

Be well,

Amit