Why Youth Mental Health Calls for More Than Clinics

By Maya Lakshman

More and more conversations are happening about expanding access to mental health care. But what if some of the most effective supports for youth already exist—just not in places we would typically describe as clinical? Maybe they look like a shared rhythm in a dance studio, a quiet sketch passed between friends, or a circle of teens snapping after a poem. This is what we call “creative belonging”: the power of self-expression in collective, culturally grounded spaces that help young people feel seen, safe, and real.

Youth in America are not just struggling—they’re reaching a crisis point. Between 2011 and 2021, the number of high school students reporting persistent sadness or hopelessness soared to 42%, the highest in 30 years (Verlenden, 2023). For LGBTQ+ youth, students of color, and those facing poverty or violence, the numbers are even more staggering (CDC, 2023). In response, many programs and policy efforts have focused on scaling up clinical services: expanding telehealth, hiring more school-based therapists, and investing in mental health first aid. These efforts matter—but they don’t reach everyone. And they can overlook the social, cultural, and developmental needs that shape how young people actually experience mental health. Importantly, they often miss the perspectives of youth themselves, who consistently say they want safe, affirming spaces as much as clinical ones (Meherali et al., 2025).

One of those needs is belonging—not as a vague social ideal, but as a biologically grounded necessity. Belonging is the sense that you matter and are safe in a space. It may help buffer the effects of trauma (König et al., 2023, improve school engagement (Allen & Boyle, 2022), and support resilience through adversity (Bethell et al., 2019; Torgerson et al., 2018). When young people feel they belong, they are better equipped to cope, grow, and thrive. Yet for many adolescents, especially those navigating racism, homophobia, or systemic instability, the absence of safe and affirming spaces can deepen distress (Sapiro & Ward, 2019). For example, when a queer teen is bullied at school and has no access to supportive peers or mentors, the resulting isolation doesn’t just feel painful—it can worsen mental health. Neuroscience helps explain why: the adolescent brain is highly sensitive to social signals (Somerville, 2013). During adolescence, being accepted by peers activates reward-related regions of the brain, reinforcing feelings of connection and emotional closeness (Fareri & Delgado, 2014; Flores et al., 2018). In contrast, social exclusion activates brain regions involved in emotional distress, including the insula and parts of the anterior cingulate cortex. The more these regions are activated, the more distress teens report feeling (Masten et al., 2018). In other words, belonging isn’t just emotionally important—it’s likely protective. This makes social environments a key determinant of mental health.

For youth already facing structural barriers or cultural stigma, the costs of disconnection are steeper, and the stakes higher. When traditional mental health services feel inaccessible or misaligned with lived experience, young people often seek alternative sources of care—spaces where identity is affirmed and community is built. That’s where creative spaces come in. Far from being extracurricular, these environments can function as mental health infrastructure. In youth theaters, slam poetry collectives, art workshops, and dance groups, young people access many of the same types of supports that therapy aims to provide: safety, regulation, and connection. Programs like Wide Angle Youth Media and Baltimore Youth Arts embody this model of care, reflecting Baltimore’s long history of youth-led arts activism. Similar initiatives exist across the country, from Youth Speaks in San Francisco to Urban Word NYC. They share a commitment to youth leadership, creative process, and collective recognition. In these spaces, teens don’t just develop skills—they make meaning, build identity, and find one another.

The science backs up what educators and youth workers have long known: engaging in creative activity—whether through rhythm, storytelling, movement, or color—activates neural systems involved in emotion regulation, memory, and social bonding. Such experiences have been shown to lower cortisol, a stress hormone; boost oxytocin, which is linked to trust and bonding; and support healthy nervous system activity through what’s called vagal tone, a marker of relaxation and emotional balance (Magsamen & Ross, 2023). Research on youth participatory action research (YPAR) supports this approach. When young people help design and lead creative programs—whether in photography, music, or storytelling—they report higher levels of self-efficacy, cultural pride, and emotional resilience (Lee et al., 2020; Sedillo-Hamann, 2021; Zarobe & Bungay, 2017). Compared to youth in traditional mental health services, participants often feel more connected to their peers and communities.

These outcomes remind us that belonging isn’t just a backdrop to mental health—it is mental health and wellbeing. And creative spaces offer a rare, vital pathway to it. Creative spaces allow for nonverbal processing, co-regulation with others, and the expression of emotion outside the clinical gaze. Yet despite this evidence, creative programs are still treated as “extras”—enrichment rather than care. This framing limits their reach and reinforces inequity, particularly in underfunded schools and communities that can’t sustain them, even when they prove effective.

It’s time to reframe creative belonging as essential infrastructure for youth mental health. Doing so expands the care toolkit: encouraging partnerships between clinicians and community organizations, resourcing culturally affirming programs, and advancing policies that treat joy, safety, and expression as protective factors. Creative belonging may not replace therapy—but for many youth, it’s the first place they turn. And in some cases, it’s the only care available.