“Being a Girl Has Become a Public Health Problem!”: Feminist Organizations Both Resisting and Reproducing Postfeminist Mental Health Discourses

ABSTRACT

An apparent decline in youth mental health in the Nordic countries has received a lot of attention over the last decade, and young women have been described as a particularly vulnerable group. To combat the problem, political debate has centred on solutions at the individual level, despite significant evidence of the associations between structural factors and adverse mental health. In this article, I explore how two feminist support organizations working for young women in Sweden (tjejjourer) frame and address girls’ mental health as a problem of feminist concern. Interviews with staff, organizational documents, websites, social media, and other communications were analysed following Snow and Benford’s theory on collective action frames, to identify the organizations’ problem diagnoses, solutions, and motivational frames for action. The results show that the organizations both reiterate and resist a postfeminist discourse on mental health. There is notable friction between structural problem diagnoses, based on intersectional analyses of power, and political demands and support oriented towards the individual. In conclusion, I argue that this friction may be a result of the organizations’ adoption of discourses on risk, vulnerability, and mental health itself, but also that the complex relationship between structural critique and individual care is indispensable for feminist organizing.

KEYWORDS:

• Youth mental health
• postfeminism
• feminist organizations
• young women
• social movements

Introduction

Corresponding to an international trend, numerous reports show that mental health is on the decline in Sweden, especially among young people (e.g. Hagquist et al., 2019). Within this group, girls and young women are overrepresented, in particular regarding stress, anxiety, and depression (Public Health Agency of Sweden, 2022). While much research shows connections between structural factors and mental health problems (Alegría et al., 2023), the political discourse around (youth) mental health has been criticized for centring on the individual, aiming to support her own responsibility and ability to “get better” (Brunila et al., 2020; Callegari & Levander, 2019; Teghtsoonian, 2009).

In contrast to this individualizing response to the decline in youth mental health, many young women’s support centres in Sweden (YWSC, tjejjourer) seek to offer an alternative framework. The YWSC movement has its roots in the feminist shelter movement in Sweden and offers (chat) support to girls and young women. The YWSCs seek to help victims of gender-based violence, but they also welcome support-seekers with other questions or concerns, for example, regarding eating disorders, stress, or family situation. While they have always been concerned with girls’ wellbeing, youth mental health has recently become a topic of explicit concern for many YWSCs.

In this article, I analyse how two selected YWSCs approach and describe youth mental health in relation to their organizational aims and feminist ideology, with the overall objective of discussing the possibilities and challenges of making young women’s mental health and wellbeing the focus of feminist organizing. How is girls’ and young women’s adverse mental health framed and addressed as a social problem of feminist concern by the two centres? What discourses on mental health, girlhood, and wellbeing are utilized, and what are the potential effects of these problem representations? The analysis is based on interviews with staff at the two YWSCs, alongside an analysis of websites, educational material, debate articles, and organizational strategy documents.

Introducing the Young Women’s Support Centres

There are approximately 60 girls’ and girls’ and trans youth support centres in Sweden, spread across the country. Many are connected to local women’s shelters, and most are members of one of the two national networks for women’s shelters. Their target group is adolescent girls and young women, sometimes including transgender youth, and their main activity is anonymous, online chat support, based on feminist principles of empowerment, safety, and egalitarianism (cf. Bäckström Olofsson & Goicolea, 2023). The YWSCs are non-profit organizations, and their support is mainly offered on a volunteer basis, although many receive some funding from public authorities and private sponsors.

Professional and lay digital support for young people is a growing phenomenon both within and outside of Sweden (Löfberg & Aspán, 2011). In the field of youth mental health, chat-based support is primarily offered by civil society by a growing number of organizations (Swedish eHealth Agency, 2021). Proponents highlight the benefits of online support to a young target group, such as increased control and availability (see e.g. Navarro et al., 2019). However, the rising interest in digital technologies in healthcare, e.g. to improve youth mental health, has been problematized as related to welfare cutbacks and as contributing to the individualization of health matters (Fullagar et al., 2017; Maturo et al., 2016). The provision of online counselling to young people by civil society in Sweden should therefore also be considered in relation to recognized problems with long waiting lists for accessing child and adolescent psychiatry (Swedish Ministry of Health and Social Affairs, 2021).

Gender Perspectives on Youth Mental Health

There are significant gender differences in mental health status among young people. In a Swedish national survey from 2022, 37% of female respondents aged 16–29 years stated that they had problems with stress, compared to 17% of men in the same age span. Similarly, 21% of the young women declared feelings of fatigue or melancholy, compared to 12% of the male respondents (Public Health Agency of Sweden, 2022). Men and boys, on the other hand, are overrepresented when it comes to neuropsychiatric diagnoses, attempted suicide, and suicide (Swedish Gender Equality Agency, 2021). These gender differences are in turn influenced by other factors, such as finances, migration background, employment, family situation, and physical health status (Alegría et al., 2023; Public Health Agency of Sweden, 2022).

When attempting to explain the gender differences in mental health, some researchers refer to biological causes, such as hormones (e.g. Garza & Jovanovic, 2017), while others stress the role of gendered norms, expectations in relation to diagnoses, and material and social differences in women’s and men’s life conditions (Strömbäck et al., 2014; Wiklund, 2010). A large body of research has also demonstrated a link between young women’s exposure to violence and adverse mental health (e.g. Moulding et al., 2021; Zetterström Dahlqvist & Gillander Gådin, 2018).

However, a feminist analysis of girls’ and young women’s overrepresentation among those experiencing mental ill health is seldom at the forefront of public debate. In their analysis of the Swedish political discourse on youth mental health, Callegari and Levander (2019) demonstrate a notable shift in how the problem has been presented in policy over the last three decades. Where an image of the socially disadvantaged boy dominated the debate during the 1990s, the vulnerable girl is now the paradigmatic figure of youth mental health problems. Concurrent with this shift, structural understandings of mental health have largely disappeared from the political agenda, and mental ill-health has been reconceptualized into a result of the individual child’s lack of coping skills. Where policy previously stressed the responsibility of society to tackle and prevent the problem, the solutions presented over the last two decades have focused on developing individual resilience through empowerment and psychoeducation (Callegari & Levander, 2019). A similar individualization has been shown to dominate discourses on (youth) mental health in other Western contexts (Brunila et al., 2020; Teghtsoonian, 2009).

Hence, girls’ and young women’s mental health problems may be highly visible and discussed, but they have become visible in concurrence with the rise of a neoliberal political hegemony, which makes it difficult to voice structural explanations for social problems (Callegari & Levander, 2019; Dubriwny, 2012; Shute, 2018). Neoliberalism is understood here as the “political, economic, and social arrangements within society that emphasize market relations, re-tasking the role of the state, and individual responsibility” (Springer et al., 2016, p. 2). Through discourses of “responsibilisation”, social risks are transformed into individual matters of self-care (Lemke, 2001), positioning the affective lives of individuals at the centre of public debate and policy (Scharff, 2016b). The YWSCs, as civil society organizations offering a form of peer counselling that aims to enhance girls’ wellbeing, make an interesting example of civic responses to neoliberal politics, entangled as they are in both its “psychic life” (Scharff, 2016b) and the transferral of resources from public to private sectors (for an overview of the impact of neoliberalism in Swedish politics, see Skyrman et al., 2022). In addition, their work is complicated by the conflict-laden relationship between feminism and therapy.

The Feminist Turn to Therapy—An Ambivalent Reading

Feminist organizing around women’s and girls’ wellbeing has a long history, ranging from feminist therapy and consciousness-raising groups to women’s health advocacy and the feminist shelter movement. These movements share an emphasis on the consequences of structural injustices and gendered violence for individual women’s and girls’ wellbeing, and a demand for personal support that takes the social context into account (Dubriwny, 2012; Pálmadóttir, 2018).

The relationship between the feminist support developed in women’s shelters, consciousness-raising groups, feminist therapy, and conventional counselling and therapeutic language is, however, complex and much debated (Becker, 2005; Rutherford, 2018). Girlhood researchers have shown that girls and young women are central figures in contemporary discourses on declining wellbeing, presented as girls “in crisis” or “at risk” (Aapola et al., 2005; Gonick, 2006), but also as ideal neoliberal subjects, not least given long-standing cultural expectations on women for self-improvement (Scharff, 2016a). The political and media culture is characterized by a concomitant postfeminist sensibility, a form of gendered neoliberalism (Gill, 2017), which privileges (women’s) individual self-development and makes it difficult to voice criticisms of structural inequality. In such a context, feminist discourses on empowerment easily lend themselves to the individualization of social problems (Aapola et al., 2005; Banet-Weiser, 2015). Likewise, critiques of consciousness-raising groups and feminist therapy have identified the blurred lines between feminist notions of empowerment and popular therapeutic culture, which prioritizes individual development and neglects collective work for change (Becker, 2005; Illouz, 2007; Pálmadóttir, 2018). The feminist turn to therapy, as expressed in the phenomenon of “feminist counselling”, has also been criticized for favouring the experiences of middle-class, white women, by assuming that all women are able to talk about their personal lives, and benefit from doing so (Becker, 2005; Thelandersson, 2023).

The intention of exploring two YWSCs’ “turn to mental health” in this article is not, however, to demonstrate an apparent depoliticization of the feminist (YWSC) movement in Sweden. I take my lead from Katie Wright (2008), who argues for more ambivalent readings of the insistent popularity of therapeutic culture. Since the mid-20^th century, scholars following both conservative and Marxist and Foucauldian lines of thought have warned against the dangers of the rising interest in psychology, connecting it to moral decline, the individualization of social problems, and new modes of governing (Furedi, 2004; Lasch, 1979; Rose, 1990). While these critiques highlight important questions, Wright argues that the discourse on suffering, vulnerability, and emotions cannot only be seen as a personalization of the political. By destabilizing a gender-blind division between public and private, reason and emotion, the therapeutic turn should also be recognized as potentially a politicization of the personal (Wright, 2008). Similarly, vulnerability has been described as a potentially subversive starting point for (feminist) political action, based on the recognition that human receptivity to harm is fundamentally tied to our relationality and ability to also give and receive care (Shildrick, 2002).

Method

Analysing the Construction of Social Problems

The analysis is based on a social-constructivist recognition of social problems, not as given entities, but as products of hegemonic cultural narratives, discursive struggles over meaning, and material conditions (McLeod & Wright, 2015). Social problems must be “produced” by the actors aiming to combat them, in order to make the advocates’ diagnoses, prognoses, and solutions intelligible and possible to communicate (Loseke, 2003). When produced by social movements, such narratives, what Benford and Snow (2000) call collective action frames, typically present a counter-narrative to the dominant problem definition (see e.g. Lehrner & Allen, 2008). According to Benford and Snow’s (2000) seminal work on collective action frames within social movements, diagnostic frames describe (and “produce”) the social problem and assign blame. Prognostic frames describe what needs to be done to remedy the problem, and motivational frames are the narratives intended to spur people to action (Loseke, 2003). Using this theoretical outlook, below I trace and discuss the different diagnostic, prognostic, and motivational frames that permeate the selected YWSCs’ production of young women’s and girls’ mental health as a social problem.

Selection Procedure and Material

After an initial review of the YWSC movement and the attention given to “girls’ mental health” in their external communications, two YWSCs were selected for analysis based on their explicit addressing of the issue. Their problem representations should therefore not be considered fully representative of all YWSCs, as not all approach girls’ wellbeing in terms of mental health. The selected centres enable however an analysis of how mental health problems can be addressed from a feminist perspective and the challenges this may entail, also for the movement as a whole.

The centres studied are the YWSCs Alicia and Billie (both pseudonyms). Both have a nationwide target group (anyone who identifies as a girl), but they are located in different parts of the country. Compared to many YWSCs, both are relatively professionalized. Alicia has four employees, around 90 volunteers, 4000 support contacts per year, and is financed primarily by the regional council. Alicia’s main form of support is the anonymous one-to-one chat, available several nights per week. Billie has 14 employees and approximately 300 volunteers working its chat channel, which is available daily. Both organizations also offer more long-term contacts, where a young girl is paired with an older volunteer for regular meetings, online or offline.

Table 1 above provides an overview of the material analysed from each organization. All the material was read thoroughly, with a focus on the organizations’ problem diagnoses, suggested solutions, and motivational frames for action.

Table 1. Overview of material

YWSC Alicia	YWSC Billie
Four interviews with staff	One interview with staff
Organisation website	Organisation website
Instagram and Facebook publications	Instagram and Facebook publications
Three written reports based on questionnaires distributed to young women, 2020–2022	Two debate articles
Statutes, organisational strategy, and annual reports 2020–2022	Statutes, organisational strategy, and annual reports 2020–2022
One recorded lecture for professional audiences (1 hr)
Participant observation of digital training of new volunteers (14 hrs)

Ethical Considerations and Data Collection

The four interviews with Alicia’s staff were conducted using video conferencing during February and March 2021, as part of the data collection for a broader study of the YWSC movement. This also included observations of Alicia’s digital two-day training of new volunteers in September 2022. The interview with the employee from Billie was conducted digitally in March 2023. All the interviews were conducted in Swedish and lasted 30–70 minutes. Considering the small number of staff, both the organizations and participants are anonymized, and selected details about the organizations have been left out to ensure confidentiality. The study has been approved by the Swedish Ethical Review Authority (2020–06371) and all participants have given their consent to be part of the study.

Results

When asked to define what social problems their organizations mainly work with, participants from both centres referred to young women’s general lack of wellbeing and mental health. “The core of it is that being a young girl today, or being a girl or young woman, has become a public health problem”, said one of Alicia’s employees.

Because even though girls normally perform very well throughout life and with jobs and education and so on, they’re not feeling well. They face extreme demands and performance anxiety, and there is also a vulnerability. To abuse, which is very common, but if to that you add social vulnerability and racism and violence at home … All that makes it a really bad precondition to be a girl today. (Employee, Alicia)

The fact that girls “are not feeling well” was also described as the core issue by the participant from the YWSC Billie.

It’s maybe this thing with mental ill health and how it affects girls to a large extent, to a greater degree than boys. And what consequences that has for their life situation. The term mental ill health contains so many different things. There’s violence, being exposed to violence, but there’s also being stressed over school, things that happen in school or in the family, or other things. (Employee, Billie)

Answering the question “Why does your organization exist?” Billie motivates its work on its website like this: “More and more girls feel mentally unwell. It is a growing societal problem where girls are the ones reporting the highest level of stress and anxiety”. In its statutes, Billie states that its primary objective is to work preventively to strengthen the mental health of the target group, through direct support and advocacy work. Alicia does not mention the term mental health in its statutes but has put improving girls’ mental health at the centre of several long-term goals in its organizational strategy.

While describing girls’ lack of wellbeing as the main, overarching problem, girls’ mental ill health is also repeatedly presented as a consequence of other issues, often related to gendered and intersectional inequalities, presenting girlhood as a state of structural vulnerability.

Mental Health Problems and Girls’ Structural Vulnerability

While several participants were hesitant to pinpoint what type of experiences that girls generally have in common, recognizing the heterogeneity of girlhood (e.g. Bäckström Olofsson & Goicolea, 2023), two diagnostic frames are nevertheless stressed as key dimensions of girls’ heightened vulnerability and as causes of girls’ declining mental health: girls’ exposure to violence and performance-related mental ill-health among young women and girls.

Girls as (Potential) Victims of Gendered Violence

On its website, as well as in the interviews and training of new volunteers, the YWSC Alicia emphasizes that girls face a threat of gender-based violence and describes the experience of violence as a substantial cause of many girls’ declining wellbeing. During the training, almost one full day was spent on the topic. Based on research and their own experiences from the chat support, the trainers informed the new members about different expressions of gendered violence, possible consequences of violence, early signs of violence, and what often characterizes violence in young people’s relationships. This information is also communicated to Alicia’s support-seekers via its external channels. In the training of new volunteers, girls were described as a group at higher risk of being exposed and boys as the most likely aggressors, but it was also stressed that violence can occur in same-sex relationships and, referring to an intersectional analysis, that certain groups (e.g. migrant women) may be particularly vulnerable due to structural inequalities.

The YWSC Billie does not pay as much attention to gender-based violence in its external communications. In its annual reports, however, it mentions exposure to violence as a common topic in the chats, and the interviewed employee described it as a contributing factor to girls’ lack of wellbeing. In an article available on Billie’s website, an employee comments on the gender difference in youth mental health, stating that:

It’s difficult to say exactly what is behind those numbers, but I think girls feel worse partly because they are more vulnerable considering stress, press, appearance, and how they are affected by social media. Girls are also to a higher degree exposed to sexual abuse. (Website, Billie)

Gendered Norms and Performance-Related Mental Ill Health

Apart from violence, Alicia and Billie both emphasize high demands on young people, for example in school and working life, as well as gendered norms, body ideals, and social media as contributing to girls’ adverse mental health. In particular, a perceived pressure to achieve in education is described as one of the main causes of stress and anxiety:

[T]he anxiety to perform may be connected to a feeling of having to succeed in school since it determines your future. Getting into high school, or getting good grades there to get into university, is one of the most central issues at this age. (Report, Alicia)

Several interviewees from Alicia also described the job market and a culture of individualism as contributing to girls’ lack of wellbeing:

We ask how things are proceeding, not how you’re feeling. And there’s too much focus on career and performance instead of the human […]. I think that’s a result of a general change in society. It’s “me” before “us” all the time. (Employee, Alicia)

Apart from pressure to perform well in school or university, external demands related to social media and physical appearance are frequently mentioned as key factors in girls’ declining mental health. When asked to reflect upon the gender differences in mental health among young people, the participant from Billie first mentioned school, and then added: “Social media of course, affects girls in a different way than boys […] and you’re also, to a different extent, subjected to abuse on social media.”

Girls’ Adverse Mental Health as a Problem for—or of—Society

By making a connection between mental health, gendered violence, and gendered norms, Alicia—and, to some extent, Billie—joins the feminist problematizations of mental health as a private matter, offering a counter-narrative to discourses that focus on the individual, or seek to explain the gender gap with reference to biology. In that sense, their diagnostic frames align with gender-theoretical research on young women’s mental health, understanding this as (often) an effect of an individual embodiment or the internalization of structural subordination and gendered norms (Shute, 2018; Strömbäck et al., 2014; Wiklund, 2010) or exposure to violence (Zetterström Dahlqvist & Gillander Gådin, 2018).

While both YWSCs refer to societal factors related to girls’ lack of wellbeing and mental health, there is a discernible tension between two versions of this relationship in the material. On the one hand, girls’ adverse mental health is described as a societal problem because it has structural, societal causes, such as gender inequality, job-market conditions, or related to the school system. On the other hand, young women’s mental ill health is framed as a societal problem because of its effects for society, and for the individual and her prospering and ability to contribute to societal development. Highlighting the negative societal effects of girls’ mental ill health can be described as a motivational frame and is discernible in both YWSCs’ communications.

In an interview with an employee published on Billie’s website, the representative asserts that “youth mental ill health is a societal problem”, because “if you are having problems and don’t get support it may be difficult to find the right place and deal with the stressors of life”. But “if you enter society with the feeling that it is possible to get through a crisis with support around you, you will be able to handle future obstacles in a completely different way”.

A similar perspective was presented by the interviewee from Billie. In the long run, she argued, young women’s mental ill health will have negative consequences for gender equality:

I think that mental ill health, it’s a feminist issue and it’s about gender equality and equality from a longer perspective […]. What are the consequences for a society, where one group is affected by mental ill health to the extent that girls are, and what does that do, not only to the individual, but from a societal perspective? […] Girls’ voices are not heard in the same way, and that makes us divert [attention] from the gender equality goals, basically. (Employee, Billie)

The quote from one of Alicia’s reports, above, referring to girls’ performance-related stress, continues with an exhortation to adults to “consider what it means to develop mental ill health related to one’s performance and main occupation”. Like the respondent from Billie, Alicia’s report highlights the difficulties for young women with mental health problems to contribute fully to society and lead good lives: “The youth of today will carry this with them into their future adult and working life, and hence be less equipped for a sustainable life with good life conditions” (Report, Alicia).

The examples above, referring to the importance of girls’ ability to “handle future obstacles” and “deal with the stressors of life” illustrate some of the YWSC’s oscillation between both problematizing and reiterating postfeminist notions of girls as responsible, “ideal” neoliberal subjects, working on themselves and their futures (Scharff, 2016a). Societal demands for performance are problematized, but the possibility that “at risk-girls” will not become contributing citizens is simultaneously described as worrisome (cf. Gonick, 2006).

Frames for Action: Raising Awareness, Demanding Recognition

Alicia and Billie also engage in outreach work for adult audiences, aiming to increase knowledge about young people’s problems. For example, Alicia offers live lectures for different audiences meeting young people, such as teachers or social workers. On its website, it promotes its training, on topics such as young people’s life conditions and mental health, writing: “We want to help adults in getting better at understanding and meeting young people where they are, and giving adults the tools needed to succeed with this!”. As the employee quoted below explains, Alicia’s outreach work is dedicated to enhancing knowledge, rather than political advocacy.

In one way, we want to form public opinion, but I usually describe our work more as awareness-raising and rights-promoting. Because I think forming opinion is one thing, but if you want decision-makers and adults on board, you must also be inclusive and welcoming, to not induce resistance towards what you’re trying to do. […] I think that [what we do] is more about increasing knowledge among adults, about our target group. (Employee, Alicia)

Increasing knowledge further entails a request for the adult world to recognize girls’ situation and listen to them.

We must listen to the young person and start off in that person’s preconditions and needs to be able to reduce the psychological suffering and ill health. We can’t start off with the adults’ way of identifying and solving problems, since adults have no idea what being young is like today. (Report, Alicia)

On its webpage, Billie describes its vision as “a society where the human right to be listened to is respected”, also emphasizing the importance of “being seen and validated”.

We have an unwavering belief in the strength of young girls, and their ability to help themselves. We recognise how important being seen and validated is to mental health. (Website, Billie)

Alicia’s stress on “starting off” in the girls’ own stories bears similarities to feminist standpoint epistemology, assuming that social change is best achieved by starting from the standpoint of the unprivileged, as this will give us a unique understanding of the oppressive system (cf. Hekman, 1997). The quote from Billie suggests a slightly different understanding of the importance of listening. Here, being listened to is understood as emancipating in itself, arguably a more “therapeutic” perspective on the value of “telling your story” and being heard. These slightly different perspectives, between which both YWSCs slide, brings to mind the disputed meaning of feminist empowerment and consciousness-raising. Without denying the psychological value of narrating your story and being heard, such practices of individual empowerment can, as commented by Becker (2005), easily leave the societal context, “the oppressive system”, to the side.

The two quotes further illustrate how a critique of structural inequalities becomes renegotiated along the way into a more moderate position, invoking a language of recognition, similar to that of youth mental health policy (Callegari & Levander, 2019). For example, in one of its reports, Alicia notes a number of external stressors for young people, but in the following call for action, it refers to the need for listening adults to enhance girls’ resilience:

Having to worry about household finances, to afford to stay in your home, whether you will get a job in the future or even get into university, is something a lot of young people must now do, which previous generations did not have to think about. We adults need to be there, we need to work preventively to combat the effects of mental ill health and meet our youth in this moment. (Report, Alicia)

When asked during the interviews what they thought is needed on a societal level, the participants primarily referred to the current lack of adult support and the inaccessibility of healthcare:

[What is needed is] more support in the form, well support that’s available for young people, school counsellors and such. And maybe more […] arenas for girls where they can speak about specific problems they have and experiences. (Employee, Alicia)

In some municipalities it may be, for example, opening hours at the youth clinics, age limits at youth clinics [… .]. We work a lot with the ability to seek healthcare as a young person […] without their parents having to participate or approve. (Employee, Alicia)

Similarly, the YWSC Billie has advocated in several debate articles for psychoeducational programmes in schools, as a way to improve youth mental health and strengthen teachers’ ability to support young people. The emphasis on girls’ “ability to help themselves”, yet assumed need for therapeutic and preventive interventions, resembles the affinity between what Gonick (2006) has described as two seemingly opposite, yet entangled, contemporary discourses on girlhood; girls are either understood as competent can-do girls, or as vulnerable, risking to fail in reaching their full potential. When framing the solution as more listening adults, this easily reads as a request for someone that can help “release” this inner potential.

“We Want to Make Noise, but Not be Confrontational”

The YWSCs’ mode of external communication is also relevant for understanding how they construe girls’ mental health as a social problem. If the YWSC’s focus on the effects of mental health problems for the individual and her societal contributions can be related to the “psychic life of neoliberalism” (Scharff, 2016b), this theme brings its potential effects on organization to the fore.

In this regard, Billie and Alicia can both be described as oriented towards cooperation rather than conflict, seeking to establish collaborations and getting adults to listen, more than presenting potentially provocative feminist claims. As the employee from Alicia put it, they seek to be “inclusive and welcoming”, because they have found this strategy the most effective. They want to “make noise, but not be confrontational”, as another participant from Alicia said.

Both organizations also seem to downplay much of their feminist problem analyses in their external communications. Most notably, Billie does not describe itself as a feminist organization on its website or in organizational documents. The interviewee from Billie confirmed, however, that it is a feminist organization, and motivated this with their membership in one of the networks for women’s shelters.

Alicia states clearly on its website and in its statutes that it is a feminist organization. Several respondents stated, however, that they may downplay these perspectives in their external work.

We’re now talking about a training session, digital, that will reach the whole region, and how should we market that so that as many as possible will join? That’s also a difficulty. How much should we clearly state the fact that we’re a feminist association, should we leave it out? So, of course, you need to do … Make some adjustments. (Employee, Alicia)

Participants from both organizations also had the perception that their organization had become “less” feminist in recent years. The participant from Alicia connected this primarily to an increasing professionalization and expansion, leading to less internal work with “gatherings and the feminist [safe] space”. The interviewee from Billie saw the shift as related to Billie’s current focus on girls’ mental health:

From the beginning, I think it may have been more about girls making their voices heard, taking up space, and some kind of justice perspective. Now, we also include these questions about mental health in the organisation […]. [Before] it was maybe partly about mental health, but it was about girls claiming part of society and taking up space, that girls and boys were treated differently and that that was unfair.

“But for me”, she continued, “these [two perspectives] are very much related”, because, she said, mental health problems will negatively affect your ability to take part in society.

Taken together, these statements point to the difficult task of the YWSCs in delivering feminist-informed peer support in a context that is both discursively (mental health) and materially (a transferral of resources and responsibility from the state to civil society) characterized by neoliberal rationalities. Dependent on external funding and wanting to “reach out”, they seemingly need to downplay their critical analyses and “justice perspectives” to not “confront” the apolitical mental health discourse and postfeminist common sense (Gill, 2017) (too much).

Support, Not Treatment? YWSCs Negotiating Their Relationship to Therapy

The feminist shelter movement has traditionally distanced itself from the logic of psychological treatment, problematizing the supposition that a victim of violence needs “fixing” (Helmersson, 2017). The studied YWSCs, however, describe themselves as different from therapy rather in terms of expertise and roles; a notable stance considering the disputed relationship between feminism and psychology (Rutherford, 2018). The studied YWSCs want to offer another – complementary – form of support, often described as a first step to seeking further help: “Sooner or later, you need to switch, I think, to more organized forms of therapy, if therapy is what’s needed” (Employee, Alicia). Several participants referred to the low threshold characterizing their anonymous chat and their availability compared to the child and adolescence psychiatry. “We’re the first line before the first line”, said one of Alicia’s employees. Their support is described (particularly by Alicia) as unique because it is based on a feminist recognition of the structural causes of girls’ lack of wellbeing. But there is no corresponding critique of psychiatry or therapy as a phenomenon in the material. When criticisms against psychological settings are raised, this rather concerns the availability and quality of professional help.

YWSCs as Similar to and Borrowing from Psychology

While describing themselves as different from therapy, there are also elements of both YWSCs’ support that are akin to practices found within psychology. Referring to its long-term support offer, where support-seekers receive a personal contact with whom they chat once a week, the participant from Billie likened this to psychotherapy:

It’s a good alternative, because a large part of our target group doesn’t have the opportunity to receive care from the public, since the queues are way too long […] So this conversational support is really close to being a psychotherapeutic support for them.

Alicia offers extensive information about mental health problems on its website. For example, in a section called “Stress”, Alicia writes about societal demands, social media, and school-related stress. The texts are characterized by a supportive tone and state that feelings of stress are common, especially among girls. They also note that stress can be an effect of exposure to violence and contend that stress is connected to a gender-unequal society.

In addition to putting the problems in a social context, Alicia’s website provides information about what happens in the body when you are stressed, why resting is important, how one can seek help, and how the reader can provide support to a friend. Similar information is provided regarding e.g. anxiety, self-harm, eating disorders, suicidal thoughts, gender dysphoria, and addiction. Alicia also provides a collection of CBT-exercises to be used if one experiences stress, anxiety, panic attacks, or sleeping difficulties.

Alicia’s ambition to communicate a feminist-informed understanding of mental health problems seems to stand at the intersection of consciousness-raising practices, conventional mental health education, and CBT-based therapy; aiming to support its young audience with knowledge about mental health and what she can do to feel better, while simultaneously stressing that she is not to blame. This arguably creates a tension between frames—the feminist recognition that the personal is political—and postfeminist discourses on mental health problems, oriented towards individual responsibility and care of the self (cf. Callegari & Levander, 2019). At the same time, this tension appears to be mediated and enabled by the already intimate relationship between feminist notions of empowerment and therapy (Rutherford, 2018). Unlike a more traditional psychoeducational model, however, Alicia’s aim is not, it seems, to disseminate “objective” knowledge about mental health problems (cf. Fullagar et al., 2017; Maturo et al., 2016) but (also) to encourage critical awareness of structural injustice and the limits of individual responsibility among its supporters and support-seekers.

Concluding Discussion

The aim of this article has been to analyse how two YWSCs, as part of the Swedish feminist movement, frame and address young women’s and girls’ mental health problems, and to discuss the possible challenges of making mental health a feminist issue. The latter question has been explored against the backdrop of a long-standing tension in feminism between individual-level support, therapy, and empowerment on the one hand and political work for structural change on the other, but also considering the current postfeminist and individualizing discourse on youth mental health. The results demonstrate a notable friction between structural diagnostic frames and individual-level solutions, oriented towards recognition, raising awareness, and improving individual support and resilience. This has several implications.

Both organizations are committed to putting girls’ and young women’s wellbeing on the agenda and emphasize girls’ precarious life conditions. When structural causes to girls’ distress are recognized, intersectionality and differences in girls’ vulnerability are often highlighted, in particular by Alicia, in their internal communication. But the emphasis on mental health itself and its negative effects for the individual arguably overshadows a comprehensive address of such structural differences. Furthermore, both YWSCs tend to use a framework of vulnerability and risk when describing their target group, for example when describing girlhood as a “public health problem”. While this narrative is closely connected to their emphasis on structural inequality as a cause of emotional distress, it is telling that participants from both organizations described the main problem of concern as girls’ general lack of wellbeing; not the inequalities themselves. While well-intended, this framing of the problem easily directs attention towards the level of effects, thereby locating the problem within the “vulnerable group” itself (cf. Aapola et al., 2005). I suggest that this emphasis on girlhood as a state of vulnerability and a “risk factor” is one of the causes of the YWSCs’ oscillation between structural problem diagnoses and individualizing solutions.

While starting in a recognition of vulnerability might foster a more caring and relational subjectivity, in opposition to the self-made and untouchable man of late modernity (cf. Shildrick, 2002), it’s critical potential is easily disarmed when paired with a therapeutic setting. As argued by Alison Cole (2016), if the language of vulnerability is not embedded in a framework of social justice, its political reach easily becomes limited to demands for recognition and visibility. As critiques of the language of “risk groups” in public health have pointed out, describing an uneven distribution of wellbeing in terms of vulnerable populations—rather than structural injustices—tends to obscure power hierarchies and direct responsibility towards the “at risk” groups themselves to better manage their vulnerable state (Olofsson et al., 2014). Responses are easily directed towards enhancing the vulnerable group’s feeling of empowerment, rather than their actual power (cf. Becker, 2005). The affinity between vulnerability and a politics of recognition is for example demonstrated by the two YWSCs’ focus on adults’ responsibility to learn about girls’ life conditions. Both stress that it is important for adults to listen to girls and acknowledge their situation, but they make few concrete political suggestions (other than greater availability of adolescence psychiatry).

Youth mental health is high on the political agenda and, in contrast to gender-based violence and feminism, it is rarely considered provocative (McLeod & Wright, 2015). Despite extensive evidence on the correlations between structural inequalities and (mental) health problems, health and wellbeing have become terms associated with the individual and “care of the self” (cf. Shute, 2018). When, or if, the YWSCs frame their aim as “combatting girls’ mental health problems”, or “supporting girls’ wellbeing”—without a clear counter-narrative to the dominant apolitical discourse—I conclude that they risk reiterating, rather than resisting, the current individualization of the problem. Despite internal awareness of structural inequalities and feminist problem analyses, many of the studied YWSCs’ aims and activities—including their political requests—seem centred around strengthening individual girls’ resilience to external pressure, partially reproducing an image of the “ideal neoliberal girl subject”, taking responsibility for her own future. Their adoption of self-help tools and language from psychology adds to this impression. The organizations’ tendency to downplay their feminist perspectives in external communications also calls for more research on the role of civil society organizations in the mental health field; for example, considering the economic preconditions for their work and the risk of co-optation.

Reading the YWSCs’ support as depoliticizing in itself, however, would be to simplify feminism’s complex relationship to the personal. Questioning the division between emotion and reason, private and public, is arguably one of feminism’s core features and contributions. The YWSCs’ attention to girls’ wellbeing can rightly be placed within a longstanding feminist tradition of care for both self and others. As such, the movement as a whole could both benefit from and contribute with new insights to the ongoing conversations about the relationship between feminism, vulnerability, and therapeutic culture. Despite the risks of individualization addressed here, feminist-informed support and a “critical mental health education” might also carry the potential of reworking the meaning of therapy and wellbeing, by also redirecting the support-seeker’s attention away from her own responsibility; helping by putting her feelings in context.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The work was supported by the Department of Epidemiology and Global Health and the Medical Faculty, Umeå University.

Notes on contributors

Hanna Bäckström Olofsson

Hanna Bäckström Olofsson holds a PhD in Gender Studies, and is working as a Research Fellow in Public Health at Umeå University, Sweden. Her research interests concerns social work in civil society, gender-based violence, and social movements.