In the face of the COVID pandemic, social and academic pressures, and an uncertain future, young people are struggling. Each week we see another news reports about a “mental health crisis” among youth in North America, including rising suicide rates. Last fall, a consortium of physicians declared poor youth mental health a “national emergency.” More recently, on December 7, 2021, the U.S. Surgeon General issued an advisory on Protecting Youth Mental Health, which prescribes actions by families, schools, governments, media and other stakeholders. Typically, these announcements call for getting kids greater access to mental health diagnosis and treatment. As MIA readers know, that frequently leads to more screening, more labels, and more prescriptions for psychiatric drugs. In his practice with children and adolescents, his research, and his teaching, Dr. Elia Abi-Jaoude is pushing back on that approach in favor of alternatives that more closely involve families and take environmental elements into account. Here, he tell us why and shares how he works in his practice with youth in crisis. Elia Abi-Jaoude, MD, FRCP(C) is a psychiatrist working mainly with children, adolescents, and their families at The Hospital for Sick Children in Toronto, Canada, primarily in an inpatient setting. He is also an assistant professor, researcher, and clinical educator at the University of Toronto. Dr. Abi-Jaoude is interested in how social factors influence how we view the experiences of youth and in asking critical questions about some of psychiatry’s assumptions about diagnosis and treatment, particularly the influence of the pharmaceutical industry. He is coauthor of a journal article taking a second look at the research behind the famous Study 329, which found that certain psychiatric drugs did not improve teenagers’ depression symptoms better than no drugs, as had been claimed.