In large parts of the world, prevention is considered a necessary component of a successful youth care practice. Time and again, pundits have pushed for prevention, the earlier the better. But an inconvenient truth is that together with the rise of prevention over the past decades, the prevalence of several mental health problems and stress in youths has also increased. In order to explain this paradox—and to resolve it—we need to critically reflect on different interpretations of mental health trends in youths and on how prevention is being operationalized. In this keynote, I critically reflect on the often-held perspective that youth mental health is deteriorating, and put forward a contrasting notion; that as a society we’ve developed a more encompassing view of what constitutes psychopathology, clinical-level mental health problems, and severe stress. In line with this ‘darker view’ of youth mental health, youth prevention in our changing society has developed into a screen-and-resolve kind of ‘troubleshooting’ approach, rather than as an approach that supports the development of good health, competence, and resilience.