It is well recognized that many psychiatric disorders are strongly influenced by cultural and social factors. Foucault's account of the modern development links together 'madness', psychiatry and the asylum. We pick up the story at the point Foucault left it, the mid-twentieth century, to examine cultural and social processes that are reshaping concepts, discourse and practices - the 'social imaginary' - around mental health, with particular reference to the apparent rise in mental health problems among the young. We conclude that this apparent rise may reflect cultural and social changes in representations of mental health. In addition, over recent decades there have been increasingly evident fractures in social solidarity, interacting with and exacerbating specific socio-political-economic-environmental stressors on younger generations, including increasing intergenerational wealth inequalities and accelerating environmental concerns.