Over recent years, there have been increasing societal, political and media concerns in relation to the ‘over-diagnosis’ and ‘self-diagnosis’ of common mental health conditions or emotional disorders, such as depression and anxiety. Using two large research projects as illustrative examples, we highlight that there is a mismatch between concern about ‘over-pathologising’ young people’s mental health and the recognition and diagnosis of emotional mental health conditions in health and care settings. Concerns around labelling risks us losing a shared understanding and language around mental health and mental health care, within services, between sectors, and for young people and families.