“Tell my wife I love her.”
The last words spoken by an Italian pensioner isolated in the ICU early in the COVID-19 pandemic echo the anguish and loss of families and children the world over. With global fatalities surpassing the one million mark and total cases nearing 36 million, we are living through the biggest shared psychological distress since the Second World War.
The uncertainty, isolation and loss around COVID-19 are profoundly impacting children everywhere. Over the last six months, parents, teachers, and childcare providers around the world have asked so much of our children: to stay home, to wait, to wash their hands and wear masks and be brave in the face of never-ending uncertainty.
None of these pressures comes without consequences — all of them together could impact the social and emotional development and well-being of an entire generation.
But in our darkest moments, we often find light. The decades that followed the second world war saw the start of an unprecedented period of innovation and collaboration. The child survival revolution, an effort led by UNICEF along with other organizations, brought global access to vaccines, oral rehydration, safe water and improved nutrition to many poorer nations, driving a five-fold decrease in child mortality within a few decades.
In the same spirit of cooperation and given the extraordinary burden on children today, we need a similar effort for mental health. We must begin to prioritize children’s mental health and well-being by demanding greater investment.
Why we need a revolution
While the coronavirus pandemic has highlighted structural violence, racism, poverty and humanitarian crises as significant risk factors for child and adolescent mental health, the topic remains largely taboo. Most countries have never had a national conversation around mental health, while related services are still significantly underfunded in almost every country, rich or poor. People seeking help face stigma and often struggle to access basic mental health services and care. In Africa there is one mental health professional for every 100,000 people.
We urgently need investment in child mental health especially in fragile and humanitarian contexts.
Recent research from the World Health Organization and the Centers for Disease Control and Prevention underscores how distress in childhood through neglect, abuse or chaotic parenting create toxic stress. When left unaddressed this can derail healthy emotional development. Evidence-based early parenting programmes and psychosocial approaches in schools, so that children feel safe and soothed, can aid recovery and resilience.
Digital connectivity is one of the essentials for learning in the 21st century. But this has, along with social media, transformed the emotional landscape of children. As the pandemic arrived, policymakers, parents and schools were ill-prepared for how this had already changed children — their relationships, daily habits and well-being. We need robust measures to manage the risks for children online and strengthen the potential of safe digital access to support children.
We urgently need investment in child mental health especially in fragile and humanitarian contexts. Not only because it is a human rights imperative but also because it brings us closer to achieving economic and social development goals.
The time has come
This World Mental Health Day, UNICEF is calling for increased investment in mental health and psychosocial support services (MHPSS) for children, especially in low- and middle-income countries.
We are calling for family-centred support that promotes healthy family relationships, caregiver well-being and increased investment in schools and communities to ensure that every child, particularly those suffering distress at home, feel safe, connected and soothed.
We also call for increased investment in MHPSS in humanitarian emergencies and greater attention to protecting children from the negative mental health impacts of the digital world.
Now is the time to break that silence and build the political will and public commitment to invest in the best possible mental health and psychosocial well-being outcomes from the earliest stages of childhood and throughout life.
As the authors of this blog, we declare a personal interest. We both come from experiences where the issue of mental health is impossible to sweep away. One from a country ravaged by conflict and the other from a state care children’s home. Perhaps like many in UNICEF, our backgrounds probably inspire our work even more than we know. For us, the cost of inaction on child mental health is seen up close and is personal. Often the risks to emotional well-being are invisible and undiscussed, but they are present everywhere, making this an often silent emergency that affects everyone, everywhere in some way.
Benjamin Perks is Head of Campaigns and Advocacy at UNICEF.
Zeinab Hijazi is the Mental Health and Psychosocial Support Specialist at UNICEF.