Turning the tide together on mental ill health for children

In some way, mental ill health has touched everyone. The statistics are alarming, and by some accounts constitute a public health emergency. Today, around 10-20 per cent of all children and adolescents suffer from some type of mental health disorder and mental health conditions account for around 16 per cent of the global burden of disease and injury among adolescents. Worldwide depression is among the leading causes of disability among young people and suicides are the third leading cause of death among adolescents worldwide, and the second among 15-19-year-old adolescent girls. Fifty percent of mental health conditions arise before the age of 14, and 75 per cent by the mid-20s.

Given the age-sensitive nature of predictors, early life investment makes good sense. However, globally relatively small sums have been allocated, with an estimate of less than 1 per cent of national health budgets in low-income countries being devoted to mental health. Yet the economic cost of mental health is enormous, amounting to around 4 per cent of GDP. Evidence supports early investment — if left untreated, it is estimated that mental health disorders which emerge before adulthood can impose a health cost 10 times higher than those that emerge later in life.

mental health disorders which emerge before adulthood can impose a health cost 10 times higher than those that emerge later in life.

Emerging evidence indicates that the prevalence of mental ill-health is growing. Issues such as climate change, environmental degradation, unplanned and rapid urbanization, migration, demographic transition, youth unemployment, and technological leaps are implicated. These may have profound impacts on the minds of children and young people. Yet we know very little today about how to manage or harness these changes to improve the mental wellbeing of children.

The 2018 Lancet Commission report compellingly illustrated the value of addressing mental health to advance a number of sustainable development goals. This suggests that effective mental health interventions may be potential development accelerators – with provisions that lead to progress across multiple SDGs. In the context of shrinking fiscal space, this makes it a highly desirable area of investment.

© UNICEF/UN06997/LynchRafeya Akhter Moni, 14, plays a game with friends at a UNICEF-supported Adolescent Club near her home in Dhaka’s Duaripara slum. Twice each week Moni and 35-40 other young people have the opportunity to get together and be ordinary teenagers in a safe space.

More work is needed to examine the state-of-the-art evidence, and the corresponding programmatic and policy responses on children’s mental health in the first decade of life, beginning in utero, through the first five years, and then into middle childhood (5-9 years). The evidence agenda is clear: we need to look at the latest findings from neuroscience; the overall prevalence and spread of mental ill health across ages and geographies; causes and contributing factors; and methods of preventing and treating mental ill health. These are all important parts of the puzzle, and critical to the response effort.

Adolescence is a critically important stage of life when many of the mental health conditions prevalent in adulthood first manifest, and also the most challenging time for those entrusted with the care and protection of young people to reach them with solutions.

Addressing the mental health of our children is imperative. Greater leadership and political commitment on policy, research and implementation is needed to turn the tide and advance healthy minds and healthy bodies of children and young people. A dedicated global plan or alliance through a shared value partnership for the mental health of children and young people is long overdue.

On November 7 – 9 2019, UNICEF and WHO will convene a conference co-chaired by UNICEF’s Executive Director Henrietta H. Fore and WHO’s Director General Tedros Adhanom Ghebreyesus. The Inaugural Leading Minds for Children and Young People conference will focus on advancing the global agenda on mental health in children. This first year will bring together a broad array of the world’s thought leaders and decison makers – from academia, business, civil society, government, international development, philanthropy and of course, children and young people – to accelerate global progress to respond to this neglected issue.

This will be the start of a critical conversation about what is needed to ensure children grow up with ‘healthy minds and healthy bodies.’ Throughout, the focus will be on the scale of the challenge and the proven and promising solutions to meet it. The conference’s final session will conclude with a deep dive into the pathways that global actors can take to tackle the issue of child and youth mental health.

Crucially the voices of children living in challenging situations will be central. Sessions will be co-designed and run with and by the Youth Leaders of the conference. We need to understand and listen to them: their emotions, fears, coping strategies, and hopes. We need to engage with how they cope, what they do to support others, and what must be done for young people themselves to feel supported and thrive in a complex world.

 

Priscilla Idele is Director of the UNICEF Office of Research – Innocenti; Prerna Banati is former Deputy Director at UNICEF Innocenti and currently UNICEF Regional Advisor on Adolescent Development and Gender; David Anthony is Chief of Strategy and Policy at UNICEF Innocenti.

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