World Children: What can be done

There are three main components necessary to promote, protect and care for the mental health of children, namely:

– Commitment to strengthen leadership and scale-up investment;
– Communication to tackle stigma and engage with young people;
– Action to minimize risk factors, maximize protective factors in families and schools, strengthen the capacity of social protection and improve research in the area.

Commitment, broadly speaking, implies the need for more vital global leadership, development of financing models to bridge the investment gap, and partnerships to share knowledge and build capacity, gather data and evidence, monitor, and evaluate progress. Additionally, it entails increased funding. In many countries, mental health is underfunded, as most of the budget is invested in psychiatric services, leaving a small amount to mental health prevention and promotion. Countries have focused on setting specific budget targets for mental health issues within the healthcare realm in recent years. These are typically at least 5% in low and middle-income countries (LMICs) and at least 10% in higher-income countries.

Countries must increase funding in both education and social protection. They should set more precise targets and develop new and innovative sources of funding and financing, involving international agencies and donors, in line with human-rights approaches based on people’s needs.

Improving communication can lead to better results. It tackles misconceptions about mental health issues that fuel stigma and prevent children and adolescents from seeking support and fully participating in their communities. Governments and media must work together to end the stigma around mental health and promote the view that it is essential to talk about mental health. This would increase people’s recognition of signs of distress and inform citizens on seeking help. Communication is critical since it provides young people with the means for active and meaningful engagement, namely through investing in community youth groups or co-creating peer-to-peer initiatives and training programs. Listening to young people’s needs will improve measures aiming to help children, young people, and caregivers throughout their lives.

Action should concern four main aspects. The first aspect is to support a child’s family as their fundamental figure. Stable relations at home can help protect children against toxic stress and promote resilience and overall wellbeing. Parenting programs need to be scaled up, focusing on Social and Emotional Learning (SEL) to support families and children in developing positive attachments and create a positive home environment. Children who live under grave home conditions, including violence or severe stress, should have specific targeted support. Their respective parents ought to be provided with knowledge (such as training programs, counseling on health, nutrition, and child development) and resources such as paid parental leave, breastfeeding support, available and accessible high-quality childcare, and child benefits. This will consequently enhance the caregiver’s engagement with their children throughout their childhood and adolescence as well as foster their social, emotional, physical, and cognitive development. Caregivers need skills training to improve the developmental, behavioral, and familial outcomes for children and adolescents’ health issues.
Secondly, schools are a big part of children’s lives, and as such, should be one of the leading institutions ensuring mental health support. Violence, bullying, stress, and pressure to perform are the main underminers of mental health. In this sense, schools must implement a holistic approach to enhancing children’s development and wellbeing. They should encourage a warm, positive climate that makes children feel safe and connected and empowers them to express their opinions, support other students in expressing theirs, and seek help when needed. It should provide regular mental health and psychosocial wellbeing training for teachers and other personnel as well as for children, adolescents, and families. Schools should further strengthen teachers’ knowledge and socioemotional competencies in order to help children and adolescents learn about mental health, develop healthy habits, and recognize students who might need additional support. They should, in addition, provide school staff with training aiming at identifying suicidal students and assist them accordingly. National suicide prevention programs should restrict access to means of suicide, encourage responsible media reporting, and identify and remove harmful content on social media.

Thirdly, multiple systems and workforces should be strengthened to address mental health challenges. Mental health services should be provided across different sectors and delivery platforms, including education, social protection, and community care. Community-based interventions such as child protection and gender-based violence case-management should be endorsed particularly to identify and support at-risk children who require specialized care. Local women’s organizations should be a crucial source of psychosocial support for women and girls, especially survivors of gender-based violence. MHPSS interventions should be upgraded so they provide children with the necessary means and resources to cope with anxiety and severe forms of distress. Child rights must be respected in the design and provision of mental health services, with service users treated not as patients but as individuals with rights. Care should be person-centered and recovery-oriented.

The fourth key factor for action is to improve data, research, and evidence. The lack of data on the mental health of children, adolescents, and caregivers, especially in the LMICs with most of the world’s adolescents, poses a challenge to policy development and planning. Countries must thus increase research budgets to apply to all ages and ethnicities, adapt to local realities, and capture diverse experiences. Qualitative research can help reduce gaps in evidence generation and provide a solid account of children’s and adolescents’ wellbeing.
It is crucial to monitor and assess mental health through a consensus-based set of core indicators around the child, adolescent, and caregiver’s mental health, covering the prevalence of mental health conditions, the provision of mental healthcare, and the extent of efforts to address issues protect at-risk children and adolescents. Research should aim to understand various needs and investigate the factors that halt or accelerate policy implementation and intervention. Increased research would provide governments with insight into the issue of mental health, turning ideas into action.

 

Summarize by Elizaveta Rusakova from A FRAMEWORK FOR ACTION of The State of the World’s Children 2021