Children around the world are afflicted with psychosocial distress and poor mental health. It is estimated that more than 13% of adolescents (aged 10 - 19) live with a diagnosed mental disorder as defined by the World Health Organization (WHO). Moreover, the COVID-19 pandemic has raised huge concerns for the mental health and wellbeing of an entire generation of children. Many of them are filled with sadness, hurt and anxiety. Some are wondering where this world is actually headed and what their place is in it! The year 2021, indeed, was very challenging times for children, young people and their parents and caregivers. UNICEF's flagship publication "The State of the World's Children 2021" examines the mental health of children and adolescents. It mainly focuses on the risks and protective factors for children's mental health and well-being at critical moments in the life course. The report aims to enhance understanding of the specific needs of children, adolescents and caregivers, and to explore critical issues around mental health through the perspectives of children and young people themselves. Ultimately, the main objective of the report is to highlight a comprehensive approach to promote good mental health for every child, protect vulnerable children and care for children facing the extreme challenges.
The report is divided into six main chapters. Chapter -1 defines positive mental health as a continuum and describes the detrimental effects of stigma. This chapter also outlines the prevalence of mental health conditions and examines their economic cost. Mental health, actually, is not disorder or even the absence of disorder. It is positive as well as a state of health. In a general sense, mental health and well-being can be understood in 3 categories: i). Emotional well-being - positive, happy, calm, peaceful, interested in life; ii). Social well-being - ability to function in the world combined with a personal sense of value and belonging; and iii). Functioning well-being - the capacity to develop skills and knowledge that help a person make positive decisions and respond to life challenges. In particular, for children and young people, understanding mental health means recognizing that the concept itself is entwined with societal and family values, cultural standards, social expectations and developmental capacities. Despite growing awareness of the impact of mental health conditions, stigmas about mental health remain a powerful force hindering efforts to promote good mental health and to protect vulnerable children. Stigmas - whether purposeful or not - obstruct children and young people from seeking treatment and limits their opportunities to grow, learn and flourish.
Chapter - 2 outlines a framework for understanding mental health and well-being in the lives of children, focusing on the world of the child, the world around the child and the world at large. It emphasizes the importance of socio-ecological influences on mental health and the vital importance of experience and environment as they impact critical phases of child development: the start, the prenatal period, early childhood, middle childhood and adolescence. This chapter also outlines the role of child development in understanding risks and protections for mental health and for building a solid foundation. The next chapter examines particular risks and protective factors for mental health throughout the course of a life. It focuses on three domains that are particularly relevant in the world of the child and the world around the child: parenting, learning environments and peer relationships. In addition to examining the data and research, this chapter also presents the thoughts of adolescents who have discussed mental health in discussion groups directed by Johns Hopkins University.
Chapter- 4 turns its attention to the world at large, focusing on key social determinants of mental health: poverty and discrimination. It also looks at the effect humanitarian crises - including the pandemic COVID-19 - have on children and young people. Globally, at least one in seven children has been directly affected by lockdowns during the pandemic. More than 1.6 billion children have suffered some loss of education, with at least 463 million unable to access remote learning. Finally, this chapter looks at our emerging understanding of resilience and how it can provide a pathway to promote and protect mental health. The fifth chapter of the report assesses the current state of the responses to children's mental health and well-being, examining the global and national initiatives, which mainly address parenting, education, social protection, primary health-care systems and humanitarian settings. This chapter also sheds light on the particular problem of suicide and the importance of data and research. Despite promising initiatives and approaches, effectively responding to children's and young people's mental health challenges requires accurate data and robust research. In most of the world, however, data are not available; they are not collected, analyzed or used to develop effective policies and programs or to allocate resources. Indeed, a lack of national data and adequate research can hide the mental health challenges of children and young people, making it difficult to advocate for services and respond effectively.
The State of the World's Children 2021 report concludes by calling for commitment, communication and action to promote good mental health for every child, protect vulnerable children and care for children facing the greatest challenges (Chapter - 6). The recommendations provided here are grounded in three core principles: I. Commit - To commit means strengthening leadership to set the sights of a diverse range of partners and stakeholders on clear goals and ensuring investment in solutions and people across a range of sectors. II. Communicate - To communicate means tackling stigmas around mental health, opening conversations and improving mental health literacy. It also means ensuring children, young people and people with lived experience are part of the conversation, that they have a voice and can meaningfully engage in the development of mental health responses. III. Act - To act means working to minimize the risk factors and maximize the protective factors for mental health in key areas of children's and adolescents' lives, especially the family and school. More broadly, it also means investment and workforce development across some key sectors and systems, including mental health services and social protection, and the development of strong data collection and research.
The writer is an independent researcher. E-mail: [email protected]
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