Introduction
The mental health of children and adolescents (from 0 to 18 years old) is one of the most neglected health problems worldwide. Before COVID-19, the WHO estimated that between 10% and 20% of children and adolescents worldwide experienced mental health problems, with half of mental disorders beginning by the age of 14.1 In the In East Asia and the Pacific, nearly 1 in 7 boys and 1 in 9 girls aged 10 to 19 have a mental disorder, and suicide is estimated to be the thirdii leading cause of death for 15 to 19 year olds in the United States. this region.2,3 In addition, millions more children and adolescents experience psychological distress that may not meet diagnostic criteria for a mental disorder but has significant impacts on their health, development, and well-being.
Poor mental health can have a profound impact on the health, learning, social well-being and participation of children and adolescents, limiting opportunities for them to reach their full potential. This age spectrum encompasses a time of critical brain growth and development, when social, emotional and cognitive skills are formed, laying the foundation for mental health and well-being in adulthood. In addition to the mental disorders that emerge during this age, many risk factors for future poor mental health also typically have their onset at this stage of development.
Despite this burden, there is a substantial unmet need for MHPSS for children and adolescents. Globally, public spending on mental health accounts for just 2% of total health spending, despite accounting for 7% of the total burden of disease. In low- and middle-income countries, the estimated proportion of mental health specialists with experience treating children and adolescents is <0.5 per 100,000 population, and there are fewer than two outpatient child and adolescent mental health facilities. adolescents per 100,000 inhabitants. There are also many gaps and missed opportunities to prevent poor mental health and promote well-being, with often fragmented and small-scale approaches. In addition to inadequate human and financial resources, lack of coordination across sectors and substantial stigma remain significant barriers to ensuring that children, adolescents, and their families have access to quality services and support. COVID-19 has exacerbated mental health issues affecting children and youth across the region and highlighted significant gaps in systems and services.
To address the mental health and psychosocial well-being of children and adolescents, there is an urgent need to transform the current approach to:
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Shift the emphasis from the medicalization of mental illness to the value of ensuring the mental health and well-being of society and communities;
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Address the overemphasis on expanding specialty clinical services for mental disorders and moving to providing an optimal mix of services and supports to promote mental health across all sectors;
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Expand the scope of mental health to include a focus on creating an enabling environment that enhances protective factors and reduces risk factors throughout the life cycle, recognizing the gendered nature of mental health and the importance of resilience, empowerment and social cohesion for psychosocial well-being. ; Y
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Ensuring that the perceptions, experiences and views of children and adolescents are central not only to understanding their mental health needs, but also to shaping and strengthening mental health services and systems.
This research initiative seeks to provide guidance for this transformation, with a focus on providing a holistic, tiered approach to MHPSS that includes actions to: promote wellness; prevent poor mental health by addressing risks and improving protective factors; and ensure quality and accessible care for people with mental health problems. This requires the mobilization of all sectors, including health, education, social welfare and justice, as well as the participation of communities, schools, parents, service providers and children and adolescents themselves. Therefore, this multisectoral approach is at the core of the UNICEF East Asia and Pacific regional framework on MHPSS, and the UNICEF Global Multisectoral Operational Framework for mental health and psychosocial support for children, adolescents and caregivers in all settings. environments.
