UNICEF is calling on societies to “break the silence” surrounding mental health, by addressing stigma, promoting understanding and taking seriously the experiences of children and young people in its 2021 edition of The State of the World’s Children report released on Oct. 5.
On My Mind: Promoting, protecting and caring for children’s mental health, published by UNICEF’s Office of Global Insight and Policy, examines how risk and protective factors in the home, school and community shape mental health outcomes and urges global action to promote good mental health for every child.
The report notes the many ways in which COVID-19 has contributed to the current global mental health crisis among young people — shutting kids out of classrooms, robbing them of the everyday joy of playing with friends and impoverishing their families.
It also points out that, even absent a pandemic, psychosocial distress and poor mental health afflict far too many children, including millions who are forced from their homes, scarred by conflict and serious adversity and deprived of schooling, protection and support.
“The COVID-19 pandemic has raised huge concerns for the mental health of an entire generation of children and young people and parents and caregivers,” UNICEF Executive Director Henrietta Fore writes in the report's foreword. But the pandemic is "just the tip of a mental health iceberg — one that has been ignored for far too long, and unless we act, it will continue to have disastrous results for children and societies long after the pandemic is over.”
Mental health is tied to critical moments of brain development, which can be affected by factors such as toxic stress triggered by adverse childhood experiences, like physical and emotional abuse, chronic neglect and violence. Mental disorders — often ignored — interfere with health and education, keeping children from reaching their full potential.
A global call for greater investment and stronger leadership to support children’s mental health
Given its critical importance to children's present and future well-being, greater investments are needed to expand and accelerate support programs for families, parents and caregivers and to ensure that schools are kinder, safer places and able to meet kids’ social and emotional needs, the SOWC report argues. Integrated strategies are also necessary to strengthen and equip multiple systems and workforces to meet complex mental health-related challenges.
"UNICEF hears it around the world, and I hear it from youth here at home," UNICEF USA President and CEO Michael J. Nyenhuis said. "We need to do better at supporting responsive, nurturing caregiving, and ensuring schools support mental health through quality services and positive relationships."
In its report, UNICEF demands urgent investment in child and adolescent mental health across sectors, not just in health. It argues for proven interventions that address mental health across a range of systems, from parenting to education to primary health care, social protection and humanitarian response. And it calls for financial commitments from global and national leaders and other stakeholders that reflect the important role of social and other determinants in helping to shape mental health outcomes.
Only 1 percent of government health budgets in low-income countries is spent on mental health — and 76 percent of people with mental illness in these countries do not receive mental health care. “The challenge we face is immense,” Fore writes. “When it comes to mental health, every country is developing.”
While the impact of mental health disorders on children’s lives is incalculable, UNICEF notes, analysts at the London School of Economics studying the cost of mental health to economies estimate nearly $390 billion in losses every year in terms of lost contributions from young people. In the U.S. the annual cost is estimated at $64.7 billion.
Improving data collection, routine monitoring and research is crucial for improving responses. “The picture we have of children’s mental health is a partial one, and it is one that is skewed heavily towards the world’s wealthiest countries,” Fore writes. “That means we know too little of how children and young people in most parts of the world experience mental health. It also means we know too little of the potential strengths and support that diverse communities and cultures may be able to offer children and families.”
Persistent stigma around mental health can block children and young people from seeking treatment — limiting their opportunities to grow, learn and thrive, the report points out. Acknowledging that “psychological distress is not deviant behavior to be repressed and hidden away, but just a normal aspect of human experience” — as the human rights advocate and SOWC report contributor Lea Labaki puts it — is essential. Other priorities include improving mental health literacy and ensuring that children, young people and people with lived experience have a voice.
UNICEF’s mental health work reaches millions of children, adolescents and caregivers in 116 countries
In recent years, UNICEF has worked to help safeguard the mental health and psychosocial well-being of children, adolescents, parents and caregivers in some of the world’s most challenging settings. Efforts in 2020 focused on addressing the sweeping impact of the pandemic on mental health. That year, UNICEF reached 47.2 million children, adolescents and caregivers with community-based mental health and psychosocial support, including targeted community awareness campaigns in 116 countries – almost twice as many countries as in 2019.
The four major pillars of UNICEF's approach to this work are to:
- promote positive mental health through actions that help people to adopt and maintain healthy lifestyles: UNICEF works to integrate prevention measures that help address the root causes of stigma, hopelessness, distress and trauma. Support for parents and families is key to this approach.
- advocate for increased investment by governments and other stakeholders in mental health support for families, with a focus on creating safe and secure school and community environments and tackling stigma and discrimination.
- generate evidence and research to better understand the true scale of global mental health needs across populations and develop effective policies accordingly: UNICEF is designing a collection tool to capture data on adolescent mental health at the population level.
“This engagement will only grow in the years to come,” Fore writes, [b]ecause we know we all must do more."
UNICEF USA: supporting children's mental health needs on multiple fronts, at home and around the world
One of UNICEF USA's top priorities in its role in advancing UNICEF's mission for vulnerable children is to advocate for increased investment in these issues by the U.S. government. This includes backing federal legislation that would increase support through foreign assistance for vulnerable children and caregivers, including those living in poverty and conflict zones, and other marginalized communities.
UNICEF USA is also calling for increased funding for schools in the U.S. to provide on-site, culturally and linguistically appropriate mental health services for students, to help them thrive in school, at home and in life.
In partnership with the Johns Hopkins Center for American Indian Health, UNICEF USA recently published Our Smallest Warriors, Our Strongest Medicine: Overcoming COVID-19, a children’s storybook that portrays communal efficacy, strength and hope in the face of the pandemic, and developed a course of psychological first aid training for frontline and essential workers adapted for indigenous communities.
In partnership with Arthur Ashe Institute for Urban Health, UNICEF USA is working to amplify mental health messages to reach more young people. Using culturally tailored curriculum, community-based members are trained in specific knowledge, attitudes and skills to enable delivery of mental health messages to others.
The objectives of these efforts align closely with UNICEF's work. "We need to listen to children and parents: mental health matters," Nyenhuis said. "Most importantly, we need to break the silence surrounding mental illness, addressing stigma, promoting better understanding of mental health and taking seriously the experiences of children and young people.”
Support UNICEF's crosscutting work in children and adolescent mental health — a critical part of UNICEF's mission to save and protect vulnerable children around the world. Donate today.
Top photo: Fatu Turay, a subsistence farmer in Senthai Community, Magbema Chiefdom, Kambia, Sierra Leone, with her nine grandchildren — six of whom she cares for full-time while her two daughters, their mothers, work in another village to help support the family. Her son lives next door with his family. Turay says she is grateful for the support she gets through a UNICEF-supported mothers support group and Caring for the Caregiver (CFC) program, in addition to regular visits from a community health worker. "It keeps me going," she says. "It has made me realize that I, as a caregiver, also need care. When I’m stressed about my age or different things that are happening with my grandchildren, I can always talk to my CFC counsellor. He advises me on how to handle my emotions and also the different emotions the children are experiencing." © UNICEF/UN0473340/Duff/VII Photo