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Health priorities: mental health

The second of three videos discussing key health priorities for adolescents. Watch Dr Mark Jordans discuss mental health issues.
MARK JORDANS: Mental health disorders among adolescents globally is a very big problem. Estimations vary but between 15% and 20% of adolescents worldwide suffer from mental health problems at any given time. So it’s a very big problem, but it’s even more pronounced in areas, in countries, or in groups of people that are dealing with adversities. For example, areas of war and conflict, or other complex emergencies, but also in groups of people that are living in lower socioeconomic status. So another important element about adolescents and mental health is that of adults with mental health problems, 75% of those have their onset in adolescence and childhood.
So actually, to reduce the burden of mental disorders among adults, in the adult population, it’s very important to intervene earlier on in childhood, in adolescence. So that’s a very important part. And also, if we’re looking at suicide rates and actually adolescents– among adolescents and young people, suicide is often the second leading cause of death in this group. Of course, it varies in different sites, but globally, it’s very high, and it’s a very high cause of death. So that’s another indicator of the importance of mental health problems. In most of the low income countries and lower middle income countries, there are no policies for children and adolescent mental health.
So even though we know that the burden is very, very big, there is no policy available. So that’s a problem. And as a result of that, there’s very little funding or specific programmes to deal with adolescent mental health, for example, setting up services. So what you’ll see is that in many countries, there’s very few mental health professionals that are able to deal with mental health in general, but specifically in children and adolescent mental health. So because of the low human resources, the low number of professionals that are able to deal with the problems, we have to find alternative ways of dealing with these problems.
And one of those is what we call task shifting, which is basically to give the tasks that are generally done by mental health professionals being implemented by other either lay or non-specialized health workers or social workers. So one thing that we can do about this is integrating mental health into primary health care. For example, by training health care workers to be able to detect and diagnose and treat the children and adolescent mental health problems. And another way that we can deal with it, and maybe more importantly, is to integrate and psychological, psychosocial, and mental health interventions at the community level.
Which means that within a school setting or other social settings, that you’re able to target mental health– mental health problems. For example, by training community counsellors or social workers to be able again to identify and respond to adolescent mental health needs. And not just for the population of adolescents that have already developed mental health problems, but also for the adolescents that are at risk so that we could prevent mental health problems to actually develop further.

The second major health priority we’ll consider is mental health. Research has shown that mental health issues account for the most Disability Adjusted Life Years (DALYs) lost in adolescents and young people, and can be associated with a broader range of health and social outcomes. In this video Dr Mark Jordans considers the context of these problems and what can be done about them.

It’s important to intervene in these kinds of issues during adolescence to prevent or better support their continuation into adulthood, but in many low- and middle-income countries there are few policies, programmes and professionals in place to deal with adolescent mental health. Approaches to reducing the burden might include integration of mental health care into primary health care practices by training non-specialised health workers to detect, diagnose and treat mental health conditions and promoting understanding of mental health issues at the community level.

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Improving the Health of Women, Children and Adolescents: from Evidence to Action

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