Earlier this year the World Health Organisation (WHO) published its report on world mental health which is designed to inspire and inform better practices in mental health, globally. Whilst the report illuminates the need for multisectoral action and collaboration between different stakeholders, the report targets decision-makers in the health sector. Unfortunately, in spite of its obvious merits, the report failed to involve adolescents sufficiently. As a consequence, adolescent mental health is somewhat neglected in the report.
The 2001 WHO World Health report is widely regarded as one of the first initiatives from the organisation recognising global mental health as an area of need. Whilst many of the recommendations made in the 2001 WHO report remain valid, the progress made has not been adequate. In light of this year’s World Mental Health Day, celebrated last Monday, it is important to not only reflect on the progress that has been made in global mental health, but also what could be further improved. With the new report as a case in point.
As a young person and student in this day and age, I was curious about how this new report can contribute to the conversations surrounding adolescent mental health. The rise of social media has seen a growing confidence among youth in sharing mental health struggles, diagnoses, and self-help tips. However, as both an avid social media user and academic, I rarely see social media portrayed in a positive light regarding mental health. Raising awareness in this informal manner has not only helped decrease the stigma surrounding mental health struggles amongst young people but also encouraged others to seek help and recognise their symptoms. According to this US blog by the National Alliance on Mental Illness, in 2021, the hashtag #MentalHealth had generated nearly 30 million Instagram posts and racked up nearly 11 billion views on Tik Tok. However, as you know, social media can also be responsible for increasing ill-mental health, with several studies such as this 2018 paper strongly correlating heavy use of social media with increased risk of depression, anxiety and loneliness. In other words, it is vital to establish a balance in the contribution social media makes to mental health conversations.
Through my research on adolescent mental health, it has become more evident that there is a lack of representation from young people, and young people with lived experiences in particular, in not only the latest WHO report, but also in many other notable policy documents on global mental health. Although the report is targeted towards decision-makers, it does not portray the value of youth participation in mental health settings. A 2014 study on the importance and benefits of youth participation in decision-making found that youth participation is essential to service delivery, beneficial for the participating youth as well as for the organisation and community. Despite these positives, young people’s lack of “real world experience” usually becomes a limiting factor.
Some meaningful examples of youth engagement are: providing concrete roles during implementation processes, investing in a youth centre and providing young people with leadership roles, planning community events, engaging young people in reflections and asking for feedback, advocacy groups. A (2021) survey organised by the World Economic Forum asked young people what changes they want for the future. They listed, among others, supporting young progressive voices into government and ensuring that environmental, social, and corporate governance literacy is integrated into school curriculums. Fondation Botnar is an example of an organisation that has put youth engagement on the agenda. They support several programmes, research and projects that “include and treat young people with trust, give them the necessary space to contribute to work that affects them, and be treated as equal partners at every stage of the process.”
The WHO report also does not clearly distinguish adolescent mental health from global mental health. However, young people face a unique challenge to their mental health as adolescence is a time of rapid psychological, physical and social change. Additionally, the brain is more susceptible to environmental influences during this developmentally sensitive period. Approximately 50% of mental disorders develop before 14 years of age and can affect an individual for a lifetime, yet the majority of mental health initiatives target those in older age groups. In 2019, 14% of adolescents were living with a mental disorder. And that was before the Covid pandemic. In short, there’s still a lack of urgency for the issue of adolescent mental health. We seem to be woefully unprepared as a society for the repercussions in the future.
Too often mental health support is only available when serious problems occur, and not used as a preventive measure. Research has found the positive effect that support programmes for adolescent mental health can have in schools. Having programmes to support adolescents in their transition into adulthood and equip them with the skills and knowledge to navigate their own struggles is vital. Safe communities, the ability to work, high-quality education, and access to healthcare are all non-healthcare factors that can impact mental health. Investing in youth is vital for economic and social progress. Unfortunately, this is not always reflected in policies and programmes at a national level.
To conclude, whilst the WHO report from June this year highlights and addresses challenges in global mental health, not enough focus is placed on adolescents, who face a unique challenge. This lack of representation is reflective of how adolescent mental health is not prioritised globally, and how much more work needs to be achieved.