Our Mental Health Needs To Be Your Priority – A Call to Prioritize the Mental Health of Children and Youth.
The Healthy Caribbean Youth (HCY), the youth arm of the Healthy Caribbean Coalition, is inviting you to review a Mental Health Call to Action (MHCTA), a whole-of-society call to step up, and support children and young people’s mental health in the Caribbean.
ARE YOU INTERESTED IN REVIEWING THE CALL TO ACTION? HERE ARE THE NEXT STEPS:
- Read the Call to Action below
- Share your contact information and-comments on the call to action in the respective text boxes at the end of this page.
DEADLINE FOR FEEDBACK: NOVEMBER 12TH 2021
Our situation:
The coronavirus disease 2019 (COVID-19) pandemic has exacerbated many challenges facing us as children and young people including the underserved mental health crisis.
The pandemic has turned our lives upside down. COVID-19 lockdowns and stay-at-home orders have restricted many of us to life indoors with little to no social interaction with our peers. Further, some of us have been forced into close quarters with abusers; this is demonstrated in the dramatic increase in domestic violence across the region. For those of us who can access online schooling, we are moving less, spending more hours online and increasing our screen time (which puts us at increased risk for cyberbullying and exposure to digital marketing of unhealthy food products and beverages). Those of us who cannot access online schooling are stressed, frustrated, and worry about the implications of the lessons we have missed. Many of us are feeling isolated, anxious, and depressed.
We need safe spaces to enter and feel comfortable seeking help for our mental health. There needs to be a shared understanding within our homes, schools and workplaces of the value of caring for our mental health, especially during these unprecedented times. Unfortunately, in many cases, this is not the reality.
The context:
Before the pandemic, regional youth voices, like those who attended the Caribbean Conference on Youth and Adolescent Health (2019), called for increased investment and research into youth mental health[1]. Over the course of the pandemic, international bodies and regional bodies[2] have drawn attention to the need to prioritize mental health and mental health services.
The need for mental health services is greater now more than ever, however, services globally and regionally have never been more out of each[3][4] which has left, many children and young people suffering.
Anxiety Disorder was the second leading cause of disability among 10- to-14-year-olds in Latin America and the Caribbean (LAC).[5]
Over the course of the pandemic, 27% of adolescents in LAC reported experiencing depression and 15% experiencing anxiety.[6] One in 2 young people reported having less motivation to do activities they usually enjoyed.[7]
Children in Jamaica reported elevations in emotions included frustration (41%) clinginess (49%) anxiety (23%) and fear (21%) since the onset of COVID[8].
The crisis has forced discussions about mental health and sparked a high-level concern in many countries across the region.
The Ministry of Education in Trinidad and Tobago was set to pilot an online screening tool to identify children at risk of developing depression and those who are already depressed. The Ministry of Education in Barbados established a Mental Health and Wellness Committee with the prime focus on student and staff mental health; ahead of the September 2021 school term, the Minister of Education announced the increase in social workers and guidance counsellors available in schools. The Government of Barbados also discussed the implementation of a national mental health policy and the Youth Parliament of Antigua and Barbuda are advocating for a similar policy. The Jamaican Minister of Health, has repeatedly emphasized the importance of increasing the mental health service response; the Ministry of Health and Wellness partnered with the Jamaican Red Cross to train 1500 volunteers in psychological First AID (PFA) to respond to the growing need for MHs support services within communities in Jamaica.
A recent PAHO report indicates that 84% of countries in the region have incorporated mental health services into the COVID-19 response. However, few of these policymakers have followed through on their promises[9].
The Obligation:
The truth is, prioritizing the mental health of children is something that is within countries’ mandate. CARICOM States’ binding obligations, pursuant to their ratification of international treaties, such as the CRC and ICESCR, to respect, protect and fulfil children’s health rights, including their mental health and emotional wellbeing. International bodies like the World Health Organization and PAHO continue to advise of the need to prioritize mental health protection. The WHO’s Special Initiative for Mental Health (2019-2023): Universal Health Coverage for Mental Health, emphasizes mental health as an integral part of Universal Health Care and highlights that there can be no health or sustainable development without mental health{10].
The Call:
For years, society has turned a blind eye to these invisible illnesses that are just as critical to holistic health and wellbeing. As youth, we continue to ask where mental health and supportive policies fall on our policymakers’ priority list; COVID-19 has demonstrated that it is far below where it should be.
It is within this context that we, as young people, write on behalf of all the children and other young people who have found themselves unsupported and suffering in silence. We raise our voices, demanding an urgent whole-of-society response to address this emerging mental health crisis. We have learned some hard lessons during this pandemic, let us seize this opportunity, without hesitation, to build back better recognizing that prioritising the mental wellness of today’s youth is an investment in our collective society’s future.
As a start, we are calling on all governments, development agencies, private sector, civil society actors and other youth to:
- Destigmatize Mental Health Issues
Normalize addressing mental and prioritize the mental health of our children and young people.
- Provide Access
Provide equitable and accessible mental health resources and treatments to school-aged children, and prioritise mental wellness in school environments such as school counsellors and safe spaces.
- Engage and Empower
Actively and meaningfully engage and empower children, youth and persons living with mental health conditions in developing youth-focused interventions and mental health policy.
Now more than ever, we need to step up to protect the mental health of children and youth and this is where we believe the start should begin.
THE THREE CALLS FOR MENTAL HEALTH
As young people, we are calling for an urgent whole of society response to the mental health crisis; we are ready to help but we cannot do this alone.
1
Destigmatize and prioritize mental health…
…through Funding, Researching and Advocating.
Governments, we need you to allocate adequate funding and resources to mental health promotion, prevention, care, and research[11]. As an integral component of Universal Health Coverage (UHC)[12], mental health needs to be prioritized in health promotion efforts and integrated within national health policy, primary healthcare and a priority in designating community-based initiatives funding. Governments should also develop appropriate frameworks on mental health and mental health wellness to inform multisectoral coordinated efforts.[13]
Private Sector, we need you to support mental health promotion in your workplaces with clear goals and objectives which are developed by staff input[14] ensuring that your community is cultivating healthy work environments. If our parents and guardians are supported at work and have access to workplace wellness activities and mental health days; this will help us at home too. Secondly, mental health promotion is underfunded, we look to you to support ongoing mental health campaigns within your workplaces and in our wider communities.
Development Agencies, we need you to offer ongoing technical support for the development of policies, programs, and research to ensure continued prioritization of mental health and implementation of context-specific, evidence-based policies and programming.[15] All efforts to increase and support mental health research capacity should be a priority.
Civil Society, we need you to amplify the importance of mental health, while simultaneously emphasizing the burden of disease associated with mental disorders among children and youth. As allies, we need you to advocate for youth-informed interventions that will promote mental health, prevent mental disorders and ensure treatment, care, and recovery of children and young people with these conditions. To our allies in Academia, with the appropriate support from the Government and Development Agencies, we need you to prioritize mental health research, especially research focused on children and youth. Strong research will help us develop evidence-informed policies and programs. Remember to engage us meaningfully in your research and knowledge translation efforts.
Youth, we have to continue to raise awareness about the importance of mental health while also advocating and creating open spaces to discuss our mental well-being. This can be at school assemblies, within classroom settings and, in school and community clubs. Every conversion, discussion and mental health-promoting event will help to destigmatize and normalize addressing mental health.
2
Provide Access
Provide access to mental health care, treatment, and support in and outside of schools (whether digital or in-person), especially for those who are most vulnerable.
Government, we need our schools and nearby community facilities to be equipped with adequate psychosocial support. Too often, mental health services are private, institutionalized and not catered to children and young people. Much like regular health, children and adults experience mental health on a spectrum that ranges from positive mental wellbeing to some mental health symptoms, to disorder and psychosocial disability. The services offered to us must cater to this spectrum. Ongoing, accessible psychosocial support offered in our communities is a critical step. In schools, we need to integrate mental health literacy within our existing school curriculums and strengthen referral pathways[16]. We need to provide teachers and other caregivers with the appropriate training to support the students in both digital and in-person school settings. In communities, we expect that our community-based health services will offer psychosocial support, treatment and care delivered by skilled mental health workers who are knowledgeable in dealing with youth.
Development Agencies should assist in strengthening mental health information systems, specifically supporting data collection to shape appropriate services and policies[17]. Agencies should then consult with children, youth, and local experts to support the development and piloting of innovative, equitable, and sustainable service delivery models to provide counselling and treatment for children and youth with mental health conditions. These can include integrating mental health into existing services for children and young people and consider adapting service delivery models that have been successful in improving access to care in other related areas, such as task shifting to well-educated lay health workers, investing in collaborative care services, home-based care and parental training.[18] We need to build back better, and we need to be innovative.
Private Sector, we need you to play your tole in increasing access to care, specifically improving access to safe, effective and quality medicines to treat mental disorders and other NCDs. There is also an important to often mental health and psychological support services for our parents as part of a health package.[19]
Civil Society, we need you to continue to advocate for these services for young people. When advocating for healthy school environments, ensure that appropriate mental health services are part of your request.
Youth, every opportunity we get, we need to advocate for these services in and around schools – we have a right to them. To take care of our health, we need support, and these school and community-based facilities that are catered to us will be critical.
3
Engage and Empower
Children, youth and persons with lived experience in developing youth-focused interventions and mental health policies.
Governments and Development Agencies, we need you to ensure that young people and persons living with mental health conditions are at the forefront of developing mental health policies, programs and research in schools, communities and where appropriate, consulted for national and regional programs initiatives. Ensure that we are integrated into program planning, execution, and evaluation. This will ensure that the initiatives are appropriate and effective for us. Relatedly, it is critical to also provide capacity-building opportunities for young people to feel more confident and empowered in advocating for mental health.
Private Sector, we need you to partner with government, civil society, youth and other stakeholders to facilitate and also monitor the empowerment and inclusion of people living with mental health conditions in program development and policymaking spaces.
Civil Society, we need you to advocate for meaningful youth engagement at all levels and consult with us, particularly children and young people living with mental health conditions, as you facilitate ongoing mental health promotion efforts to destigmatize and normalize mental health. Provide opportunities for us to share our stories with the hopes of inspiring change and encouraging others to speak out.
Youth, remember, our voices are critical. We need to continue to raise our concerns and ensure that we are part of ongoing discussions and interventions and confident in asking for what we need to continue to advocate for mental health change. We also need to ensure that we are also empowering one another to be brave, speak up and seek help.
THIS IS JUST THE BEGINNING, AS WE BUILD BACK BETTER, WE NEED YOU TO KEEP IN MIND THAT:
The calls to action, the call to Destigmatize, Provide Access, Engage and Empower, that we have outlined are just initial steps that we need you to consider in our build back better efforts. There is much more work to be done to ensure that our mental health wellness, as children and youth are prioritized.
In order for these actions to be sustained, we need strong mental health policy that should be integrated into existing national health and education policy. Moving forward, any policy related to youth health, wellness and development, should consider mental health.
Further, as recently highlighted by the WHO, mental health needs to be integrated into preparedness and response plans for public health emergencies. The COVID-19 pandemic demonstrated how unprepared society was to manage the COVID-19 mental health crisis; our flaws in our current system were exposed and we know what needs to be done to ensure we are in position to prevent, treat and manage this in the future.
Now more than ever, we are calling on all members of society to step up for us.
Please contact Healthy Caribbean Youth by using the from below or emailing hcy@healthycaribbean.org
[1] Caribbean Congress on Youth and Adolescent Health Roadmap: https://www.paho.org/en/news/20-10-2020-caribbean-roadmap-adolescent-and-youth-health-launched
[2] PAHO urges investment in Mental Health Programmes: https://jis.gov.jm/paho-urges-investment-in-mental-health-programmes/
[3] COVID-19 disrupting mental health services in most countries, WHO survey: https://www.who.int/news/item/05-10-2020-covid-19-disrupting-mental-health-services-in-most-countries-who-survey
[4] PAHO: The Impact of COVID-19 on Mental, Neurological and Substance Use Services in the Americas: Results of a Rapid Assessment June 2021: https://iris.paho.org/bitstream/handle/10665.2/54784/PAHONMHMHCOVID-19210018_eng.pdf?sequence=1&isAllowed=y
[5] UNICEF urges focus on mental health issues in children, adolescents post-COVID-19: https://www.jamaicaobserver.com/your-health-your-wealth/unicef-urges-focus-on-mental-health-issues-in-children-adolescents-post-covid-19_218949
[6] UNICEF The Impact of COVID-19 on the mental health of adolescents and youth: https://www.unicef.org/lac/en/impact-covid-19-mental-health-adolescents-and-youth
[7] UNICEF The Impact of COVID-19 on the mental health of adolescents and youth: https://www.unicef.org/lac/en/impact-covid-19-mental-health-adolescents-and-youth
[8] Caribbean Policy Research Time Out: The Impact of COVID on Education in Jamaica: https://www.jamaicaobserver.com/opinion/the-negative-impact-of-covid-19-on-our-students_230532
[9] PAHO Urges Investment in Mental Health Programmes: PAHO: The Impact of COVID-19 on Mental, Neurological and Substance Use Services in the Americas: Results of a Rapid Assessment June 2021: https://iris.paho.org/bitstream/handle/10665.2/54784/PAHONMHMHCOVID-19210018_eng.pdf?sequence=1&isAllowed=y
[10] The WHO Special Initiative for Mental Health (2019-2023): Universal Health Coverage for Mental Health: https://apps.who.int/iris/bitstream/handle/10665/310981/WHO-MSD-19.1-eng.pdf?sequence=1&isAllowed=y
[11] Caribbean Wellness Day 2020 Governments. Action Guide: https://carpha.org/Portals/0/Images/CWD/2020/Action%20Guides/CWD%20Action%20Guide%20Governments.pdf
[12] The WHO Special Initiative for Mental Health (2019-2023): Universal Health Coverage for Mental Health: https://apps.who.int/iris/bitstream/handle/10665/310981/WHO-MSD-19.1-eng.pdf?sequence=1&isAllowed=y
[13] Caribbean Wellness Day 2020 Governments. Action Guide: https://carpha.org/Portals/0/Images/CWD/2020/Action%20Guides/CWD%20Action%20Guide%20Governments.pd
[14] Caribbean Wellness Day 2020 Private Sector. Action Guide: https://carpha.org/Portals/0/Images/CWD/2020/Action%20Guides/CWD%20Action%20Guide%20Private%20Sector.pdf
[15] UNICEF: Adolescent Mental Health Matters: https://www.unicef.org/media/82926/file/Adolescent-Mental-Health-Matters-Report-Final-July2020.pdf
[16] UNICEF: Adolescent Mental Health Matters: https://www.unicef.org/media/82926/file/Adolescent-Mental-Health-Matters-Report-Final-July2020.pdf
[17] PAHO: The Impact of COVID-19 on Mental, Neurological and Substance Use Services in the Americas: Results of a Rapid Assessment June 2021: https://iris.paho.org/bitstream/handle/10665.2/54784/PAHONMHMHCOVID-19210018_eng.pdf?sequence=1&isAllowed=y
[18] UNICEF: Adolescent Mental Health Matters: https://www.unicef.org/media/82926/file/Adolescent-Mental-Health-Matters-Report-Final-July2020.pdf
[19] Caribbean Wellness Day Private Sector. Action Guide: https://carpha.org/Portals/0/Images/CWD/2020/Action%20Guides/CWD%20Action%20Guide%20Private%20Sector.pdf