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WHO conference: Experts stress need to prioritise child and youth mental health

Publication date 8.12.2005 22.00
Press release N5-38345

Helsinki 13 Jan: The situation of the mental health of children and adolescents is central to efforts to raise overall mental health standards, according to speakers at the WHO European Ministerial Conference. Professor Sir Michael Rutter of the Institute of Psychiatry, UK, said that he hoped the draft conference declaration would take better account of the place of child mental health. “It would be wrong to exclude children from consideration."

Rutter said that priority should be placed on children because during the last 50 years there has been an increase in mental health disorders among them. The suicide rate among young people has also increased, whereas over the same period it has declined among the adult population. “The situation is getting worse," he said.

“There is also much evidence that disorders in adult life begin in childhood. Childhood is the starting point for adult psychology." Rutter said there is a lack of systematic study of drug treatment for children, and a neglect of the situation of children in mental health research. At the same time, children come low on the scale of human rights implementation.

Rutter outlined a number of principles that need to be considered in planning services for children and adolescents. He stressed that while there are similar principles in paediatrics and mental health services for young people, important differences between the two should be identified.

There is a need for specialised training on child mental health, he said. “Most mental disorders in young people are thought of as a benign part of growing up, but we now realise that this is not so." Rutter stressed that exist interventions of proven efficacy there is a gap between what could be provided and what is available in most services.

He said that interventions need to be based on total population coverage, and that the pre-school period of children’s lives needs to be given a higher priority than it now receives in most countries.

Childhood no golden age

Professor Katherine Weare also focused on the changed climate of how child and adolescent mental health is viewed. “No one sees childhood as a golden age any longer." she said, “We now recognise that depression starts at a very early age. And we need to make sure that our declaration at this conference prioritises child mental health."

Weare said that the WHO conference has been examining a major shift in mental health, where holistic approaches have tended to supersede traditional models that concentrate on illness, problems, solutions and treatments.

“We have to be careful not to throw the baby out with the bathwater here," she said. “The traditional approach remains an important cornerstone, but the holistic approach has a good deal to offer."

She stressed that good results in holistic approaches to child and youth mental health show this, such as in school, community and family based programmes that have done much to reduce depression, aggression and anti-social behaviour.

“Universal and specialist approaches are best when they complement one another. They make targeting and specialist treatment more effective." Weare said the combination of the two approaches help reduce the problem of stigma as the universal or holistic approach uses more accessible language, thereby demystifying the world of mental health.

Toxic environments

Dr Dainius Puras spoke about the situation of child mental health in the Central and Eastern European (CEE) area.

He said the main problems are rooted in “the ineffective response to change in the social environment, representing a huge psychological crisis and public health crisis" for which people were unequipped. “Most governments failed to respond with new priorities and effective health policies." Puras described the region as a “socially toxic environment."

Despite this, work in Lithuania integrating a network of demonstration models, child and adolescent psychiatry and community services has become a model for the Baltic region, and is known as the Vilnius model. “People and organisations are learning from our achievements, and also from our mistakes."

Puras said that the main obstacle facing mental health care for the young in the CEE area stems from lack or recognition of child mental health as a priority.

He said that governments need to show the political will to decide on making child mental health a priority, and that this should involve changes in the funding of services, training and research, as well as the deeper involvement of health care resources in psychosocial approaches.

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