Youth Mental Health
Find out more about our #MHForAll webinar series here.
Zeinab Hijazi, UNICEF
Chiara Servili, WHO
Matt Hughsam, citiesRISE
Yves Miel Zuniga, MentalHealthPH
Aviwe Fuanani, Waves For Change
Joanna Lai, UNICEF
In the previous #MHForAll session we discussed early childhood experiences, and this time we’ll be discussing youth mental health with our panel of experts.
We know that 1 in 7 adolescents has a mental disorder. This has increased during the COVID19 pandemic, and we don’t yet know the long term impact on youth mental health. But we must build back better and improve environments and services to ensure that.
In our work we focus on strengthening the workforce capacity with a focus on improving access to interventions for adolescents through various platforms across different types of modalities. This includes online and remote strategies.
Last July the Secretary General launched a policy brief on this important issue. We know the direct and indirect impacts of the pandemic across settings on mental health of youth. So why is it so important to address youth mental health in cities and urban areas?
60% of all city dwellers will be under the age of 18 by 2030. Intense urbanisation, pandemics, weather changes and so on are all intensified in cities, which are hotspots for these issues. We must intervene for young people specifically in cities. There are high concentrations for opportunities for rapid progress and collaboration for supporting young people.
At citiesRISE, connecting cities to each other is key to our work. Supporting learning and collaboration across cultures and geographies results in stronger mental health support for young people across all the areas we work in.
How does Mental Health PH use social media to campaign for action on youth mental health?
Yves Miel Zuniga
We have a responsibility to make social media a safer space for everyone, especially the youth. Youth use social media extensively, as a free channel that can reach everyone. We shouldn’t discount the fact that there are still some youth who don’t have access, but we have to start somewhere.
We can mobilise people, such as the passage of the new Mental Health Law. We can reach more networks, without physically being there, and the youth have created their own tribes for a sense of belonging. They are finding ways to manage their stress around what is happening right now [with the COVID-19 pandemic and subsequent lockdowns).
We can see how social media is important, but we must approach it in a societal and systemic approach to ensure these spaces stay as safe as possible.
What does Waves for Change do, and how does it promote good mental health among young people?
We’re a mental health therapy programme, an evidence based mind and body programme focused on surfing for children and adolescents who have difficult experiences and backgrounds. They receive the tools to help them cope with stress and make positive decisions and develop positive relations.
Could you also speak to the pyramid of interventions and what your programme does?
Our programme is principally focused on preventative mental health care for children and adolescents from vulnerable backgrounds, linked to poverty, violence etc. that can cause issues in the longer term. By the age of 14 they have a higher chance of developing mental health conditions, which is why we start working with them from a young age to help them develop the tools and skills to better respond to trauma and stress.
It’s important to think how adolescence is an important moment for this kind of preventative work. What is UNICEF’s approach to Adolescent Mental Health, and how does it fit into the broader global mental health agenda?
At the core of our approach is that we put adolescents at the centre. This means having increased availability of data of mental health outcomes and determinants for 10-14 and 15-19 year olds, particularly in LMICs, so we know what we need to address and what we need to change. The data we have right now is representative of only a small portion of the population, which we need to expand on.
We centre the policies and programming not only on the problems faced in early adolescence, but also on the strengths that they have in the face of this early development. Young people are increasingly vocal about their wants and needs, and open to working with us on these issues.
Another core aspect of UNICEF’s approach is responding multi-sectorally. This means embedding mental health across different goals, different areas of our organisation.
We’d like to hear more specifically about the different work and approaches to supporting the mental health of adolescents. So first, can you tell us more about what has worked best to support youth mental health in cities?
The need for real intergenerational partnership is key. We work to activate diverse groups of leaders and connect them to the relevant people who they wouldn’t traditionally work with. We’ve seen great innovative models including ones that have pivoted in the pandemic, including young people in communities using media and music.
We’ve also seen progress in taking a system lens. We believe in cities, people don’t just have individual level needs, but societal ones too. For example lots of schools focus more on singular intervention, such as building literacy. But what we’ve found works best is takingmore of a whole of school approach, engaging not only young people but their peers, their parents, their administrations and so on, to ensure a fully supportive environment.
The Philippines has elections in 2022, what do you want the political parties to promise they will do to improve youth mental health? And can you tell us more about your upcoming work, and any projects that will be launching soon?
Yves Miel Zuniga
30 to 40% of the voting population are young people, so it’s all about the youth taking part in nation building. One organisation conducted a survey of 50,000 youth members, and the majority said that good governance was key right now. Putting youth mental health at the front and centre of the pandemic response is also important.
Some partnerships are actually focused on the long term benefits, such as our work with technology companies in developing a mental health app. Getting mental health support should be as easy as ordering a pizza over a food app.
We want to create a mental health agenda for political leaders, so that youth mental health is prioritised regardless of the outcome of the elections.
We’ve partnered with some social media organisations to develop a chat bot, as we are receiving a lot of cries for help and questions on our channels. We’ve crowdsourced and hired professionals to help supply the right information, so that everyone can get support at any time.
Waves for Change has conducted research on Heart Rate Variability (HRV), to see how your surf therapy can help young people affected by chronic adversity or trauma. Can you tell us more about this study and it’s findings?
When we began the HRV study it was because we had found that some data may not be accurate, as children could be reporting what they thought we wanted to hear, rather than what was actually happening. HRV could help us to monitor the capacity to self regulate, how easily participants could adapt to changing demands, their sustained attention and coping styles among other things. Because of the nature of the participants’ experiences, it was important for them to see the outcome of the 12 month programme with Waves for Change.
We saw the programme has a positive impact on the minds of the participants over an 8 week period. This doesn’t mean they should stop being exposed after 8 weeks, but the longer they were exposed the more they would benefit.
HRV is also helping us to show how toxic stress impacts the brain structure of the participants, and how through neuroplasticity the brain’s development of positive neural pathways provides great benefits the longer they remain in the programme. Participants also become more open to learning information, had improved relaxation responses in moments of stress, and were thinking more before acting in their fight or flight response.
What is the WHO-UNICEF Helping Adolescents Thrive Package, and how do you hope for it to be used to progress youth mental health, and spur on action?
This package is something that we’ve been working on and one of the key parts is the WHO guidelines on what kinds of support should be given. These recommendations are specifically for 10-19 years across the board, but also for specific at-risk groups. The guidelines are important for giving us a joint starter for action. We hope that these don’t just stay recommendations but become solutions that are easy and effective to implement at scale.
The toolkit outlines strategies and activities for what kinds of intervention could look like, and there are several HAT tools that we’re designing in collaboration with young people in different countries. This will be released on 18th May. Our hope is that the materials will be openly available and accessible so that we can mainstream promotion and prevention of mental health.
The success of HAT will rely on collaboration with a range of different partners, including all those here today, to ensure it reaches young people more broadly.
A question from the audience for Cities Rise, do you also support youth with autism? And if so, how?
We don’t focus specifically on this, mainly on prevention work. But we do help connect young people to care, ensuring they have access to mental health professionals and that this system is youth friendly.
The next question from our audience, what would be the key lessons that can be modelled in Africa to advance youth mental health?
One of the key things I believe we need is to address the literacy gap. In most local African languages, there is no vocabulary for mental health, depression and anxiety. We’ve been working on how we can translate our existing tools, but also build a community across the continent to make these things more accessible. Mental health literacy is key to this.
Influencing policy makers and decision makers is also necessary to close the treatment gaps and prioritise mental health at a national level. We can then bridge the divide that exists across the 3 layers of society, ensure policy prioritises mental health across the different countries, and say to the health sector that they do not have to tackle mental health on their own. We can also empower young people to speak about mental health, and help educate one another around this.
Aviwe has articulated this perfectly. Making sure that the home and the school is a safer place for young people is also crucial. This could mean working more with parents and caregivers, and with teachers, who can help reinforce these skills and create the support that we know that young people leave.
You spoke about important youth-led policy work in the Philippines. How might this be used as a model for other countries?
Yves Miel Zuniga
We firmly believe that mental health is a fundamental human right, particularly for youth. We put the emphasis on society to fight the stigma and normalise this until it no longer exists. We also want to focus on the suicide piece and how this relates to youth mental health. We also want to ensure safety and stability for youth to protect their mental health. This provides us with our framework for what we do.
What is the most urgent priority for supporting young people’s mental health?
To partner with young people to integrate mental health in the spaces where they already are. We have to not just translate clinical support, but deliver support in ways that resonate with young people.
Yves Miel Zuniga
Good governance translates to good policy, which translates to good investments in mental health, which leads to better outcomes.
Make mental health more inclusive. Prioritise the different sectors of society. Collaboration is the future for mental health.
We need more structured spaces for young people to connect and talk. Young people shouldn’t have to feel like they need to hide what it is that they are feeling.
Thank you to all of our panellists, and we hope to continue this conversation on social media.
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