Child and adolescent mental health
World Autism Awareness Day: 2 April 2012
On 18 December 2007, the United Nations General Assembly adopted resolution 62/139, which declares 2 April as World Autism Awareness Day (WAAD).
Despite the high burden of autism and other developmental disorders in children and adolescents, these conditions have been widely neglected by policy makers and public health experts, particularly in low- and middle-income countries. As a consequence, children and families in need have often poor access to services and do not receive adequate treatment and care. Greater investments in advocacy, awareness, research, and services and human resource development are needed.
The annual observance of World Autism Awareness Day is meant to spur these and other steps, and to draw attention to the unacceptable discrimination, abuse and isolation experienced by people with autism and their families.
Child and Adolescent Mental Health Initiatives of the Department of Mental Health and Substance Abuse
For the past two years the Department has supported the development of a coordinated child and adolescent mental health programme. The programme has fostered a recognition throughout WHO and in the WHO Regions that child and adolescent mental health is a necessary priority for the healthy development of societies. Child and adolescent mental health is central to the future development of low income countries throughout the world, but in particular in sub-Saharan Africa and elsewhere where AIDS orphans, displaced populations of child combatants, reintegrated child soldiers, AIDS affected and infected youth and youth marginalized because of lack of economic opportunity are jeopardizing the future of whole nations. Furthermore, the free and forced migration from Africa and other parts of the world affected by conflict brings to the shores of the United States and elsewhere youth who are unable to integrate into society because of mental health problems. The economic and social consequences are obvious and now well documented. WHO has developed initiatives that will address these core problems at their origin and provide programmatic support.
WHO's Department of Mental Health and Substance Abuse has initiated three programmes which together form a coordinated effort to address global child and adolescent mental health problems. The programme at its very core appreciates the global interdependence of societies. The three programme elements include 1) a campaign on the stigma associated with mental illness among youth, 2) a global policy initiative that will equip ministries of health to develop coordinated, responsive programmes where child and adolescent mental health will be integrated into overall health care, and 3) a programme to assess the global treatment gap associated with mental illness. In regard to all of these programmes there is a keen awareness that poor mental health on the part of youth leads to lack of compliance with medical regimens, participation in health promotion activities, failure to achieve educationally, lack of ability to participate in work skills development, and adds to the burden in developing societies with increased participation and instigation of violence, abuse of self and others, and support for a broad range of illegal activities. The activities related to identifying treatment resources and the policy initiative parallel the original programmes addressing adult mental health issues.
The World Health Day 2001 featured a school contest for children and adolescents around the world addressing the problem of stigma. The theme of the contest mirrored the theme of World Health Day "Dare to Care: Stop Exclusion." The contest drew worldwide participation and has resulted in the publication of a WHO book "Through Children's Eyes" which provides, through essays and pictures, a child and adolescent view of stigma associated with mental disorders. The book also contains brief descriptions of several mental disorders prominent in youth and a guide for teachers to help lead discussions with youth about stigma. The goal is to see this product lead to a broader campaign on reducing stigma associated with child and adolescent mental disorders. In the future, we visualize a series of regional meetings on stigma followed by a coordinated series of training for a broad range of community resources including religious leaders, educators, key community leaders and parents. In addition, we will develop an enhanced curriculum on mental disorders for use with youth in health education programmes throughout the world. The anti-stigma campaign will be linked to the ongoing policy initiative.
The child and adolescent mental health policy initiative seeks to provide countries with the tools to develop appropriate, sustainable mental health policy. A particular focus is on the stewardship of resources, both human and financial. The child and adolescent component of this broader WHO mental health policy initiative requires a considerable extra effort since international surveys have found a dearth of existing policy. Regional development meetings, key country technical assistance and the dissemination of information to NGOs, governmental organizations will follow on finalization of the policy and services guidance document.
Lastly, the child and adolescent ATLAS resources survey will provide important baseline data to complete the development of policy at the national level. The survey, which has already been initiated, will be the first of its kind and will provide a key tool for interacting with policymakers in countries and with those who seek to develop more coordinated and cost-effective services. In the future WHO will hold technical workshops to demonstrate the use of the epidemiological and demographic data for key countries, again focusing on low-income countries.
In addition to the focused programme areas, the Department has recently sponsored a conference on "Caring for Children and Adolescents with Mental Disorders: Setting the WHO Agenda." This meeting brought together experts from the WHO Regions to discuss issues related to diagnosis and treatment. Gaps in knowledge, issues related to clinical practice and policy considerations were explored. The Report of the meeting was recently published and is available on request. An electronic version can be accessed on line in the Publications. During the coming year it will be made available in several languages.
The child and adolescent mental health programme serves as an internal resource to other WHO programmes involved with child and adolescent health and more targeted initiatives. Statements on particular aspects of practice will be forthcoming as a result of consultations with the WHO Regions. The child and adolescent mental health programme also responds to public inquiries.