Adolescent mental health: new hope for a “Survive, Thrive and Transform” policy response

Abstract

Purpose– Mental health problems make a significant contribution to morbidity and mortality in adolescents worldwide. To address mental health in adolescents policy response should intertwine the life course approach and the ecological model that positions adolescents in the context of multifactorial influences. The purpose of this paper is to describe policy response at four levels: multisector policies and interventions, health systems policies and interventions, evidence-based clinical interventions and actions to monitor progress. It aims to analyse the implications for adolescent mental health of key recent global commitments including the sustainable development goals (SDGs) and the Global Strategy for Women’s, Children’s and Adolescents’ Health.Design/methodology/approach– Multisector policies and interventions on determinants of adolescent mental health and well-being are drawn from the Global Strategy for Women’s, Children’s and Adolescents’ Health. Key health systems actions are derived from the Comprehensive Mental Health Action Plan (2013-2020). In both cases, policies and interventions are made specific for provisions relevant to adolescents. Examples of implementation of policies and interventions are drawn from a World Health Organization (WHO) review of national policy documents found in WHO MiNDbank. A list of indicators to monitor progress is being proposed based on Mental Health Atlas and WHO indicators for adolescent health.Findings– With some notable exceptions, the mental health of adolescents is not adequately addressed by national health policies. There is a considerable body of evidence on the effectiveness of policies and interventions, and recent global commitments give new hope for promoting adolescent mental health through a multisectoral response, within which the health sector has an important role to play. Global reporting mechanisms, including the Mental Health Atlas, should be “adolescent-sensitive”, meaning that adolescent specific impact, outcomes, inputs and determinants should be measured, reported and acted upon.Originality/value– This paper analyses the meaning specific to adolescents in the policies and interventions promoted in the SDGs, the Global Strategy for Women’s, Children’s and Adolescents’ Health and the Comprehensive Mental Health Action Plan (2013-2020). For the first time a four-levels policy response specific to adolescent mental health is put together: multisector policies and interventions, health systems policies and interventions, evidence-based clinical interventions and actions to monitor progress.