Enabling equity, inclusion and access: Mental health support for every child

Season 4, episode 6 

Enabling equity, inclusion and access: Mental health support for every child

It’s 2023 and 1 in 5 children is still not protected against vaccine preventable diseases, according to UNICEF’s latest State of the World’s Children report. In this episode of the For Every Child podcast, we mark World Immunization Week, and look at what it would take to build back immunity following the pandemic – globally and in Canada.

Host: Saara Chaudry

Guests: 

Zeinab Hijazi, Senior Mental Health Technical Advisor, UNICEF

Matin Moradkhan, UNICEF Canada Youth Advocate

Producers: Sara Faruqi and Priyadarshini Mitra

Composed and mixed by: Chandra Bulucon

Episode Transcript: 

[00:00:05.66] It's not an easy time to be a child or young adult. The world is recovering from a pandemic. There's economic uncertainty, conflict in many parts of the world. Mass displacement, and an unfolding climate crisis.

[00:00:20.54] Add to that poverty, discrimination, and gender based violence, and it's understandable why children and youth may be anxious, sad, or even angry.

[00:00:30.77] The pandemic forced us to examine the well-being and mental health of young people and children, something we have been ignoring for far too long, and something that may be new to many families, communities, societies, and even countries.

[00:00:46.53] However, the time for action is now. The challenges may be great, but the rewards will be far greater.

[00:00:55.55] Hello, everyone. Welcome to For Every Child podcast. I'm your host, Saara Chaudry. And in this month's episode, we talk about mental health.

[00:01:23.65] In 2021, UNICEF's State of the World's Children Report focused on mental health for the first time ever. And in it it, was concluded that greater action was needed around mental health, from data collection, routine monitoring and research, to better supporting children and youth, caregivers, and schools in addressing mental health needs.

[00:01:46.27] The report also outlined that current data on mental health is skewed heavily towards the world's wealthiest countries, and hence the picture we have of children's mental health is a partial one.

[00:01:59.58] We know too little of how children and young people in most parts of the world experience mental health. Zeinab Hijazi is UNICEF's Senior Technical Advisor on Mental Health.

[00:02:12.41] Hi, Zeinab. So we mental health during the pandemic became a really hot topic. But it was already something that was being discussed, perhaps just not as much as during the pandemic. Can you elaborate a bit more on how mental health has come to be spotlighted more and more in today's world?

[00:02:31.62] Yeah, you know, I've been deeply involved in the global mental health field for more than 18 years now. And of course, alongside mental health experts from around the world, we've been raising the alarm bells for ages, trying to get governments and donors and practitioners to really take mental health seriously.

[00:02:51.88] finally it seems like the world is starting to pay attention. And it's funny how things work. But I think COVID-19 played a role in shining a spotlight on the magnitude of mental health challenges, especially among young people.

[00:03:05.25] And let's not, of course, forget the incredible efforts of young people themselves. They've been speaking up, and they've been demanding action on mental health, making it a central part of discussions on policy and funding and services.

[00:03:18.97] So I think that it's really exciting how children and young people today are much more open to discussing mental health. And in a strange twist, COVID-19 may have actually had a positive impact in this regard. These conversations about mental health are becoming increasingly common. And you know what that means. We're showing children that they're not alone in their emotions and challenges that they face.

[00:03:42.60] We're really fostering connections and understanding around these feelings, whether they're an anxiety, sadness, loneliness, or even joy. And it's a really powerful shift, that I believe that it can make a real difference in young people's lives.

[00:03:56.76] But of course, it's not just COVID. There's this great sense of urgency like never before. Let me repeat that. But it's not just COVID. There is this great sense of urgency like never before, with many challenges that young people face these days.

[00:04:14.16] So there's climate change, economic hardships, employability struggles, the rising cost of living. It's a lot for anyone to handle, let alone someone in their formative years.

[00:04:26.61] And of course, very important to mention-- and this comes up quite a bit-- there is this new phenomenon we're grappling with-- the constant access to limitless information, endless conversations, and bite-sized entertainment, right at our fingertips, 24/7.

[00:04:41.43] And it's a brave new world for developing minds. And we're still figuring out whether this flood of stimuli risks overwhelming their delicate maturation processes.

[00:04:51.82] So in brief, the burden of mental health issues on young people has really weighed heavily on societies for decades. But the plates have finally started to shift. And we're seeing a drumbeat of progress towards solutions and new ways of working and a clearer lens through which we approach mental health of young people and families.

[00:05:11.77] Thank you. So let's talk about how the needs of children and young people when it comes to their well-being can differ quite drastically when given different context. So can you explain how an organization like UNICEF supports young people on their mental health in these different contexts?

[00:05:31.92] I think there's so many things to unpack in that question. What is important to understand maybe firstly is that different contexts will bring unique challenges.

[00:05:43.15] So in stable countries with existing infrastructure, like, for example, right now in Spain, we're working very closely with governments to advance policies and secure financing for mental health systems and services. And this allows us to strengthen the existing resources and create sustainable support networks for children and young people.

[00:06:03.25] But on the other hand, in countries that are deeply impacted by emergencies, such as conflicts or natural disasters, you mentioned the Syria-Turkey earthquake response. There, the challenges are much more complex.

[00:06:17.59] So in these contexts, our focus is on providing immediate and life saving interventions. And this includes mental health and psychosocial support.

[00:06:27.21] And what that looks like on the ground is psychological first aid, applying trauma informed care, setting up safe spaces in schools and communities for children to heal and recover.

[00:06:38.70] We're not doing this work alone. We're collaborating with local partners and communities to ensure that our interventions are informed by the needs, that they build on local strengths and opportunities, and really have the best chance of ensuring children and young people receive the support that they need during these critical times.

[00:06:59.34] But across these settings, I think what we're really putting our focus on is some key programming areas to better support for parents, to make schools and education settings kinder, gentler places, and to really utilize existing community care and support structures and social protection mechanisms to deliver mental health support.

[00:07:22.35] So we're not focusing on diagnosing or treating conditions. We really see mental health on this continuum, from positive mental health to a diagnosable mental health condition. And we all fluctuate on this continuum, depending on different factors affecting us in our day-to-day lives.

[00:07:40.49] Things like a supportive home or a safe school, positive relationships can really boost a child's mental well-being. On the flip side, issues like poverty, abuse, and emergencies can really challenge their mental health. So we're all about understanding and addressing those factors.

[00:08:01.07] Prevention and promotion are core to this approach. It's not just about waiting for a problem to pop up, and then trying to fix it. We want to create environments that nurture good mental health from the get-go.

[00:08:13.79] That means integrating mental health support into all sorts of services, like education and health care and social services and justice. And let's not forget about caregivers. They play a huge role in a child's mental health and their overall well-being.

[00:08:29.54] We're all about giving caregivers a tool and support that they need to provide a loving and stable environment. It's about empowering them to help their children cope with the challenges that they face, whether it's in conflict, war, or other tough situations.

[00:08:44.88] But in order for us to do that, it's not about giving the caregivers those tools and resources alone. It's about prioritizing their own mental health, too. Because we understand that when caregivers are supported, it positively impacts the well-being of their entire family.

[00:09:02.54] And we're also, of course, all about breaking down the stigma surrounding mental health. We want people to feel comfortable talking about it and seeking help when they need it.

[00:09:13.28] In a lot of contexts where we work, we're tirelessly setting up mental health services. But then people don't access those services. So if you don't really address stigma and deep rooted discrimination within communities, we're not going to be able to achieve the results that we need, and we're not going to be able to increase access to the services that are needed by the people who need them most.

[00:09:37.67] And of course, to achieve this, we need to make sure that it's not just top down efforts. We talked a little bit about engaging young people earlier. It really is, at the heart of it, about engaging with communities, engaging with schools and parents and service providers, and most importantly, children and adolescents themselves.

[00:09:58.85] Because we believe by working together and involving everyone in the process, we can really create real change in mental health support for young people and their families.

[00:10:08.69] Right. And what do you think are some areas we need to work on more in order to ensure that young people are provided the tools, support, and services they need for their well-being and mental health?

[00:10:21.59] Yeah, that's such an important question. And it's not one that-- it's not a one size fits all type of answer. In communities where we have deeply rooted stigmas-- and I will talk a little bit maybe about Syria, or even other contexts like Ethiopia or Afghanistan, where the politics, the culture sometimes really creates restrictions in how we respond.

[00:10:46.13] And for us, it's important to sometimes understand that language is quite powerful. And we can come in and use language that we apply in the Western world, for example.

[00:10:59.90] What we need to be doing is engaging the community. What we do is, we create-- we carry out needs assessments with young people, with their caregivers, to understand their needs. That's the first step.

[00:11:13.32] But then second is to be able to understand the words in the language they're using to describe their problems. And that is really critical. Because we need to be able to take that language and apply it in the interventions, in the way that we speak about those interventions, in the way that we promote them, and also gain information from those conversations and dialogues in order to understand, what are the entry points for care? Where are young people going in this community to meet one another, to meet their peers, to have fun, to gain knowledge or seek certain growth in certain aspects of their life?

[00:11:51.20] And for us, it's about meeting them where they are in those communities. So whether it's a community center, or it's within their schools, sometimes, for caregivers, it's easier for them to receive support through primary health care, because they're already going to these services anyway to provide support to their young children's physical health.

[00:12:13.05] And in by integrating mental health into primary health care, then we're able to reduce the stigma surrounding mental health by ensuring that mental health is provided together with services that these caregivers and children and young people are already accessing.

[00:12:30.52] So one misconception I try to correct quite often is, when we approach mental health, we're not setting it up as a standalone mental health service. By doing that, we're actually creating the stigma. We're adding to it.

[00:12:44.88] What we need to do is really look at it as an accelerator for outcomes that we're trying to achieve across other areas. So going into schools, working with teachers, setting up an environment within the classroom by, for example, implementing an intervention that we have, which is called I Support My Friends.

[00:13:02.94] This is a peer to peer psychological first aid intervention manual that supports children in talking to one another and creating empathy for and between children when they are finding that their peer is struggling emotionally with something, or with their academics, et cetera.

[00:13:22.68] So really trying to establish an environment that supports them, through them, and by accessing the spaces where they are at the most.

[00:13:33.90] One area that I feel very passionately about and that I think holds immense potential is really empowering young people to become co-creators of solutions that address mental health challenges in their communities. Young people are incredibly creative. They're incredibly tech savvy. And we should harness their skills and ideas to develop both digital and non-digital innovations.

[00:13:56.55] Imagine young minds coming up with apps or online platforms or interactive campaigns that promote mental health awareness and provide peer support, involving them in the design and implementation of these solutions. We tap into their unique perspectives and ensure that interventions are truly effective and relatable.

[00:14:17.52] So digital tools can play a significant role in reaching young people where they are most comfortable, whether it's through online support groups, mental health resources available at their fingertips or virtual counseling services.

[00:14:31.44] And technology has been shown to really help bridge the gap and provide accessible support. But of course, it's really important to strike the balance and ensure the safe and responsible use of digital platforms, protecting young people from potential harm as well online.

[00:14:49.56] Thank you, Zeinab. That was truly insightful. So as Zeinab said, youth are beginning to push to have their voices heard, seek solutions, and look for support with their mental health and well-being.

[00:15:02.97] UNICEF Canada youth advocate, 23-year-old Matin Moradkhan certainly knows this well. She is a fierce advocate for mental health who just founded a non-for-profit that aims to raise awareness about mental health and provide mental health literacy to equity deserving people.

[00:15:23.31] Hi, Matin. Thanks for joining us. What has your work with UNICEF Canada been like in the area of mental health for youth?

[00:15:31.35] Yeah, so during that 10 week, 10 month program that we had, we had a lot of sessions where we got to chance to meet as a group of advocates and learn more about what is advocacy and how is it done.

[00:15:45.61] And when we formed smaller groups, I chose to be part of the mental health equity group. And I was paired with five more young people who are very interested and also advocating for mental health equity. And we worked on publishing the report which became part of the Reimagine Playbook published by UNICEF Canada in 2022, about our recommendations and our asks from the government about mental health equity in schools.

[00:16:13.62] And then I think one of the proudest moments that I had with UNICEF Canada was able to-- was being able to read that report in front of Canada's governor general, and also a lot of other policymakers and decision makers, just sharing our youth perspective on what needs to change regarding mental health equity and where we stand as a country and what should be done for our youth.

[00:16:37.47] Because we want to move forward, and we want to make sure that our youth are equipped with the tools and resources. So that was a very proud moment for me to be able to share the work that our team had been working on for a very long time.

[00:16:50.22] And since then, I guess things have been a little bit slower. But now that I've been appointed the official youth advocate, I'm looking forward to starting again and looking forward into raising more awareness about mental health.

[00:17:04.18] So what do you think are some areas we need to work on more in Canada to ensure that young people are provided the tools, support, and services they need for their well-being and their mental health?

[00:17:16.18] So I think one of the biggest things that I've learned from connecting to a lot of youth, and also my own research and work that I've done in the field, is the importance of mental health literacy. Because as I've learned and research shows, 70% of all the mental health illnesses and struggles have their onset during childhood and adolescence.

[00:17:42.87] It's very important to use that time of children growing up and during their teenage years, investing in their mental health and making sure that we're preventing a lot of struggles because that's when it could be prevented. And I think mental health literacy and providing students and young people with the tools and education they need to figure out what they could do to take care of their mental health is very important.

[00:18:11.26] And I think the government and a lot of local governments have started working on that. But I personally see having mental health education for students in school, using that awesome time that they spend.

[00:18:26.01] Youth spend a lot of their time in school, and school is the place for education. So why not redirect that some time of-- some of that time to teaching them more about mental health and providing them with the resources?

[00:18:40.03] The other thing that I've learned is that there are resources out there. Unfortunately, youth are not aware of most of those resources. So just familiarizing them with some of the tools and who they can go when they need that help is something that could be worked on more, especially for underserved communities and equity deserving groups.

[00:19:02.67] Regarding mental health equity, I think my understanding of it and what I've heard from a lot of young people is that everybody needs to have a chance to get mental health education, and also be able to access resources.

[00:19:18.75] Currently, unfortunately, although there has been a lot of great steps into having resources available, there are a lot of wait times to receive free or low budget mental health care for people who can't pay a lot of amounts. And also, it's not accessible for everyone.

[00:19:37.59] And I believe mental health care should be something that anybody can access at any time because it's as important or not more important as physical health.

[00:19:47.52] And unfortunately, that's not the situation right now. And we want to move forward in the direction of having mental health resources and mental health care available to everyone, regardless of their background, race, sex orientation, or anything, so anybody can access that care they need.

[00:20:07.86] Is there a message you would like to give young people when it comes to mental health and well-being?

[00:20:12.96] So one thing that I want to just share with you, and I think it's worth saying, is that if you want to become a changemaker and be part of the decision making processes, what I've learned in my journey is that nobody really asks you for your voice to be heard. So make sure that you're active in your community and actively look for opportunities that allow you to share your voice, and make sure that are heard as a young person, because we young people are the future of Canada and we need to have our voices heard.

[00:20:46.00] So great to hear your thoughts on mental health advocacy and your own journey. As we heard from Matin and Zeinab, there are positive developments in the area of mental health for youth and children. Yet we have a long way to go.

[00:21:01.96] As the state of the world's children report on mental health so rightly stated, ignoring the mental health of children and young people undercuts their capacity to learn, work, build meaningful relationships, and contribute to the world, while ignoring the mental health of parents and caregivers leads to failing them in supporting them to nurture and care for children to the best of their ability.

[00:21:29.41] And when we ignore mental health issues in our societies, we close off conversation, reinforce stigma, and prevent children and caregivers from seeking the help they need.

[00:21:42.46] In the face of this reality, we are too often silent, too often unwilling to embrace the full complexity of what it is to be human.

[00:21:54.43] And with that thought, I'll see you next time. Thank you.