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The State of the World’s Children 2021: On My Mind: promoting, protecting and caring for children’s mental health - Regional brief: Europe

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Fear. Loneliness. Grief.

As the coronavirus pandemic descended on the world in 2019, these powerful emotions enveloped the lives of many millions of children, young people and families. In the early days especially, many experts feared they would persist, damaging the mental health of a generation.

In truth, it will be years before we can really assess the impact of COVID-19 on our mental health.

For even if the potency of the virus fades, the pandemic’s economic and social impact will linger: over the fathers and mothers who thought they had left the worst of times behind them, but are once again struggling to put food in a baby’s bowl; over the boy falling behind in school after months of disrupted learning; and the girl dropping out to work on a farm or in a factory. It will hang over the aspirations and lifetime earnings of a generation whose education has been disrupted.

Indeed, the risk is that the aftershocks of this pandemic will chip away at the happiness and well-being of children, adolescents and caregivers for years to come – that they will pose a risk to the foundations of mental health.

For if the pandemic has taught us anything, it is that our mental health is profoundly affected by the world around us. Far from being simply a question of what is going on in a person’s mind, the state of each child’s or adolescent’s mental health is profoundly affected by the circumstances of their lives – their experiences with parents and caregivers, the connections they form with friends and their chances to play, learn and grow. Mental health is also a reflection of the ways their lives are influenced by the poverty, conflict, disease and access to opportunities that exist in their worlds.

If these connections were not clear before the pandemic, they certainly are now. COVID-19 has put the mental health and well-being of an entire generation at risk, but mental health concerns are not new: Indeed, long before the COVID-19 pandemic struck, parents, teachers and many others were voicing growing unease about the mental health of children and adolescents.

This is the reality that is at the heart of The State of the World’s Children 2021.

A challenge ignored

Indeed, what we have learned is that mental health is positive – an asset: It is about a little girl being able to thrive with the love and support of her family, sharing the ups and downs of daily life. It is about a teenage boy being able to talk and laugh with his friends, supporting them when they are down and being able to turn to them when he is down. It is about a young woman having a sense of purpose in her life and the self-confidence to take on and meet challenges. It is about a mother or father being able to support their child’s emotional health and well-being, bonding and attaching.

The links between mental and physical health and well-being, and the importance of mental health in shaping life outcomes, are increasingly being recognized. They are reflected in the connection between mental health and the foundations of a healthy and prosperous world acknowledged in the Sustainable Development Goals. Indeed, that agreement among the nations of the world positioned the promotion and protection of mental health and well-being as key to the global development agenda.

Despite all this, governments and societies are investing far, far too little in promoting, protecting and caring for the mental health of children, young people and their caregivers.

A time for leadership

At the heart of our societies’ failure to respond to the mental health needs of children, adolescents and caregivers is an absence of leadership and commitment. We need commitment – especially financial and political commitment, from global, regional and national leaders and from a broad range of stakeholders – that reflects the important role of social and other determinants in helping to shape mental health outcomes. The implications of such an approach are profound. They demand that we set our sights on a clear shared goal of supporting children and adolescents at crucial moments in their development to minimize risk – and maximize protective – factors.

As well as commitment, we need communication: We need to end stigmas, to break the silence on mental health, and to ensure that young people are heard, especially those with lived experience of mental health conditions. Without their voices being heard and their active participation and engagement, the challenge of developing relevant mental health programmes and initiatives will not be met.

And we need action: We need to better support parents and caregivers so that they can better support their children; we need schools that meet children’s social and emotional needs; we need to lift mental health out of its ‘silo’ in the health system and address the needs of children, adolescents and caregivers across a range of systems, including parenting, education, primary health care, social protection and humanitarian response; and we need to improve data, research and evidence to better understand the prevalence of mental health conditions and to improve responses.

A time for action

The COVID-19 pandemic has upended our world, creating a global crisis unprecedented in our lifetime. It has created serious concerns about the mental health of children and their families during lockdowns, and it has illustrated in the starkest light how events in the wider world can affect the world inside our heads. It has also highlighted the fragility of support systems for mental health in many countries, and it has – once again – underlined how these hardships fall disproportionately on the most disadvantaged communities.

But the pandemic also offers an opportunity to build back better. As this report sets out, we know about the key role of parents and caregivers in shaping mental health in early childhood; we know too about children’s and adolescents’ need for connection; and we know about the dire impact that poverty, discrimination, marginalization and domestic violence can have on mental health. And while there is still much work to be done in developing responses, we already know the importance of key interventions, such as challenging stigmas, supporting parents, creating caring schools, working across sectors, building robust mental health workforces, and establishing policies that encourage investment and lay a solid foundation for mental health and well-being.

The European Union (EU) institutions should scale up their action to build back better by laying down the foundations for more resilient national health and social protection systems, while centring the recovery on the new generation’s well-being with a focus on making mental health services accessible to all who need them.

We have a historic chance to commit, communicate and take action to promote, protect and care for the mental health of a generation. We can provide support for the foundation of a generation equipped to pursue their dreams, reach their potential and contribute to the world.