They key mental health priority topics for the High-Level Meeting
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Child and youth mental health
Anxiety and depression alone in adolescents – young people aged 10 to 19 – make up 40% of the global burden of disease. More than 1 in 7 adolescents are living with a diagnosed mental health condition, such as depression, anxiety, or behavioural disorders, with 50% of these beginning before the age of 18 (and almost two-thirds by the age of 25).
Each year, an estimated 45,800 adolescents tragically lose their lives to suicide, leading to suicide being the fifth leading cause of death of those aged 10-24 years old. Suicide is the leading cause of death among boys aged 10 to 19 and the second leading cause among girls aged 15 to 19.
There are several key drivers of poor mental health among children and young people, such as poverty, domestic and community violence, bullying, family dysfunction, substance use, and the abuse of technology and social media. Failing to address these issues through prevention and support measures prevents children and youth from growing up to realize their full potential.
Investment in the prevention and treatment of mental health conditions among children and young people, and the promotion of their mental wellbeing, remains extremely low. The adoption of national child and adolescent mental health (CAMH) policies remains slow: in the WHO Mental Health Atlas 2020, only 53% of 168 responding countries had a plan or strategy for CAMH. In 2020, approx. 60% of countries reported that they had updated their policies/plans for children and adolescents since 2017.
The contribution of children and young people to society is limited by mental health conditions. Anxiety and depression, for example, influence a child’s ability to learn, develop, form relationships, and reach their full social and economic potential.
Young people are more than beneficiaries of mental health interventions - they are experts in designing and implementing the programmes and services that best address their needs.
Suicide prevention (incl. decriminalisation)
Every year, more than 720,000 people lose their lives to suicide. Almost three-quarters of these deaths are in low- and middle-income countries (LMICs). For each person who dies by suicide, there are likely 20 more who make a suicide attempt. Suicide represents a significant public health challenge.
Suicide is the third leading cause of death among 15–29-year-olds, while close to 8,000 children between the ages of five and 14 are estimated to have died by suicide worldwide in 2021.
Suicide and suicide attempts are criminal offences in civil law in more than 20 countries worldwide. The punishment of suicidal behaviour deters people from seeking the help they need, increasing the risk of suicide, and exacerbating the stigma and shame associated with suicide. Criminalization results in suicide being underreported, preventing governments from understanding the true scale of the problem, recognizing at-risk groups needing additional support, and appropriately investing in suicide-prevention strategies.
Suicide can be prevented through evidence-based interventions. WHO’s LIVE LIFE approach recommends four effective, evidence-based key interventions which should be included in every national response to suicide: limit access to the means of suicide; interact with the media for responsible reporting of suicide; foster socio-emotional life skills in adolescents; early identify, assess, manage and follow up anyone who is affected by suicidal behaviours.
Service reform (ending institutionalisation)
In most countries, mental health care is heavily focused on provision in institutions (i.e. long stay mental hospitals, traditional institutions such as prayer camps and other NGO- or government-run custodial care that operates as an asylum for people with severe mental health conditions).
On average, only around 2% of government health budgets are allocated to mental health, which drops to 1% in low-income countries (LICs). Of this limited budget, on average, 67% globally goes towards institutions. It is nowhere near enough to meet the level of need: in 2020, there were 71.8 admissions to mental hospitals per 100,000 people globally and only 10.8 beds per 100,000.
In certain WHO regions, including the Americas and the Eastern Mediterranean, more than 25% of all people in institutions were kept there for as long as five years, in 2020.
Institutionalizing people living with mental health conditions (ie. isolating long-stay) often breaches several articles of the UN Convention on the Rights of Persons with Disabilities. Involuntary admissions, arbitrary detentions, coercive practices, inhumane treatment and other forms of human rights abuses are common in institutions and can harm mental health.
The WHO Comprehensive Mental Health Action Plan (2013-2030) and the UN Special Rapporteur's report on the right of everyone to the enjoyment of the highest standard of physical and mental health recommend systematically shifting the locus of care from institutions and over-medicalisation towards human rights-based care models prioritising early interventions and a network of community-based mental health services. These services should be holistic, recovery-oriented, person-centred and high-quality. They should protect human rights and align with the Convention on the Rights of Persons with Disabilities.
Institutionalization affects not only people living with mental health conditions, but also persons with psychosocial and physical disabilities, as well as minorities, a disproportionate number of women, and children and young people.
People in institutions are more vulnerable to both communicable and non-communicable diseases.
Social and commercial determinants of mental health
Mental health is profoundly shaped by the circumstances in which we are born, grow up, work, live and age. Many of these co-determinants are shared with physical health and NCDs (e.g. smoking, burnout, domestic violence, unhealthy eating).
Even under optimal conditions, treatment alone will never be sufficient to reduce the global burden of mental ill health. Social and economic conditions shape the mental health of populations. For example, childhood adversity is directly causally responsible for almost 30% of all psychiatric conditions (Kirkbridge et al., 2024).
Attempting to reduce the number of people with mental ill health without combating adverse social and economic conditions would be like trying to tackle lung cancer with no regulations on cigarette smoking, or trying to reduce infectious disease without investments in public sanitation.
There is growing attention on the potential mental health impacts of digital technology, especially on young people. The Pact for the Future, especially the commitment under Digital Trust and Safety paragraph 31, highlights the urgent need for further work in this area.
The smoking, alcohol, ultra-processed foods and gambling industries' products and practices directly or indirectly harm mental health in a variety of ways, very few of which are currently addressed by policies and regulations.
