The mental health issues people experience cannot be considered separately from areas of development such as education, emergency response, employment, and human rights. Without question, the majority of people who experience mental and psychosocial disabilities live in poverty. They also experience poor physical health and are subjected to human rights violations as well.
Governments, bilateral development agencies, civil society, research institutions, as well as others must work to ensure that people who experience mental and psychosocial forms of disabilities benefit from development efforts.
People with forms of mental and psychosocial disabilities are a vulnerable population due to the way they are treated by society as a whole. They are subjected to discrimination and stigma on a consistent and often times daily basis, experiencing particularly high rates of physical and sexual abuse. People with mental health disabilities frequently encounter restrictions to their exercise of political and civil rights, as well as their ability to participate in public affairs.
People who experience forms of mental and psychosocial disabilities also experience restrictions to their abilities to access needed health and social care, to include emergency relief services. The majority of people with mental health disabilities face unreasonable barriers related to finding work or attending school. Due to these factors, people with mental health disabilities are far more likely to experience other forms of disabilities as well and premature death in comparison with the general population.
Approximately two-thirds of the populations of people who have HIV/AIDS also have depression. The rates of mental health disabilities among people who are homeless may be greater than fifty percent, yet their mental health care needs commonly remain unmet. People with mental health disabilities are not only missed by programs, they may be actively excluded from the same programs, despite explicit goals to reach them. Among the populations of people who experience mental health disabilities are children.
Improving Outcomes for People with Mental and Psychosocial Disabilities
Several principles and actions, ones that are consistent with the Convention on the Rights of Persons with Disabilities (CRPD), can substantially improve the lives of people who experience forms of mental and psychosocial disabilities. The principles and actions can improve development outcomes for them, their family members, as well as the communities they live in. What follows are these principles and actions, which should be integrated into national development, strategies, and planning.
Children and Mental Health Disabilities
Mental health is a crucial part of a child's healthy development. Children must be healthy in order to grow, learn, and lead lives that are productive. Effective treatments, supports, and services exist that can assist children and young people with mental health issues and ones at risk to live successfully and thrive. The majority of children and young people who need mental health services unfortunately do not receive them.
Mental health issues among children are widespread, commonly occurring in young people at a young age. In fact, one in five children has a diagnosable form of mental health disorder. One in every ten young people has a serious form of mental health disorder; one that is severe enough to impair their ability to function at school, home, or in their community. The onset of a major mental health disorder can happen as early as age's seven to eleven. The factors that predict mental health disorders may be identified in a child's early years.
Children and young people who are from low-income households are at an increased risk for experiencing mental health issues. Fifty-seven percent of low-income children and young people come from household with low-incomes that are at or below the federal poverty level. Twenty-one percent of children and young people who are low-income between the ages of six and seventeen experience a form of mental health issue.
Of the children and young people involved with the child welfare and juvenile justice systems, a larger proportion experience mental health issues than children and youth who do not. Fifty percent of children and young people in the child welfare system have mental health issues. Sixty-seven to seventy percent of young people involved with the juvenile justice system experience a form of diagnosable mental health disorder.
The Mental Health System is Inadequate for Children and Young People
The plain fact is - the mental health system is not adequate to meet the needs of children and young people. The majority of children and young people with mental health issues do not get the mental health services they need. Seventy-five to eighty percent of children and young people in need of mental health services do not receive them; an incredibly high number.
The mental health services and supports that are available vary depending upon the state a child or young person with mental health needs lives in. There is a thirty percent difference between the states with the highest and lowest unmet needs for mental health services. Even some children and young people with the greatest needs do not receive the mental health services they require.
Insurance coverage does not seem to matter too much. Eighty-five percent of children and young people who need mental health services in the child welfare system do not get those services. Seventy-nine percent of children with private health insurance and seventy-three percent with public health insurance also do not receive the mental health services they need.
A gap also exists between need and treatment for young people with substance use disorders that sometimes accompany the mental health issues they experience. Less than ten percent of the more than 1.4 million young people between the ages of twelve and seventeen who needed substance abuse treatment in the year 2004, for example, received facility-based treatment for substance abuse.
Children, Young People, Mental Health and the Struggle to Succeed
Children and young people who experience mental health issues also have lower levels of educational achievement, greater involvement with the criminal justice system, and fewer stable, long-term placements in the child welfare system than children and young people with other forms of disabilities. If they are fortunate enough to receive the treatment they need, they do better at school, home, and in the community. Preschool children who lack attention to their social and emotional needs face an expulsion rate that is three times greater than children in kindergarten through the twelfth grade.
Children in elementary school who experience mental health issues are more likely to be unhappy at school, be absent, or be suspended or even expelled entirely. Over the course of a school year they might miss as many as eighteen to twenty-two days of class. Their rates of suspension or outright expulsion are three times greater than their peers.
Young people in high school who experience mental health issues are more likely to fail or even drop out of school. As many as fourteen percent of them receive mostly D's and failing grades compared to seven percent for children with all forms of disabilities. Up to forty-four percent of young people with mental health issues drop out of school.
Young people in the child welfare and juvenile justice systems with mental health issued do less well than others. Children with mental health issues who are in the child welfare system are less likely to be placed into a permanent home and more likely to be placed out of home in order to receive services. They are more likely to over rely on services that are restrictive or costly, such as residential treatment, juvenile detention, or emergency rooms. Young people leaving the child welfare system experience major mental health issues as well as drug and alcohol dependency at notably higher rates than those in the general population.
Strategies to Enhance Mental Health for Children and Young People
Certain strategies can help to enhance mental health for children and young people. The strategies involve concentrating on these populations, presenting them with services that are aimed at them, and providing the services in a timely manner. What follows are the suggested strategies.
Citations and References:
Poverty, social inequality and mental health
This article considers the direct and indirect effects of relative poverty on the development of emotional, behavioral and psychiatric problems, in the context of the growing inequality between rich and poor.
Poverty, Material Hardship and Mental Health (PDF)
Recent evidence suggests that there can be substantial differences between the population defined as poor according to the federal poverty measure and the population reporting material hardships such as food insecurity and housing problems.
Poverty and Mental Health
The link between poverty and mental health is well known. Arguments regarding the causality of the relationship continue but it seems likely that it is bi-directional.
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