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Editorial · Volume 24, Issue 1, 7 May 2018 · Open Access

Innovative Ways to Promote Children's Mental Health: Developing Accessible and Sustainable School Mental Health Services in Pakistan

Affiliations & Notes ⌄
  1. 1MBBS
  2. 2FRC Psych (London)
  3. 3MRCPsych (England), Head/ Associate Professor, Department of Child & Family Psychiatry, King Edward Medical University, Lahore, Pakistan
  4. 4Email: nazishimrandr@gmail.com
Article Info ⌄
Journal:
Annals of King Edward Medical University
Published:
7 May 2018

From the article

  • The risk of mental health problems in youth in Pakistan is much higher due to multitude of social adversities.
  • World Health Report: Mental Health: New Understanding, New Hope.
  • Prevalence of emotional and behavioural problems among primary school children in Karachi, Pakistan — multi informant survey.
  • Committee on School Health: School based mental health services.

Selected from the article's own text.

Abstract

According to World Health Organization (WHO), approximately 10-15% of children and adolescents worldwide suffer from mental health problems.(1) The WHO also highlights that “Lack of attention to mental health of children & adolescents may lead to mental disorders with lifelong consequences, undermines compliance with health regimens and reduces the capacity of societies to be safe and productive”.(2) More than half of all mental disorders have an onset in childhood and adolescence with suicide being the third leading cause of death among adolescents.(1), (3) Child & adolescent mental health thus needs to be considered & emphasized as an integral component of overall health & growth of young population. Youth with positive mental health have positive self-efficacy beliefs, are productive and able to tackle developmental challenges adequately.(4) On the other hand, poor mental health in young age is associated with school failure, delinquency, social and peer problems, substance misuse alongside adverse outcomes in adulthood. 

Possible Models of School Mental Health Service delivery:

School mental health services delivery can take different formats in Pakistani schools.

  • • Student support services financed by schools: Many schools have started hiring psychologists & counselors to help with student’s emotional, behavioral issues and learning difficulties.
  • • Teachers Training programs: This can help by increasing awareness among teachers regarding mental health issues, capacity building to screen problems, & encouraging teachers to take steps to help students in need as well as address myths and stigma related to mental health issues.
  • • Classroom based curriculum and special “pull out” interventions: Many good schools focus on activities enhancing student’s emotional and social well-being in their curriculum. These also include sessions related to awareness about specific problems e.g. bullying, drugs abuse etc. Unfortunately, these activities are less common in schools, where student population is more vulnerable in term of social adversities faced.
  • • Community Connections Model: Schools may develop formal links so that a mental health professional may deliver services part time in schools or referral pathways to off-site mental health services may be developed.
  • • Comprehensive Integrated services: This is the ideal model towards which all efforts should be directed eventually. The focus here is to develop a whole range of programs to encompass all efforts for promoting positive emotional development, healthy and conducive school environment, prevent problems, screening, early intervention after onset of problems and offer of evidence based treatment.

Developing school mental health services in Pakistan is not an easy task but it is important to accept the reality that it is the need of the day if we wish to have healthy, well-adjusted youth. All stakeholders need to contribute in creation of environment that strengthens students, schools, and families and overall our society and school mental health services are an accessible effective and sustainable way to do it.

References

  1. 1. World Health Report: Mental Health: New Understanding, New Hope. World Health Organization Geneva; 2001. Available from www.who.int/whr/en/index.html
  2. 2. World Health Organization (2003a). Caring for Children and Adolescents with Mental Disorders: Setting WHO Directions. Geneva: World Health Organization.
  3. 3. Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustun TB. Age of onset of mental disorders: a review of recent literature. CurrOpinPsychiatr 2007, 20:359-364.
  4. 4. Young Minds Annual Report 2007-08. Available from http://www.youngminds.org.uk/documentlibrary/pdf/2008%20ym%20annual%20report.pdf London, Routledge, 2000
  5. 5. Syed E, Hussein SA, Mahmud S. Screening for emotional and behavioural problems amongst 5–11-year-old school children in Karachi, Pakistan Social Psychiatry and Psychiatric Epidemiology2007;42(5):421-27
  6. 6. Syed E, Hussein SA, Haidry SZ. Prevalence of emotional and behavioural problems among primary school children in Karachi, Pakistan — multi informant survey. The Indian Journal of Pediatrics2009;76(6):623-27
  7. 7. Weare K: Promoting Mental, Emotional and Social Health: A Whole School Approach. London, Routledge, 2000
  8. 8. Flaherty LT, Weist MW. School-based mental health services: the Baltimore models. Psychology in the Schools 1999; 36:379–389
  9. 9. Nabors LA, Weist MD, Reynolds MW. Overcoming challenges in outcome evaluations of school mental health programs. Journal of School Health. 2000 ;70(5):206-9.
  10. 10. Stormshak EA, Dishion TJ, Light J, Yasui M. Implementing family-centered interventions within the public middle school: Linking service delivery to change in student problem behavior. Journal of Abnormal Child Psychology. 2005 Dec 1;33(6):723-33.
  11. 11. Committee on School Health: School based mental health services. Pediatrics 113:1839–1845, 2004

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Innovative Ways to Promote Children's Mental Health: Developing Accessible and Sustainable School Mental Health Services in Pakistan · ResearchersLinks