Suicide is the leading cause of death among young people aged 15 to 29 in the World Health Organization European Region, which spans 53 countries across Europe and Central Asia. At the same time, one in seven children and adolescents under 19 lives with a mental health condition, and the numbers are rising. Yet despite this growing burden, one in five countries still lacks a dedicated policy for child and adolescent mental health. In its latest report, the World Health Organization calls for urgent action to strengthen mental health care for young people.

By Jennifer Hall, Ledia Lazeri and Joao Breda, WHO Regional Office for Europe

Mental health is an integral part of our well-being and general health, and impacts on our ability to learn and be part of a community. Yet across the WHO European Region, it is estimated that one in seven children and adolescents live with a mental health condition, and far too many continue to struggle in silence.  

According to WHO’s recent report, Child and youth mental health in the WHO European Region: status and actions to strengthen the quality of care, there is a pressing need to act fast to strengthen mental health supports for children and young people.

Mental health is worsening over time

Since 2010, children and young people aged 0-19 years old living with a mental health condition has increased by one third (34%). Of particular concern is the increase in the percentage of children and young people living with anxiety conditions, which has almost doubled since 2010. Females, older adolescents and those from lower socioeconomic backgrounds are more likely to report negative outcomes. 

Suicide remains a major public health concern

Suicide is the leading cause of death for young people aged 15-29 years old. However, on a positive note, suicide rates among children and young people have decreased since the year 2000. 

Environments are not adequately supporting the mental health and well-being of young people

The environment within which we live profoundly impacts our mental health and well-being. An emotionally supportive  environment can strengthen brain development and social and emotional skills, setting the ground for a child to thrive across their lifespan.

However, environments contain many stressors for today’s youth. Approximately half of children and young people are exposed to adverse childhood experiences (such as abuse, neglect, war), school satisfaction is decreasing over time and one in five report no social support. Online environments also contain potential stressors, including limited regulation, exposure to cyberbullying, and addictive design features.

Countries are not adequately equipped to respond to these growing needs

One in five countries across the WHO European Region lack a policy or plan for child and adolescent mental health, and data on child and adolescent mental health is scarce. 

Despite calls from young people for services to be delivered in community-based settings that are free from stigma and easy to access, child and adolescent mental health services remain primarily based in hospitals and inpatient settings, with one in four countries lacking community-based outpatient services. Only one in three countries report having school-based services.

The workforce is not adequate to meet the population’s increasing needs. For each psychiatrist, there are 76 000 children and adolescents (inclusive of those with and without mental health conditions).

The type of care received varies greatly depending on where a child or young person is based

Existing data show huge variations in the types of treatment received (e.g. medication and psychosocial interventions), the type of service (community-based, hospital-based), the cost of accessing services, and treatment rates between countries.  A child or young person’s access to treatment, and the quality of care they receive, may completely differ depending on where they live.

There is a need for action 

Every child and young person requiring mental health support has the right to access high-quality care. 

WHO Regional Office for Europe is actively working towards this through the WHO European Progamme on Quality of Child and Adolescent Mental Health care, an innovative workstream hosted by the WHO Office on Quality of Care and Patient Safety in Athens in collaboration with the WHO European Mental Health and Well-being team, supported by the Government of the Hellenic Republic. 

Under this workstream, WHO has developed the first WHO quality standards for child and youth mental health, hosted an annual Autumn School for Ministry of Health nominated experts, set up a young researchers forum with over 700 members, and has published over 10 scientific publications. With partners, WHO has also co-developed proposed actions to strengthen quality of child and youth mental health care, some of which are below for consideration by governments: 

• Adopt a “mental health in all policies” approach to ensure that national actions plans and strategies jointly call for higher-quality mental health services. 
• Develop and implement evidence-based standards, protocols, and clinical guidelines to standardize care. 
• Engage young people and communities meaningfully in co-designing services and policies that better meet their needs. 
• Invest in a stronger child and youth mental health workforce.

 A whole-of-society approach to strengthening the quality of child and youth mental health care can foster supportive environments and services that enable children and young people to thrive, contributing to a more resilient population and a better future. Behind every number is a young person with hopes and potential, and the future health and prosperity of our societies depend on how well we respond to their needs and their right to high-quality care.

The WHO report was developed under an innovative WHO Regional Office for Europe workstream dedicated to strengthening quality of child and youth mental health care, hosted by the WHO Athens Office on Quality of care and patient safety in collaboration with the WHO European Mental Health and Well-being team and supported by the Government of Greece. The article authors Jennifer Hall, Ledia Lazeri and Joao Breda are staff members of the WHO Regional Office for Europe. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions or the stated policy of the World Health Organization.