OPINIONS
Anna-Kynthia Bousdoukou
March 3 2022
Andreas Dracopoulos, Stavros Niarchos Foundation (SNF) Co-President
It seems we are finally coming out of the Covid-19 tunnel—it has been a global pandemic, a global war against an invisible and at times a seemingly 'invincible' enemy. Nearly six million people have lost their lives, and billions of people have suffered in so many ways. Our own world as we know it was caught unprepared, and at least we have to hope that next time we will be better prepared. Will we?
The collateral damage of this global war will be felt by billions of people for years to come, in so many ways. Among the issues that will be affecting us maybe more than ever is dealing with our mental health. In a strange way, it is because of (and, ironically, thanks to) Covid-19 that the stigma associated with mental health issues is starting to lift in a big way. For the first time, so many people all around the globe have come out to talk about mental health—their own, their families’, etc. Solving any problem requires that first you can clearly identify it, and in this case we, as people, seem to have finally accepted that our mental health needs at least as much care as our bodies. We used to stress the need to maintain good physical health in order to maintain a healthy mind, emphasizing on what we needed to do for our bodies, and it seems we took for granted that our mental health would then be fine. But it’s not; it’s far more complicated, but yes, thanks to Covid-19, we now have a new opportunity—an obligation—as a global human society to focus on the diagnosis, prevention, treatment, etc. of mental health at large. And we all need to join in in this effort. At our Foundation, the Stavros Niarchos Foundation (SNF), we have been engaging with and supporting various efforts in the field, and we are particularly proud of our collaboration with the Child Mind Institute, with projects both in the US and in Greece dealing with the mental health of children and teens.
Please see below a piece I coauthored with Dr. Harold Koplewicz, who leads the Child Mind Institute.
Harold S. Koplewicz, MD Founding President and Medical Director of the Child Mind Institute
The mental health crisis that’s been building over the past twenty years is very real and touches every corner of the globe. One in five children struggle with a diagnosable mental health or learning challenge. These early-onset mental health challenges are a crucial turning point for development. More than half of mental health disorders in adulthood start by age 14. And yet this population is critically underserved. In the United States, 70% of counties don’t have a single child and adolescent psychiatrist. Worldwide, there are entire countries without a single child psychiatrist. Stigma keeps too many children and families from even asking for help.
What can we do? It is incredibly important to lobby for changes that will increase the supply of mental health professionals to an adequate level to care for the world’s children. But there is another, synergistic approach: prevention. As US Surgeon General Vivek Murthy recently wrote, mental health challenges in youth are real and widespread. “But most importantly, they are treatable, and often preventable.”
Feelings of anxiety, uncertainty, and isolation put youth at higher risk for developing mental health disorders and unhealthy coping strategies. Giving them tools to cope with the outsized stressors of their lives can set them on a positive developmental trajectory without the need for treatment.
As a doctor, I want everyone to know that there are effective and life-changing treatments for common disorders like anxiety and depression. But it is at least as important that we do what we can to prevent these disorders from ever occurring. We need to provide every child (particularly underserved and isolated youth) the skills and support they need to rebound from adversity. Prevention can help all our children. To reach every child and family, we need innovative partnerships between the government and mental health experts, extended by technology, to scale our efforts.
We have good tools to address the pandemic in youth mental health. Let’s use them.
Op-ed by Andreas Dracopoulos, Stavros Niarchos Foundation (SNF) Co-President, and Harold S. Koplewicz, MD, Founding President and Medical Director of the Child Mind Institute
We are just beginning to appreciate the long-term impact of the past two years on mental health—and especially for children and adolescents. But we know already that lockdowns, isolation, and uncertainty have contributed to increases in anxiety and depressive symptoms, and parents have been pushed to the breaking point as the crisis disrupts their fragile support networks.
Covid-19 doesn’t just cause mental health symptoms—it is uncovering the lack of basic support for the emotional health of our children, who as a group are underserved by current systems. In a recent report on the state of youth mental health noting the disproportionate impact on marginalized communities, the United States Surgeon General encourages responding with a “whole of society” approach.
We, who are working at the forefront of philanthropy and child mental health, urge our cross-sectoral peers to embrace this call to action and come together in a “whole world” approach. We need to be able to give our mental health the same attention we give our physical health, to recognize that this is a universal problem, and to finally banish the stigma that hinders healing. The single most important takeaway from the Covid-19 mental health crisis is the need to build capacity to support children's emotional health.
This isn’t an easy task. In the United States, deficits in training and workforce development in children’s mental health at all levels—at school, in the pediatrician’s office, and in mental health care settings— has been a persistent barrier to access and utilization. 70% of US counties don’t have a single child and adolescent psychiatrist. (The same is true for most rural areas in Greece, where we are collaborating on a mental health initiative.) And that was before the pandemic. In the same way that Covid-19 revealed weaknesses in our pandemic preparedness, it also revealed weaknesses in our mental healthcare system, which has historically ignored children almost completely, and is still woefully underdeveloped. The risks of untreated mental health problems are significant and long-lasting—including continued mental health disorders, school dropout, family dysfunction, social isolation and suicide. Yet two-thirds never get the treatment they need.
The mental health crisis shares another similarity with the coronavirus pandemic: it is global and has a disproportionate effect on marginalized and under-resourced communities. Black and Hispanic teens are more likely than white teens to express concern about pandemic mental health challenges, according to the Child Mind Institute’s 2021 Children’s Mental Health Report. In Greece, the Stavros Niarchos Foundation (SNF) Health Initiative has seen that households in remote areas, refugee and migrant populations as well as Roma communities are less likely to have access to adequate mental healthcare. There is a critical, global need to invest in access to evidence-based mental healthcare for all children and adolescents—particularly those most at risk.
When we listen to the needs of the people on the ground who have recognized the barriers and inequalities present, we hear calls for capacity-building. The Child Mental Health Initiative (CMHI), a new joint initiative between the Child Mind Institute and the SNF as part of the latter’s Health Initiative in Greece, hopes to do just this; to expand capacity for mental health support for children and youth in Greece.
The CMHI aspires to reinforce and extend the critical work done by mental health and child protection providers across the country. Through a collaborative, interdisciplinary model between the Child Mind Institute and regional teams of Greek professionals specializing in child mental health and psychosocial care, the program aims to increase care access, capacity, and resources while developing a country-wide network and improving mental health literacy and awareness. By collaborating and bringing together international and local expertise, our initiative is using field-leading research to build robust and accessible mental health support for young people across Greece.
We see this capacity-building effort in Greece as a blueprint that can be applied across Europe and potentially around the world.
This work is not optional. Organizations like ours must recognize that addressing challenges facing children and young people is both an immediate priority and a long-term commitment. Governments and NGOs can play their part by sharing best practices and openly communicating with the local professionals and communities who utilize this care.
What’s next? Whether it’s Covid-19 or mental health, public health crises require sustainable international collaboration to determine the best ways to direct resources and build capacity for preventing further harm. We need to demonstrate a common will to come together across borders and agree that access to mental healthcare is an area we cannot be divided about. As Surgeon General Vivek H. Murthy writes: “It would be a tragedy if we beat back one public health crisis only to allow another to grow in its place.”