The State of the World’s Children 2021: On My Mind – Promoting, protecting and caring for children’s mental health

The report estimates the prevalence of mental disorders – including anxiety, depression, schizophrenia, alcohol or drug addiction – among children across gender, age groups and regions. In 2021, 12.5 per cent of all girls (77 million) and 13.8 per cent of boys (89 million) between 10-19 years of age were suffering from mental disorders.

Among the mental health conditions experienced by adolescents (aged 10-19 years) across the world, the most common disorders are ‘anxiety and depressive disorders’ (42.9 per cent), ‘conduct disorder’ (20.1 per cent), ‘attention-deficit/hyperactivity disorder’ (19.5 per cent), and ‘idiopathic developmental intellectual disability’ (14.9 per cent).

The report uses data from the WHO Global Health Estimates from 2019 to evaluate the incidence of suicide among adolescents (10-19 years of age). It states that around 45,800 adolescents die from suicide every year.

In North America, Western Europe and South Asia, incidences of suicide are higher among adolescents with suicide being the second most leading cause of death.

Globally, suicide is the fifth most common cause of death among adolescents aged 10-19 years. It is the fourth most common cause for death among those aged 15-19 years.

The report, citing a 2019 article from the Journal of Family Medicine and Primary Care, states that stigma related to mental health conditions is passed to children through the opinions and behaviours of others around them. The article studied responses of 566 school teachers from southern India to find that as high as 70 per cent of them were of the opinion that depression is neither a sickness, nor dangerous.

The report highlights various factors that adversely affect the mental health of children. Underage mothers and a low birthweight can negatively impact the child during the perinatal period, the report notes. Inadequate diet during early childhood (0-8 years), child labour, orphanhood, and absence of schooling also cause mental harm to children. In addition to these, being bullied, alcohol and marijuana use and child marriage also affect children negatively.

The report cites a 2021 study titled Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis which surveyed 80,000 children and adolescents globally. The report notes that clinically significant cases of depression and anxiety doubled during the Covid-19 pandemic. Around 25 per cent children and adolescents (less than or 18 years of age) reported experiencing depression and about 20 per cent reported suffering from anxiety during the pandemic.

Citing the World Health Organization’s Mental health atlas 2020, the report notes that the global median government spending on mental health was as low as 2.1 per cent of the total global median spending on health.

During 2018, low-income countries spent roughly 0.08 US dollars per capita on mental health annually while lower middle-income countries spent 0.37 US dollars per capita.

During 2018, governments in upper middle-income countries spent 3.29 US dollars per capita on mental health whereas high-income countries spent 52.73 US dollars per capita.

In high-income countries, the median number of psychiatrists specialised in treating children and adolescents was 5.5 per 100,000 children and adolescents. In the remaining countries, the median number of such specialists was as low as 0.1 per 100,000 children and adolescents.

The report notes that stigma around mental disorders, lack of coordination between health, education and social protection sectors and inadequate financial and human resources are major barriers in promoting and protecting the mental health of children.

The report recommends investing across sectors (health, education and social protection systems), supporting and training parents and caregivers and improving research on mental health to promote mental well-being among children.

Focus and Factoids by Abizar Shaikh.

PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.