ADVOCACY: The future, now

ADVOCACY: The future, now

The mental well-being of the world’s youth is an increasingly recognised challenge, but by investing in evidence-based approaches we can unlock better outcomes

Physical, emotional and social changes, including exposure to adversity, poverty, stress or violence, can make young people vulnerable to poor mental well-being. Millions of young people around the world experienced such changes during Covid-19. But poor mental well-being already constituted a major challenge for young people before the pandemic: around one in five of the world’s children and adolescents have a mental health issue. 

However, mental well-being is still neglected: worldwide, less than 2% of national health budgets in low- and middle-income countries is spent on mental health. Equally, only 0.15% of official development assistance is dedicated to child- and adolescent-specific mental health. Investing in evidence-based, effective approaches informed by the experiences and ideas of young people is critical to giving the mental well-being of young people the attention it deserves.


The perspective of a young mental health advocate with lived experience

Manvi Tiwari, a 19-year-old woman from India, is no stranger to speaking out about the challenges to mental well-being. At 12 years old, Manvi had to care for her mother who was diagnosed with obsessive-compulsive disorder and depression. Five years later in 2020 and prompted by the mobility restrictions imposed in response to the Covid-19 pandemic, Manvi had to confront her own struggles with depression and OCD. Shaped by these challenges, Manvi has become a strong advocate for intersectionality in global approaches to youth mental health and well-being.

What are the main challenges to mental well-being you have experienced? 

At the time my mother was formally diagnosed, mental health awareness was limited in India. It took three years to learn that mum should receive care from a psychotherapist, rather than a general practitioner. In terms of my mental well-being, self-stigma and stigma outside the family were major challenges. We didn’t want friends, neighbours or teachers to know about my struggles. I thought I was open-minded as I knew mental health conditions were normal, but I later realised I had self-stigmatised it and had attached some shame to it.

How do you deal with challenges to your mental well-being? What kind of support did you receive?

Due to my mother’s experiences, my family was aware of the issues I was facing and emotionally very supportive. Unfortunately, many young people don’t receive the same kind of support and parents can dismiss their children’s experiences. Weekly therapy, which I still attend, along with my family’s support was critical. Reassurance that there are others with similar experiences was also important. The Global Mental Health Peer Network has given me this shared sense of understanding – we get to talk and share stories. Sharing my own story was also cathartic for me and could hopefully empower others.

What are the challenges for young people more broadly in terms of mental well-being? 

Young people who identify as LGBTQIA+, are disabled or have a refugee background experience different challenges. Therefore, a one-size-fits-all approach to mental well-being won’t work. Moreover, mental health services are not always accessible to young people – there are long waiting lists, sometimes high costs, and they may not be youth-friendly. Parents can also be a barrier to their children seeking care as they do not understand what poor mental health is or the purpose of specific therapies. More investment is needed to ensure that mental health support is available to everyone.

What more must be done to ensure adequate support for young people with mental health issues?

If someone is having an anxiety attack, what do you do? Sometimes we can be insensitive and make it worse despite our best intentions. Mental health first aid taught in schools is one way to address this. If awareness is created at a young age, people may be more sensitive and able to better care for someone close to them suffering from poor mental well-being. We also need an intersectional approach to mental well-being, based on evidence. For example, we lack data especially in India and LMICs on the intersection of mental well-being and young people who are refugees or who identify as transgender or queer.

You are engaged in the Global Mental Health Peer Network. What is it about?

We participate in international fora and events to raise awareness and advocate for mental well-being. Young people with lived experiences are getting space to speak. I remember the 12-year-old girl who was crying herself to sleep at night, and now she is at the World Health Summit talking about why and how the mental health of young people must be improved. That girl is so proud right now. So that is the beauty of the network, that is what it does.

A new mental health initiative for young people

A new mental health initiative for young people by Grand Challenges Canada in collaboration with United for Global Mental Health, Fondation Botnar and other partners strives to contribute to the continuous improvement of youth mental well-being in low- and middle-income countries. The initiative applies a systemic approach combining research, innovation, policy and advocacy measures that address social, economic and other drivers to create an enabling environment for mental well-being. Young people will be an integral part of developing locally driven approaches that have the potential for transformative change, helping alleviate the
mental health burden seen in all ages.