Meeting the psychosocial-related needs of adolescents
Awareness of the mental ill-health and psychosocial distress related challenges facing adolescents is increasing, and there is also increased awareness of the need to address mental health challenges more generally (see e.g. the welcome addition to the Sustainable Development Goals (SDGs) of the need to strengthen mental health by promoting “physical and mental health and well-being…for all” (Paragraph 26) with specific mental health goals in targets 3.4, 3.5, and 3.8, as well as the WHO Mental Health Gap Action Plan that aims at scaling up services for mental, neurological and substance use disorders for countries especially with low- and middle-income). However, the needs of adolescents in this area are largely unmet, and particularly in developing countries, with programmes being often age and gender blind. Additionally, while some countries may have some infrastructure and capacity (as well as appropriate policies) for dealing with severe mental health disorders (autism, schizophrenia, epilepsy) largely because they are easily recognisable, less severe forms of mental ill-health (depressions, anxiety, stress) often go unreported and untreated because they are more difficult to diagnose, are less visible, and often people are unwilling to come forward because of the associated stigma, preferring rather to deal with it either at home or alone (Samuels et al, forthcoming).
In order to address some of the underlying drivers of mental ill-health and psychosocial distress, in this case the discriminatory gender norms that underlie a lot of this distress, solutions need to include linking to programmes that unpack and address these range of gender norms. Thus, for instance, programmes targeting early marriage, linking also to notions of sexual purity for girls, restrictions of their mobility and freedoms, should include discussion on how such norms can lead to isolation, depression, anxiety and fear and ways of mitigating these need to be dealt with upfront. A cadre of service providers with social work or psychology backgrounds is also critical to address these less severe forms of mental ill-health and psychosocial distress, something which is often missing in many developing country contexts. Similarly, capacity building and tailoring services to the specific needs of adolescents, and indeed other age groups, as well as ensuring they are gender sensitive, is vital - adolescent girls are often fearful of, or unable to access reproductive health services often because providers are male and may have patronising attitudes.. More generally, service provisioning needs to be informed by an understanding of the prevailing gender norms which underlie much of the mental ill-health and psychosocial distress that adolescents, particularly girls, face and which also affect the extent to which they are able and willing to access services.