Battling anxiety and other mental illnesses worsened by the pandemic, Caribbean youth have set their governments an agenda for change in a region hobbled by inadequate mental health services and recurrent environmental disasters.
In Latin America and the Caribbean, 16 million adolescents live with a mental disorder. The covid-19 pandemic exacerbated this; children and youth have been more worried, anxious, and depressed than ever before, and while mental health needs have increased, the limited mental health services in the Caribbean have been disrupted.
Recognising this, youth from across the Caribbean are calling on policymakers to re-evaluate their mental health care systems to better protect children and youth. Leading the charge is Healthy Caribbean Youth (HCY), the youth arm of the Healthy Caribbean Coalition, which believes that the key to a transformed mental health system that ensures the wellbeing of children and youth necessitates tackling four key areas—leadership, research, regulations and services. Alongside youth from across the region, HCY is demanding urgent and comprehensive action from policymakers.
Exploring the reality
The structure of the average mental health care system in the Caribbean, paired with the region’s geographic location, are sources of concern when it comes to the mental wellbeing of its citizens. The average system is focused on traditional, institutionalised, and centralised care with little to no community-based services or disaster management plans that integrate mental health.
Since small island developing states (SIDS), like those of the Caribbean, are extremely vulnerable to environmental disasters, its people are increasingly susceptible to the associated negative mental health impacts. A general lack of investment in mental health and wellbeing has halted progress in health promotion and the development and implementation of effective policy across the region.
Leadership
Unfortunately, provisions for mental health support are not adequately integrated into national health and wellness, youth or disaster response plans, where they exist.
It is paramount that policymakers ensure that mental health and wellbeing are incorporated into national policies to ensure that a multisectoral and whole of society approach is used to promote, protect, and care for mental health.
In addition, the youth must be given opportunities within the government to voice issues related to their wellbeing and co-create and lead on action plans that prioritise their mental health concerns.
Research
There is little to no data to guide mental health interventions. As such, there is a need for greater collaboration between policymakers and related entities to create or strengthen research systems related to mental health and wellbeing.
Specifically, this could involve the integration of mental health into population-based surveys to better inform policy and programming, and ensure that research findings are disseminated appropriately and translated into action.
Regulations
Children and youth are often subject to bullying, harassment, and exploitation on the basis of their age, weight, gender, sexual orientation, or socioeconomic status, among other factors. In addition, they are prime targets of the pervasive marketing of health-harming products including ultra-processed foods, tobacco products, alcohol, and skin bleaching products.
These issues are especially prevalent in schools and other environments populated by children and youth. Unfortunately, the pandemic has had a multiplicative effect as the digital environment has become a more accessible, less supervised breeding ground for these activities.
Policymakers must prioritise the development and enforcement of regulations that concern the accessibility and marketing of health-harming substances in recognition of their negative correlation to adverse or exacerbated mental health effects, as well as implement, expand, or strengthen discrimination laws in schools, workplaces, and other places that children and youth occupy.
Services
From HCY consultations, youth across the Caribbean believe that mental health services offered at the country level do not meet the needs of the majority. During the pandemic, some policymakers and development agencies across the region intervened and ramped up mental health support services locally, such as helplines for children and youth, but more can be done. Although these interventions are valued and appreciated, they have not addressed the systemic issues related to stigma, accessibility, and affordability of mental health services.
To address this, there is need for urgent implementation or strengthening of services to support the mental health and wellbeing of children, youth, and their caregivers, including the provision of psychological first aid training to all who engage with youth, the implementation and strengthening of school and community-based services and referral systems, and the integration of mental health into school curricula.
The time to act is now. Coming out of the pandemic, Caribbean youth have seized the opportunity for collective mental health advocacy, calling for policymakers to build forward and better in this 'new normal'.
Given SIDS’ resource constrained settings, it is imperative that 'building forward' prioritises investment in mental health system strengthening activities that are evidence-based, cost-effective and informed by, tailored to, and accessible to the unique needs of children and youth in the Caribbean region.
Prioritising the building and strengthening of a mental health system that is focused on supporting children and youth’s optimal mental health is what they deserve; it is also an investment in our society’s collective future.
The opinions expressed are those of the author and do not necessarily reflect the position of Re:solve Global Health.
These views are informed by youth consultations across the Caribbean and do not necessarily reflect the views of any particular country.
Co-authors Danielle Walwyn, Kerrie Barker, Stephanie Whiteman, Neorgia Grant and Simone Bishop-Matthews are members of Healthy Caribbean Youth, the youth arm of the Healthy Caribbean Coalition. They oversee the subcommittee of young people across the Caribbean who were instrumental in developing the call to action and planning related activities.