Strategic Plans and

Policies to Improve Adolescent Mental Health

in the Caribbean

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Dr. Claudina Cayetano

Mental Health Regional Advisor (PAHO/WHO) 

Introduction

• Youth with good mental health can concentrate and complete tasks, build and maintain friendships and adapt to changes in their circumstances.
• Poor mental health can impact education/learning, and increase risky behaviors and premature death, primarily due to suicide and violence.
• Strategic plans and policies are essential to address the gaps in youth’s mental health across the region.
• To monitor the existence and use of youth policies and plans PAHO/WHO uses the Mental Health Atlas

Background of the Atlas

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• MH Atlas Project (MSD/WHO) - collect, analyze and disseminate data on mental health resources in the world
• Mental health policies, plans, financing, care delivery, human resources, medicines, and information systems
• Instrument to measure implementation progress of the comprehensive Mental Health Action Plan 2020-2030
• Serve as the vehicle for monitoring and evaluation and the achievements of global targets

WHO Mental Health Atlas Series

Mental Health Atlas, first implemented 2001, updates were produced in 2005, 2011, 2014, 2017, and the most recent is 2020

PAHO Mental Health ATLAS

of the Americas Series

Rational:

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• The rational of the ATLAS of the Americas Series is to provide PAHO/WHO countries and territories a detailed overview of the state of the Region’s mental health.

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• Valuable resource on regional information on mental health and an important tool for planning and monitoring mental health services within countries

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• Conducted every three (2) years, the document serves as a guide for countries in the development & planning of mental health services

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Participating Countries and Territories in the Americas

by subregion

The Questions in the Mental Health Atlas

Child And Adolescent Mental Health Care�

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To evaluate the mental health needs of this population, the questionnaire includes four (4) items focused on their mental health needs.

Items:

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1. Does your country have a plan or strategy for child and/or adolescent mental health?
2. The level of availability of inpatient care for children and adolescents.
3. The level of availability of outpatient care for children and adolescent
4. The total number of health workers in child and adolescent mental health services in your country

Plan or Strategy for Adolescent MH�

Q1. Countries that have a plan or strategy for adolescent mental health.

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• 58% (19 of 33) countries from the Americas responded that a national (stand alone or integrated) policy/plan has been adopted by their respective government.
• A comparative view between the Region (AMRO) & the sub-region of the Caribbean, shows the Caribbean (33%) remains below the Regional average (58%) for governance adopting adolescent MH policy/plans.

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For the sub-region of the Caribbean only.

• 4 of 14 countries (ATG, BLZ, JAM & TTO), responded that a national policy/plan has been adopted by the government.

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Inpatient care for Adolescents�

Q2. Availability of inpatient care for adolescents

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• 83% (30 of 36) of countries in the Americas responding to the 2020 ATLAS, indicated that there is no availability of inpatient care for adolescents.

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• However, in responding to the number of bed allotted to adolescents, 36% (13 of 36) provided a response. Indicating that adolescents may receive treatment at the mental health hospital.

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Outpatient care for Adolescents�MH ATLAS 2020

Q3. The level of availability of outpatient care for adolescents.

Q3.1. Hospital-based mental health outpatient services specifically for children and adolescents

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• 71% (27 of 38) countries in the Americas reported having outpatient services for children and adolescents.

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• A comparative view between the Americas (AMRO) and the sub-region of the Caribbean, show the provision of outpatient services for the Caribbean (50%) to be below the Regional average (86%).

Outpatient care for Adolescents�

Q3.2. Community-based mental health outpatient facility.

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• 60% (21 of 35) countries in the Americas reported implementing community-based mental health services

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• 43% (6 of 14) countries in the Caribbean sub-region indicated that they provided these services at the country level.

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• A comparative review of the findings shows the Caribbean sub-region (43%) to be below the Regional average (60%) for the provision of this services.

Median number of individuals working in the mental health sector by type of profession�(per 100,000 population)

Regional Overview of Mental Health HR Psychiatrists

Q4.1a. Number of child and adolescent mental health Psychiatrists.

Countries respond to this question reported the total number of Psychiatrist employed by the government, providing MH services to child and adolescent.

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• When compared, Cuba (n=416) reported the highest number of Psychiatrists employed by the Gov. within the Region.
• In the sub-region of the Caribbean, TTO (n=13), reported the reported the highest number of Psychiatrists.

Regional Overview of Mental Health HR Psychologists

Q4.1b. Number of child and adolescent mental health Psychologists.

Countries provided the total number of child and adolescent Psychologist:

• DOM (n=8564) reported the highest number of Psychologist providing public MH care within the Region.
• In the Caribbean, ATG (n=35), reported the reported the highest number of Psychologists.
• AIA & GUY all reported having no Gov. employed Psychologist, specialized in child and adolescent mental health.

Conclusion

• Adopting Adolescent mental health policies are a valuable resource to guide the provision of, and access to quality youth and adolescent mental health services.

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• More effort is still needed for the integration of adolescent mental health services into country's primary health care setting, and away from mental health hospital.

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• The lack of policies hinders the abilities of countries to strive toward improving youth and adolescent mental health services. At the same time, policies are not enough. They also need implementation/operational plans and monitoring and evaluation components to assess implementation challenges and impact.

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• The results of the 2020 ATLAS shows limited/lack of data provided by country’s, on human and financial resources to address the mental health needs of adolescents. This is a concern for the Caribbean sub-region. Improvement in data collection and analysis is required as part of the effort to improve service delivery to youth and adolescents.

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• The PAHO/ WHO will continue to offer technical support to the member states to address the Regional adolescent mental health burden

video

Thank You!��

Reference�

1. Pan American Health Organization. Mitigating the Direct and Indirect Consequences of COVID-19 on the Health and Well-Being of Young People in the Americas [Internet]. Washington DC: Pan American Health Organization; 2021 [cited July 2022]. Available from: https://iris.paho.org/handle/10665.2/54815

1. World Health Organization. Guidelines on mental health promotive and preventive interventions for adolescents [Internet]. Geneva. WHO; 2020 [cited July 2022]. Available from: https://apps.who.int/iris/bitstream/handle/10665/336864/9789240011854-eng.pdf?sequence=1&isAllowed=y

1. World Health Organization. Mental Health Atlas [Internet]. Geneva. WHO; 2020 [cited July 2022]. Available from: https://www.paho.org/en/node/83744