World HealthOrganization(WHO)
Background Guide Topic:

Promoting Mental Well-Being in a Post-Corona World

Director’s Note
Dear Delegates,
Welcome to the Japan Metropolitan Model United Nations conference 2022! My name is Miho Ando andI will be serving as the director of the World Health Organization council. It is an honour to chair thisyear’s Beginner I committee, and I sincerely hope that your time at the conference will be aonce-in-a-lifetime experience.
As a student at Senzoku Gakuen, my experience in Model United Nation began five years ago.
Back then, I lacked the skills and knowledge required to fully participate in and thus enjoy the discussions
held at the conference. It is for this rudimentary grasp of MUN which I possessed as an amateur that myfirst impression of MUN turned out to be far from enjoyable. However, my negative perception of MUN
underwent a major shift at an in-school conference in my second year as a junior. At the conference, I wasfortunate enough to receive support from a senior student who encouraged me to make a bold speechwithout overly worrying about the eyes of the other delegates -- an act that I had never dared to take as arather passive member of the MUN club up to this point. Having given a determined speech and receiving
positive attention from other countries, I came to realize the thrill of MUN one can gain by simply being
confident. In this way I was introduced to the fun world of MUN.
Participating in large MUN conferences can at times be daunting with a group of experienced
delegates who attempt to dominate the discussions. Whilst these people may be the most vocal ones, I canassure you from my experience that they are not necessarily the most wise ones. It is not about speaking
the most but indeed about speaking with confidence, even if it is only once. Making mistakes is absolutely
fine too; it is the Chair’s duty to support delegates of all levels, not to tell them off!
My final advice to you all is simple: do your research and speak with confidence. In the end, it is
all about the basics.
All three chairs of this committee look forward to a conference jam-packed with new discoveries
and enduring memories. We wish you all the very best of luck!
Sincerely,

Miho Ando, Director
World Health Organization
Senzoku Gakuen Model United Nations ClubJapan Metropolitan Model United Nations 2022

Introduction of theCommittee
Founded in 1948, WHO is the agency of theUnited Nations responsible for international
health. The work of WHO is strictly basedon the basic principles of the right to healthand well-being for all people, as defined in
the WHO 1948 Constitution. The WHO is
dedicated to promoting health, keeping theworld safe, and serving the vulnerable
worldwide while leading global efforts to
expand health coverage.

Key Terms
Mental health 1
Mental health is a state of well-being inwhich an individual realizes his or her own
abilities to cope with the normal stresses oflife, to work productively, and to make acontribution to his or her community.
Mental health is an integral part of healthwhich is more than the mere absence ofmental disorders and disabilities.
Anxiety
Anxiety is “an emotion characterized byfeelings of tension, worried thoughts, andphysical changes like increased blood

1WHO. (2018 May 30). Mental health: strengthening
our response. Retrieved July 24, 2021 fromhttps://www.who.int/news-room/fact-sheets/detail/me
ntal-health-strengthening-our-responsepressure.” 2 Anxiety can also develop into
anxiety disorder which is not merely atemporary worry or fear and can involve
symptoms that interfere with daily activities
such as job performance and relationships. 3
Depression4
Depression is “a common mental disorder,
characterized by sadness, loss of interest or
pleasure, feelings of guilt or low self-worth,disturbed sleep or appetite, feelings oftiredness and poor concentration”.
Suicidal ideation
Suicidal ideations are “thoughts about or apreoccupation with killing oneself, often asa symptom of a major depressive episode”. 5

Current Situation
In 2015, the 2030 Agenda for Sustainable
Development and its 17 Sustainable
Development Goals (SDGs) were adopted
by all members of the United Nations. Goal
2

Anxiety. (2021). Anxiety - American Psychological
Association. https://www.apa.org/topics/anxiety
3
NIMH » Anxiety Disorders. (n.d.). Anxiety
Disorders. Retrieved August 29, 2021, fromhttps://www.nimh.nih.gov/health/topics/anxiety-disor
ders4WHO. (n.d.). Key terms and definitions.
WHO/Europe. Retrieved July 30, 2021, fromhttps://www.euro.who.int/en/health-topics/noncomm
unicable-diseases/mental-health/data-and-resources/key-terms-and-definitions-in-mental-health#depression
5
APA Dictionary of Psychology. (n.d.-b). Suicidal
Ideation. Retrieved August 29, 2021, fromhttps://dictionary.apa.org/suicidal-ideation

3 of the SDGs is to “ensure healthy lives andpromote well-being for all at all ages,”making mental health and well-being a key
aspect of creating a world of peace andprosperity. 6 In target 3.4, promoting mental
health and well-being is recognized as apriority for sustainable development. The
United Nations has used suicide mortality
rates to measure the progress that the world
has made in terms of promoting mental
health. From 2000 to 2019, there was nearly
a 30% decline in the global suicide rate. In
2000, there were 13.0 deaths by suicide per
100,00 population. In 2019, this number
decreased to 9.2 deaths per 100,00
population. 7
Although the suicide rates are declining,nearly one million lives are lost to suicide
every year. This equates to one suicide every
forty seconds. Despite this shockingly large
number, less than 2% of the global medianhealth budget was allocated to mental healthin 2017.8 Poverty, compromised education,
gender inequality, ill-health, violence, andother global challenges are all contributing
factors to poor mental health. 9
6

THE 17 GOALS | Sustainable Development(The United Nations) https://sdgs.un.org/goals
7
Goal 3 | Department of Economic and Social Affairs(The United Nations) https://sdgs.un.org/goals/goal3
8
Mental health (World Health Organization)
https://www.who.int/data/gho/data/themes/mental-health9Mental Health and Development (World HealthOrganization)

The World Health Organization conducted asurvey on suicide prevention in 2013 across
157 countries with 90 responses. The survey
revealed that 55 of the participating
countries perceived suicide as a serious
public health concern. 28 of the responding
countries had adopted a comprehensive
national strategy or action plan. 10 As of July
21st, 2021 the number of countries thatreport having a national suicide prevention
strategy has increased from 28 to 38. 11

Case Studies
Subtopic I: Sexual and Gender
Minorities
The World Health Organization recognizes
that groups who experience discrimination
have a high suicide rate. Sexual and genderminorities, such as lesbian, gay, bisexual,
transgender, and intersex people is one
example of these vulnerable groups. 12
Sexual and gender minorities are at an evenhttps://www.un.org/development/desa/disabilities/iss
ues/mental-health-and-development.html
10Preventing Suicide: A global imperative (World
Health Organization)
http://apps.who.int/iris/bitstream/handle/10665/13105
6/9789241564779_eng.pdf?sequence=1
11
Preventing Suicide: A global imperative (World
Health Organization)
http://apps.who.int/iris/bitstream/handle/10665/13105
6/9789241564779_eng.pdf?sequence=1
12
Suicide (World Health Organization)
https://www.who.int/news-room/fact-sheets/detail/sui
cidegreater risk now due to the pandemic. They
make up a large portion of those who arepoor, experiencing homelessness, and don't
have access to healthcare. Additionally, thepandemic had a detrimental effect on
industries that people of the LGBT
community were more likely to work in,such as food service, retail, public sector
education and grooming. 13
Under such circumstances, the mental healthof sexual and gender minorities is at stake.
Taking steps to reinforce the protection andpromote the well-being of these groups is
crucial to ameliorate mental health in a
post-Corona world.
The United States
A survey conducted in 2015 showed thatamongst students in Grades 9-12, 42.8% ofgay, lesbian, or bisexual students
experienced suicidal ideation. This is asignificantly larger number compared to
14.8%, the percentage of heterosexual
students who experienced similar thoughts.
Additionally, 29.4% of gay, lesbian, or
bisexual students attempted a suicide in the
twelve months leading up to the survey, as
13

THE IMPACT OF THE COVID-19 PANDEMIC
ON THE HUMAN RIGHTS OF LGBTPERSONS(Office of the United Nations HighCommissioner for Human Rights)
https://www.ohchr.org/Documents/Issues/SexualOrie
ntation/ImpactCOVID19LGBTpersons.pdf

opposed to the 6.4% of heterosexual
students. 14
Sexual and gender minorities often
experience institutional, interpersonal, andindividual pressures due to the negativesocial attitudes they experience due to theirsexual orientation or gender identity. These
stressors can lead to a decline in one’s
mental state, leading to severe mental healthconcerns. 15
Sexual and gender minority adults who
experienced high levels of family rejection
have a higher chance of suffering fromsubstance abuse, sexual risk behaviors, andsuicide attempts. On the contrary, sexual andgender minority adults who were acceptedby their families have greater self-esteem
and are at a lower risk of depression,suicidal ideation, and substance abuse. 16

14Sexual Identity, Sex of Sexual Contacts, andHealth- Related Behaviors Among Students in
Grades 9-12— United States and Selected Sites, 2015
(US Department of Health and Human
Services/Centers for Disease Control and Prevention)
https://www.cdc.gov/mmwr/volumes/65/ss/pdfs/ss65
09.pdf15
Ending Conversion Therapy: Supporting and
Affirming LGBTQ Youth ( Substance Abuse andMental Health Services Administration)
https://store.samhsa.gov/sites/default/files/d7/priv/sm
a15-4928.pdf
16Ending Conversion Therapy: Supporting and
Affirming LGBTQ Youth ( Substance Abuse andMental Health Services Administration)

Germany
In May of last year, Germany’s parliament
passed a bill which banned conversion
therapy for minors under the ages of 18, as
well as for those above the legal age whose
consent was obtained through deception,
threat, and coercion. 17 18
Conversion therapy aims to change people’s
sexualities from gay, lesbian or bisexual toheterosexual, and from transgender orgender diverse to cisgender. Such practices
are built on the belief that one’s sexual
orientation or gender identity is somethingthat can and should be changed. These'treatments’ often include psychotherapy,
medication, or faith-based practices. 19A UN
Expert claimed that, “Practices known as‘conversion therapy’ inflict servere pain andsuffering on lesbian, gay, bisexual, trans andgender-diverse (LGBT) persons, often

https://store.samhsa.gov/sites/default/files/d7/priv/sm
a15-4928.pdf
17
Act to Protect against Conversion Treatments(Federal Ministry of Health)
https://www.bundesgesundheitsministerium.de/en/pre
ss/2020/conversion-treatments.html
18
Germany passes law banning 'gay conversion
therapy' for minors (BBC News)https://www.bbc.com/news/world-europe-52585162
19
Report on Conversion Therapy (Office of theUnited Nations High Commissioner for Human
Rights)https://www.ohchr.org/EN/Issues/SexualOrientationG
ender/Pages/ReportOnConversiontherapy.aspx

resulting in long-lasting psychological andphysical damage.” 20
Although Germany received criticism forlimiting the age of which gay conversion
therapy is prohibited, it still remains as oneof the fifteen countries in the world toprohibit such procedures. 21
Spain
On July 3rd of this year, 24-year old Samuel
Luiz was beaten to death outside of anightclub. 22 It is suspected that his assailants
had homophobic motives due to thehomophobic slurs they used against Luiz, as
well as the fact that Luiz was homosexual.
This sparked outrage in Spain, and led tostreet protests on a large scale. 23

20

UN expert calls for global ban on practices of
so-called “conversion therapy” (Office of the United
Nations High Commissioner for Human Rights)
https://www.ohchr.org/EN/NewsEvents/Pages/Displa
yNews.aspx?NewsID=26051&LangID=E
21
Conversion Therapy bans in National Legislations
around the Globe (National Center of Biotechnology
Information)
https://pubmed.ncbi.nlm.nih.gov/33395666/22
Protests in Spain against suspected LGBTQ hatecrime (NBC News)https://www.nbcnews.com/nbc-out/out-news/protestsspain-suspected-lgbtq-hate-crime-rcna1347
23
Spanish police arrest fourth suspect in fatal beatingof Samuel Luiz (El País)
https://english.elpais.com/spain/2021-07-09/spanishpolice-arrest-fourth-suspect-in-fatal-beating-of-samuel-luiz.html

In 2005, Spain became the third country tolegalize same-sex marriage. This granted
same-sex couples the rights to adopt
children, inheritance, and tax benefits.
Moreover, the principle ofnon-discrimination on the ground of sexual
orientation have been incorporated into
Spanish laws. These laws include, asylum
protection, employment, health, education,
State Security Forces and Corps, personaldata, communication, and penitentiary
regulations. 24
Despite these efforts, 278 out of 1076 casesof hate crimes reported by police in 2019were motivated by bias against gender andsexual minorities, making it the second
leading motivator after racism andxenophobia. 25 This puts gender and sexual
minorities in vulnerable positions, which canlead to a decline in one’s mental state.

Subtopic II: Social Equity
Happiness is closely linked to social equality
and community spirit, according to theWorld Happiness Report 26. This section
24

SPAIN LGBT GOOD PRACTICES ( Office of theUnited Nations High Commissioner for Human
Rights)https://www.ohchr.org/Documents/Issues/Discriminat
ion/LGBT/Res_27_32/Spain.pdf
25
Spain | OCSE - ODIHR - OSCE Hate Crime (Organization for Security and Co-operation in
Europe) https://hatecrime.osce.org/spain
26
Helliwell, John F., Richard Layard, Jeffrey Sachs,
and Jan-Emmanuel De Neve, eds. 2020. World

introduces several cases of how social equity
can be considered as a contributing factor tomental health instability in people fromvarious countries.
Denmark
According to the World Happiness Report, 27
Denmark is the second happiest country in
2021, scoring 7.646 out of 10. Denmark alsoranked 6th in growth domestic production(GDP) per capita, slightly lower than the
United States, which ranked 5th. Danish
people pay some of the highest tax rates in
the world; the lowest possible income tax
rate in the country is 39.86%, which ranked
the highest in the world. Some citizens evenpay up to half of their salary. Most Danes,on the other hand, are satisfied with this rateconsidering what they get in return.
In Denmark, the majority of healthcare isprovided free to the patient. University
students pay no tuition and are given a grant
to aid with living expenses while they areenrolled. The cost of child care is
subsidized. In addition, the elderly are given
pensions and are frequently visited at homeby caretakers.
Happiness Report 2020. New York: Sustainable
Development Solutions Network
27
World Population Review. (2021). Happiest
Countries In The World 2021.
https://worldpopulationreview.com/country-rankings/
happiest-countries-in-the-world.

Moreover, when it comes to diagnosing
mental illnesses like bipolar disorder or
schizophrenia, Denmark utilizes the ICD-10
manual from the World Health Organization.
If the patient's primary care physician
suspects they have a serious condition, they
will be referred to a specialist center- in
Copenhagen, the Psykiatriens Centrale
Visitation For Voksne in sterbro – for further
diagnosis and treatment referral 28. Since
these healthcare options are mostly provided
free to the citizens, it is less challenging tosee psychiatrists regardless of their incomes.
India
WHO stated that India's mental healthburden is 2443 disability-adjusted life years(DALYs) per 100 000 population, with a
21.1 age-adjusted suicide rate per 100 000
population. Between 2012 and 2030, theeconomic loss related to mental healthdisorders is predicted to be USD 1.03
trillion. 29 India’s suicide mortality rate
marked the highest among the world in
2019: 381 suicidial deaths per day.
28

Redohl, S. (2021, July 9). Depressed in Denmark:How to find a therapist in the ‘world’s happiest
country.’
https://www.thelocal.dk/20210709/depressed-in-den
mark-how-to-find-a-therapist-in-the-worlds-happiestcountry/.
29
World Health Organization. (n.d.). Mental health.
World Health Organization.
https://www.who.int/india/health-topics/mental-health.

Furthermore, India is 144th on the World
Happiness Report; 3.57 out of 10. Despite
being the world’s fifth largest economy,
India has only spent 0.05 percent of its
annual healthcare budget in recent years.
The amount spent on mental health isaround 33 paisa (0.004 USD) per mental
health patient, while 150 million people
require urgent care 30.
The worldwide COVID-19 pandemic has
accelerated India’s mental health crisis.
Loneliness and isolation has caused theelderly population to be diagnosed bymental disorders such as depression,schizophrenia, obsessive-compulsive
disorders and dementia. Within the young
population, on the other hand, the lack of
educational and employment opportunities
are the contributing factors of the ongoingissue. 31
However, a huge portion of India’s
population still lacks access to mental healthservices. The social stigma often causes
people to reject seeing a psychiatrist or
30

Ministry of Health & Family Welfare, Governmentof India. (2017, October 31). National Mental Health
Programme. DIRECTORATE GENERAL OF
HEALTH SERVICES.
https://dghs.gov.in/content/1350_3_NationalMentalH
ealthProgramme.aspx.
31

Krishnan, M. (2021, May 19). India's COVID crisis takes
toll on mental health . DW.COM.
https://www.dw.com/en/indias-covid-crisis-takes-toll-on-m
ental-health/a-57582565.

visiting a mental health hospital. Due tolanguage barriers and the lack of education,
most news and social media coverage ofmental health concerns does not benefit the
majority of the Indian population. Othersignificant obstacles include unequal accessto mental health care, economic inequality,
and a shortage of qualified mental healthprofessionals. 32
South Korea
Although South Korea has been well known
for its glamorous and happy K-POP music
culture, the country has marked the highest
suicide rate and hospitalization rate
regarding mental health, among the 37
OECD (Organism for Economic
Co-operation and Development) countries 33
for almost 13 consecutive years. In 2019,
South Korea’s suicide rate was 26.9 cases
per 100,000 population; roughly 36 people
per day, and one person every 40 minutes
commit suicide. In addition, suicide is sadly
the number 1 cause of death among young
populations. According to studies, the32

Sarkar, S. (2021, April 27). COVID-19 has exacerbated
India's hidden mental health pandemic . IndiaBioscience.
https://indiabioscience.org/columns/opinion/covid19-has-exacerbated-indias-hidden-mental-health-pandemic.
33

Denyer, S., & Kashiwagi, A. (2020, November 30).
Japan and South Korea see surge of suicides among
young Women, raising new questions about Pandemic
stress. The Washington Post.
https://www.washingtonpost.com/world/asia_pacific/j
apan-suicides-pandemic-women/2020/11/28/0617e3a2-fdbd-11ea-b0e4-350e4e60cc91_story.html.

biggest reason for teenage suicide in South
Korea is the academic pressure, whereas
unemployment and economic difficulty isfor those in the 20s and 30s. 34“[South] Korea’s consumption ofantidepressants is ⅓ of the average of OECD
countries. That means there’s still a highbarrier to getting mental health treatment
here,” says psychiatrist Se-Hoon Shim of
Soonchunhyang University Hospital 35.
South Korea has higher suicide rates among
elderlies compared to other OECD nations
and this is thought to be because the South
Korean social security system wasunderdeveloped for a long time. In the
1970s, a financial crisis overtook South
Korea, causing roughly 2,000,000 people tolose their jobs, and many of whom arecurrently senior citizens, making elderly
poverage a serious issue in the country. The
government’s slow response to thisunemployment issue accelerated theinequality within the country. It was 1999
when South Korea finally introduced its
universal pension coverage system.
Therefore, since the elderlies only paid for a
Korea Now. (2021, March 13).
Why South
Korea has high suicide rates. YouTube.
https://youtu.be/lkx0T9wMWXg.
35
Korea Now. (2021, March 13).
Why South
Korea has high suicide rates. YouTube.
https://youtu.be/lkx0T9wMWXg.
34

short time for the system, many of them areonly able to receive a small amount ofpension, and some of them are not eveneligible to receive any 36.
The South Korean government lead bypresident Moon Jae-in, on the other hand,approved ‘the National Suicide Prevention
Action Plan (2018-2022) 37’ in 2018, aiming
to reduce the number of suicide cases in the
country by 50% by 2022. Additionally, oneof the largest South Korean online
platforms, NAVER, closed its comment
sections for entertainment and sports related
topics in order to prevent online slandering,which is a contributing factor of mental
health issues. 38
The suicide rate especially among young
women has increased by 4.8% in the city of
wowKorea. (2021, July 8). ＜W解説＞⾼い⾃殺率が続く韓国、背景には何が？＝昨年には⽇韓の対策センターが意⾒交換. wowKorea.
36

https://www.wowkorea.jp/news/newsread_image.asp?imd=306379&numimg=1.
37
Government of the Republic of Korea. (2018).
WHO MiNDbank: More Inclusiveness Needed in
Disability and Development.
__(National Action Plan for
Suicide Prevention) 2018.
https://www.mindbank.info/item/6785.

자살예방 국가 행동계획38

KYODO NEWS+. (2021, July 31). Olympic
athletes pained by online bashing, mental health caresought. Kyodo News+.
https://english.kyodonews.net/news/2021/07/13be0e9
0b1a9-olympic-athletes-pained-by-online-bashing-me
ntal-health-care-sought.html.

Seoul. According to Joo-Ji Young, deputy
head of the Seoul Suicide Prevention Center,the city’s suicide prevention hotline hasreceived a record number of calls since thepandemic began, while the number ofpeople attempted suicide nationwide
increased 10% in the first eight months ofthe year, according to the Health Ministry. 39

Subtopic III: Children andAdolescents
The WHO recognizes childhood andadolescence as a critical stage in life formental health. Especially adolescence(10-19 years) is a crucial period fordeveloping and cultivating both social andemotional habits which are essential for
mental well-being. 40
Despite the importance of childhood andadolescence when it comes to developing
the basis for mental well-being, mental
health conditions account for 16% of the
global burden of disease and injury in
39

Simon Denyer, A. K. (2020, November 30). Japanand South Korea see surge of suicides among young
Women, raising new questions about Pandemic
stress. The Washington Post.
https://www.washingtonpost.com/world/asia_pacific/j
apan-suicides-pandemic-women/2020/11/28/0617e3a2-fdbd-11ea-b0e4-350e4e60cc91_story.html.
40
Adolescent mental health. (2020, September 28).
World Health Organization.
https://www.who.int/news-room/fact-sheets/detail/ad
olescent-mental-healthpeople aged 10-19 years. 41 Being one of theleading causes of illness and disability
among adolescents, mental conditions suchas depression can cause adolescents tobecome vulnerable to social exclusion,
discrimination, educational difficulties,risk-taking behaviours, physical ill-health,and human rights violations.
Moreover, the outbreak of the Covid-19
pandemic has affected and changed the livesof many young people, depriving them ofopportunities needed to promote
psychological well-being. Surveys have also
revealed that the emotional well-being ofchildren with mental health disorders suchas autism has significantly deteriorated amid
lockdowns.42 Further, the rapid speed atwhich the world is changing as seen in
movements such as globalization anddigitalization is altering the future into anincreasingly unpredictable one; this may
also be contributing to the escalation ofdepression and anxiety among young people
and thus the decline in their mental

well-being. The WHO is eager to provide
support for all children and adolescents who
suffer from mental health conditions andguide them towards the achievement of
mental well-being.
LebanonIn Lebanon, an estimated 488,000
school-aged Syrian refugee children (3-18
years) are currently registered by the
UNHCR.43 This forced displacement
resulting in the loss of homes, belongings,
and opportunities for education has made agreat negative impact on the refugee
children. A research conducted by Caritas
Lebanon Migrants Center in 2015 reported
that although most refugee children did not
directly experience trauma-inducing
experiences, they had either witnessed orindirectly heard of the incidents. 44 This has
resulted in the children’s development ofsymptoms associated with trauma as well as
the consequences of one third of the children
frequently feeling sad, nervous, or anxious.
A study has also identified that an alarming

41

Adolescent mental health. (2020, September 28).
World Health Organization.
https://www.who.int/news-room/fact-sheets/detail/ad
olescent-mental-health42
Lepper, J. (2021, February 3). Autistic children
facing mental health crisis during lockdown, charity
warns. CYP Now.
https://www.cypnow.co.uk/news/article/autistic-children-facing-mental-health-crisis-during-lockdown-cha
rity-warns

43

Education. (n.d.). UNHCR Lebanon. Retrieved
July 29, 2021, fromhttps://www.unhcr.org/lb/education
44
Insights into Syrian Refugee Children’s Mental
Health Status & Coping Mechanisms - Lebanon.
(2016, February 4). ReliefWeb.
https://reliefweb.int/report/lebanon/insights-syrian-refugee-children-s-mental-health-status-coping-mechanisms

41% of adolescent Syrian refugees has
thought about committing suicide. 45
Currently, Lebanon is facing its worst
economic crisis in decades with high levels
of inflation and currency devaluation. The
world bank has mentioned that the crisis“could rank among the world’s three worst
since the mid-1800s in terms of its effect onliving standards”. 46 In the midst of thisuncertainty and instability, the mental healthof children are facing increased risk due tosevere anxiety and stress. Further, the Beirut
explosion which occurred in August 2020 issaid to have put the mental health ofchildren among the casualties under serious
threat. Many are likely to be suffering fromanxiety, sleep-terrors, and sleeplessness. 47
Long-term consequences will also be faced
should proper support for these children be
neglected.

The Covid-19 pandemic has further
accelerated the worsening of the children
and adolescent’s mental well-being in
Lebanon. National lockdown measures haveboosted the prevalence of psychologicaldisorders among children including anxiety,depression and stress. Approximatley 83%
of the families reported a change in the
behaviour of their child during the
lockdown, and 40% of refugee adolescents
aged 15 to 18 reported that the pandemic isdamaging their mental health status. 48 The
income loss and school closure triggered by
the pandemic has aggravated child abuseand violence, leaving devastating effects
both short-term and long-term on the mental
health of the children.
Japan
Although physical health of children in
Japan is not a significant issue, the mental
well-being of children in Japan falls wellbehind other developed countries.
According to a UNICEF study 49 released on

45

DeJong, J., Sbeity, F., Schlecht, J. et al. Young lives
disrupted: gender and well-being among adolescent
Syrian refugees in Lebanon.Confl Health 11, 23(2017). https://doi.org/10.1186/s13031-017-0128-7
46
Hubbard, B. (2021, July 17). As Lebanon’s Crisis
Deepens, Lines for Fuel Grow, and Food andMedicine Are Scarce. The New York Times.
https://www.nytimes.com/2021/07/05/world/middlee
ast/lebanon-economic-crisis.html
47
Beirut’s children are likely to suffer from anxiety,night terrors – Save the Children - Lebanon. (2020,
August 7). ReliefWeb.
https://reliefweb.int/report/lebanon/beirut-s-childrenare-likely-suffer-anxiety-night-terrors-save-children

48

Ibrahim And Farhat, S. T. (2021, July 15). Global
Health Institute | The Impact of COVID-19 on Syrian
Refugee Children’s Mental Health, Access, andRetention to Education in Lebanon. AUB Global
Health Institute.
https://ghi.aub.edu.lb/ghiblog/the-impact-of-covid-19/
49
Worlds of Influence: Understanding what shapes
child well-being in rich countries. (n.d.). (C)2021
Www.Unicef-Irc.Org - UNICEF Office of Research Innocenti. Retrieved July 24, 2021, fromhttps://www.unicef-irc.org/child-well-being-report-ca
rd-16

September 8 2020, Japanese children had
the second worst rated mental well-being outof the 38 nations studied. One reason thatcan be suggested for the undeveloped mental
health care support for children andadolescents in Japan is the age compositionof the population. Children and adolescentsages 18 and under account for 16% of thenation’s population compared to 22% in theUK, making the Japanese population one ofthe oldest in the world. 50 As a result, theJapanese social welfare system -- including
mental health care systems -- is centeredaround geriatric care rather than care for thechildren and adolescents.
Lack of training and workforces for themental health of children and adolescents inJapan is also a challenge faced by the nation.
Within Japan, Child and Adolescent
Psychiatry (CAP) has been considered asubspeciality of psychiatry and pediatrics,
depriving the CAP of opportunities tobecome a formally established speciality. 51
As of 2017, there existed neither

50

Sakanoa, M., & Snowden, N. (2018, July 18).
Paving the way for the future of child and adolescentmental health in Japan. PubMed Central (PMC).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074
641/
51
Tateno, M., Inagaki, T., Saito, T., Guerrero, A., &Skokauskas, N. (2017). Current Challenges andFuture Opportunities for Child and Adolescent
Psychiatry in Japan. Psychiatry investigation, 14(5),525–531. https://doi.org/10.4306/pi.2017.14.5.525

standardized training programs of CAP nor
any national guidelines for CAP training.
The number of suicides committed byelementary, junior high and high school
students in 2020 in Japan further reflects thelack of support for children and adolescentsin the field of mental health. According to
the Ministry of Health, Labour and Welfare,the number of school-age suicides in Japan
hit a record high of 499 in 2020, showing a
sharp increase from 339 the previous year. 52

Figure 1: Number of school-age suicides in Japan has
hit a record high in 2020

Moreover, a survey conducted online in2020 involving 344 high school students
revealed that 30% had experienced
symptoms of moderate to severe depression.
The outbreak of the Covid-19 Pandemic has
made the encouragement of mental
well-being for children and adolescents in
52

Saori, Y. (2021, July 27). Japan's child suicide
crisis. NHK WORLD.
https://www3.nhk.or.jp/nhkworld/en/news/backstories/1672/

Japan a much more urgent and unavoidable
path to take.
Netherlands
The mental well-being of children in the
Netherlands ranks first out of 38 developed
countries, according to a report released by
UNICEF in 2020. In fact, young people in
the Netherlands have been reported to beamong the highest levels of mental
well-being since the start of the 21st century.

least once a year. 54 This designation of GPs
as the gateway to mental health careenhances the identification and treatment ofchild mental health problems in times ofneed. However, GPs could not have made apositive contribution to the care of children’s
mental health had it not been for the various
initiatives introduced to the country. One
initiative was the implementation of YouthWelfare Work Offices in 2005. Another was
the opportunity offered to the GPs to consult
secondary health care professionals,
stimulating the cooperation between primaryand secondary mental health care.

Past Actions
53

Figure 2: Ranking of Child mental well-being by
UNICEFIn the Netherlands, general practitioners(GPs) play a substantial role in the care ofchild and adolescent health. Almost all
citizens are registered in general practices
close to the community, and the majority ofchildren and adolescents visit their GP at
53

De Looze, M.E., Cosma, A.P., Vollebergh, W.A.M.
et al. Trends over Time in Adolescent Emotional
Wellbeing in the Netherlands, 2005-2017: Links with
Perceived Schoolwork Pressure, Parent-AdolescentCommunication and Bullying Victimization.J YouthAdolescence 49, 2124–2135 (2020).
https://doi.org/10.1007/s10964-020-01280-4

The first step taken by the United Nation
regarding mental health 55 was in 2008, when
the WHO Mental Health Gap Action
Programme (mhGAP) was introduced.
mhGAP aims for the expansion of services
for mental, neurological and substance use
disorders in countries, especially those in thelow- and middle-income categories 56. Since
2008, this has been introduced to treat
54

Zwaanswijk, M., van Dijk, C. E., & Verheij, R. A.
(2011). Child and adolescent mental health care in
Dutch general practice: time trend analyses. BMC
family practice, 12, 133.
https://doi.org/10.1186/1471-2296-12-133
55
World Health Organization. (n.d.). Scaling up
mental health care. World Health Organization.
https://www.who.int/activities/scaling-up-mental-heal
th-care.
56
World Health Organization. (n.d.). Introduction to
mhGAP.

persons suffering from mental disorders
such as depression, schizophrenia, andepilepsy in over 100 countries.
Furthermore, in 2010, WHO launched its
first mhGAP Intervention Guide, focusing
on expanding services for mental health in
low-resource settings 57. The guide aims tolessen gaps such as regional, economical,
and racial disparity regarding mental health,by developing human resources to provide
mental health care in non-specialized healthsettings. The guide is based on the globally
accepted principle, “No health without
mental health,” and provides specificassessments and management guides ofmajor mental disorders. Although thisintroduces specific advice for developing
countries with few mental health treatment
resources, it leaves the rest of the world in
the dark.
Moreover, WHO launched theComprehensive Mental Health Action Plan
2013-2020 on May 27, 2013, addressing the
global community to provide guidance fornational action plans, such as the response ofsocial and other relevant sectors as well as
promotion and prevention strategies 58. The
major difference between the mhGAP and
57

介⼊ガイド

Ozawa, H. (2015). (rep.). mhGAP(pp.
1–124). World Health Organization.
58
World Health Organization. (2013, May 27).
Comprehensive mental health action plan 2013–2020.

this Comprehensive Mental Health Action
Plan is that the former focuses on providing
health care in low-resource settings, whereas
the latter targets the global community.
In order to achieve equity, this action plan
acknowledges that mental health is a crucial
factor in people’s health and underlines thesignificance of universal health coverageand prevention based on the life course
approach.
In addition to the two actions mentioned
above, WHO published a report,
accelerating the prevention of suicide causedby mental health disorders. “Preventing
Suicide: A global imperative” is the firstreport published by the United Nations
regarding suicide prevention, encouraging
and supporting authorities to develop andstrengthen a comprehensive suicide
prevention strategy as a public healthapproach 59. The report provides a global
knowledge foundation on suicide andsuicide attempts as well as actionable
reccomendations to move forward in suicide
prevention based on their current resourcesand environment.

World Health Organization. (n.d.).
Preventing
suicide: A global imperative. World HealthOrganization.
https://www.who.int/publications/i/item/978924
1564779.
59