Transforming global mental health: The perspectives of young people in LMICs
Creators: name: Booysen, Chantelle
name: Pavarini, Gabriela
name: Tanvi Jain
name: Lai, Joanna
name: Manku, Kiran
name: Humanity, My Mind Our
name: Mychelle Farmer
name: Singh, Ilina
Publisher: name: Gates Open Research
Year: 2021

description: In order to create youth friendly and stigma free cultures of prevention, care, and support for mental health and wellbeing (MHWB), partnership with young people is critical. Young people are potentially the most powerful agents in determining their own well-being, and such partnership ensures that their unique knowledge, attitudes, and views – deriving from their direct professional and lived experiences – contribute to effective and sustainable MHWB programming. Participatory engagement can take many forms such as co-development of MHWB literacy programs, peer-to-peer interventions, health policy, youth-led advocacy and research. It can take place online, in schools, workplaces, and other community settings. To leverage young people as a catalytic resource in the promotion of MHWB, it is necessary to understand their own interests and priorities, as well as their support needs. <br> <br> Using U-Report, UNICEF’s social messaging tool and data collection platform, we conducted a large cross-sectional survey to understand the perspectives of young people in low-and middle income countries (LMICs) on participatory engagement with mental health. The survey covered their aspirations for engagement, spheres of influence, capacity building needs and key barriers for participation. The survey was co-designed by the Lancet Young Leaders for Global Mental Health, UNICEF and Oxford Neuroscience, Ethics and Society Team, and circulated to youth in February-March 2020. <br> <br> There was a total of 80,496 respondents aged 15-29, across 120 LMICs. Most respondents were from Brazil, Burundi, Dominican Republic, Jamaica, Namibia, Nigeria and South Africa. Across countries, young people reported aspirations to join a mental health awareness project and engage in peer-to-peer support initiatives. Participants considered schools and community settings to be the most critical spheres for participatory engagement, over online, home and work settings. Participants reported the need for more platforms to have their voices heard, and indicated the lack of information about mental health as a key barrier to engagement in MHWB initiatives.<br> <br> Young people’s aspirations to provide peer support and joining a project align with emerging task shifting approaches to address unmet mental health needs in LMICs. While many MHWB initiatives are highly medicalized, youth-led interventions offer unique, low-resource solutions to upscale mental health and psychosocial support. In many countries, MHWB is not taught or discussed in schools and other community settings, and youth-led programmes are scant. Yet, schools and community organisations were perceived as a critical setting for participatory engagement with MHWB. It is worth noting, however, that the survey was conducted before COVID-19 lockdown measures had been implemented in LMICs. Currently, 1.6 billion children and youth are out of school and it remains unclear how long the pandemic will last. Given the current scenario, online tools -- accessible to 67% of the youth in developing countries -- might provide unique and valuable means to engage young people during this time.<br> <br> Our findings reiterate the notion that youth engagement is not only about young people; it requires a reciprocal commitment from educators, mental health providers, researchers and other stakeholders. Young people indicated a clear need for training and support, for instance in the form of mental health classes in schools, and more information about how to get involved. To effectively channel young people’s activism in support of MHWB, relevant stakeholders must provide them with appropriate resources and platforms, including local youth councils, research advisory groups, mental health classes, peer support training, among others. We are confident that supporting young people in their role as change agents pays off, in the form of more effective and innovative prevention, treatment and advocacy initiatives for MHWB in LMICs.