Promoting Resilience and Psychological Well-Being in Vulnerable Life Stages
Authors: Ernesto Caffo, Carlotta Belaise, Barbara Forresi
Journal: Psychotherapy and Psychosomatics (2008)

vices, even in high-income countries [16] ; t he majority of young people with mental health problems are still not getting the help they need. A major reason for this is the worldwide gaps in child and adolescent mental health policy and services well identified by the World Health Organization through its Atlas project [17] . T he degree of coverage and quality of mental health services for the youths are generally worse compared with the ones pro-vided for adults [18] . Little information is now available about health and social investment into child and ad-olescent mental well-being. However, as denounced in the Florence Declaration – developed during the 13thEuropean Society for Child and Adolescent Psychiatry (ESCAP) Congress and signed by WHO and by EACAP (European Academy for Child and Adolescent Psychia-try) – as regards Europe, all indicators strongly suggest that child and adolescent mental health in most countries is receiving a relatively small proportion of funding, with, in turn, a typically low investment for general health, on average only 5.6% (see appendix). The median percentage of governments’ health budget earmarked for mental health is as little as 1% in low income countries [19] T . he gap is not limited to the quantity, as the quality of ser-vices is often extremely poor, even in high income coun-tries [19] . Nevertheless, the mental well-being of children still remains a major public health priority and a prominent area of international debate. Scientists and researchers from all over the world are focusing on how to improve Mental health and emotional and psychological well-being are fundamental for all children, enabling them to meet their potential, to experience life as meaningful and to be active citizens. Unfortunately, current estimates indicate that at least one out of every four to five young people in the general population will suffer from at least one mental disorder in any given year [1] . Similar data have been previously reported by WHO, showing that worldwide up to 20% of children and adolescents suffer from a mental illness with at least mild functional impairment: one adolescent in five has behavioural, cognitive and emotional difficul-ties and one adolescent in eight suffers from a mental dis-order [2]. C omorbidity is very common and can occur at three levels: with other mental disorders, with substance abuse and with chronic diseases [1] . Developmental psychiatric disorders rarely have a spontaneous remission and may cause difficulties in so-cial adaptation or mental disorders in adult life [3–12] . There is evidence that adult mental disorders usually be-gin during youth [13, 14] , although they are often first detected later in life [1] . Besides personal suffering, stigma and discrimina-tion, mental disorders may have a high social impact, in terms of treatment and support costs, reduced or lost pro-ductivity, and the expenditure of criminal justice (e.g. conduct and behavioural disorders) [15] . De spite these data, only a minority of vulnerable chil-dren and adolescents have access to mental health ser-