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Empowering People with Severe Mental Illness: A Practical Guide

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Book Review Full Access. Kraig J. Knudsen Ph. Add to favorites Download Citations Track Citations. Volume 58 Issue 4 April, Pages History Published online 1 April Close Figure Viewer. As temperatures increase and water becomes scarcer it is children who will feel the deadliest impact of waterborne diseases. Today, more than half a billion children live in areas with extremely high flood occurrence and almost million in high-drought severity zones. Regions like the Sahel, which are especially reliant on agriculture, grazing and fishing, are especially vulnerable to the effects of climate change.

In this arid region, rains are projected to get even shorter and less predictable in the future, and alarmingly, the region is warming up at a rate one and a half times faster than the global average. In the Sahel, the climate gets hotter and the poor get poorer, and it is all too common for armed groups to exploit the social grievances that arise under such pressurized conditions.


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In approximately million children were living in areas with the most toxic levels of outdoor air pollution — six or more times higher than international guidelines, and it contributes to the deaths of around , children under the age of 5. Even more will suffer lasting damage to their developing brains and lungs.

And, by , one in four children will live in areas of extreme water stress and thousands will be made sick by polluted water. The management and protection of clean, plentiful, accessible groundwater supplies, and the management of plastic waste are very fast becoming defining child health issues for our time. To mitigate climate change, governments and business must work together to tackle the root causes by reducing greenhouse gas emissions in line with the Paris Agreement. Meanwhile, we must give the highest priority to efforts to find adaptations that reduce environmental impacts on children.

UNICEF works to curb the impact of extreme weather events including by designing water systems that can withstand cyclones and saltwater contamination; strengthening school structures and supporting preparedness drills; and supporting community health systems. Innovations such as Managed Aquifer Recharge MAR schemes — if deployed at scale — could preserve reservoirs of clean water to protect millions of children from the dangers of water scarcity and disease.

Even in complex environments like the Sahel, there is hope — it has a young population, hungry for work and opportunity, and the climate offers vast potential for harnessing renewable, sustainable energy sources.

An open letter to the world’s children

To turn the tide on air pollution, governments and business must work hand in hand to reduce fossil fuel consumption, develop cleaner agricultural, industrial and transport systems and invest in scaling renewable energy sources. Many governments have taken action to curb pollution from power plants, industrial facilities and road vehicles with strict regulations. In the meantime, it is vital that we search for solutions that can ameliorate the worst effects of air pollution on child health. And we are finding ways to recycle and reuse plastics in innovative ways as well, reducing toxic waste and putting rubbish to good use.

Conceptos Plasticos , a Colombian social enterprise, has developed a technique to make bricks out of non-PVC plastics that are cheaper, lighter and more durable than conventional bricks — and is using them to build classrooms. It cost 30 per cent less than traditional classrooms. This innovative approach of transforming plastic waste into construction bricks has the potential to turn a plastic waste management challenge into an opportunity, by addressing the right to an education with the construction of schools, empowering these communities and cleaning up the environment at the same time.

Children have always been the first victims of war. Today, the number of countries experiencing conflict is the highest it has ever been since the adoption of the Child Rights Convention in One in four children now live in countries affected by violent fighting or disaster, with 28 million children driven from their homes by wars and insecurity. Many lose several years of school — as well as records of achievements and qualifications for future learning and careers.

Conflicts and natural disasters have already disrupted learning for 75 million children and young people, many of whom have migrated across borders or been displaced. That is a personal tragedy for every single child. To abandon the aspirations of a whole generation is a terrible waste of human potential. Worse, creating a lost, disillusioned and angry generation of uneducated children is a dangerous risk that could cost us all.

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Some states have demonstrated effective policies to keep refugees learning. When large numbers of children escaping the war in the Syrian Arab Republic arrived in Lebanon, the government faced the challenge of accommodating hundreds of thousands of children in a public-school system already under strain. With the support of international partners, they turned that challenge into an opportunity and integrated refugee children into schools while strengthening the education system for Lebanese students at the same time. And digital innovations can help us do more.

The learning passport is being tested and piloted in countries hosting refugees, migrants and internally displaced persons. A digitally inclusive world should allow young people, no matter their situation, to get access to education. Scaling up solutions like the digital learning passport could help millions of displaced children gain the skills they need to thrive. If we believed everything we read about teenagers today, and the images portrayed in television and film, we could be forgiven for thinking they are a wild, antisocial bunch. Yet nothing could be further from the truth.

The evidence actually shows that teens today smoke less, drink less, get into less trouble and generally take fewer risks than previous generations. You might even call them Generation Sensible. Yet there is one area of risk for adolescents showing an extremely worrisome trend in the wrong direction — one that reminds us of the invisible vulnerability that young people still carry inside of them. Mental health disorders among under 18s have been rising steadily over the past 30 years and depression is now among the leading causes of disability in the young. The World Health Organization WHO estimates that 62, adolescents died in because of self-harm, which is now the third leading cause of death for adolescents aged 15 — This is not just a rich country problem — WHO estimates that more than 90 per cent of adolescent suicides in were in low or middle-income countries.

And while young people with severe mental disorders in lower-income countries often miss out on treatment and support, there is no country in the world that can claim to have conquered this challenge. UNICEF works with children who have suffered unthinkable traumas, gender discrimination, extreme poverty, sexual violence, disability and chronic illness, living through conflict and other experiences that place them at high risk of mental distress. The cost is not only personal, it is societal — the World Economic Forum consistently ranks mental health as having one of the greatest economic burdens of any non-communicable health issue.

Despite this overwhelming evidence of a looming crisis and the alarming trends in rising self-harm and suicide rates, adolescent mental health and well-being have often been overlooked in global health programming.

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With half of lifetime mental health disorders starting before age 14, age-appropriate mental health promotion, prevention and therapeutic treatment and rehabilitation must be prioritized. Early detection and treatment are key to preventing episodes of mental distress reaching a crisis point and precious young lives being damaged and lost. But all too often, what stands in the way of young people seeking help at an early stage is the ongoing stigma and taboo that prevents communities talking openly about mental health problems.


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  • Fortunately, this taboo is beginning to fall, and young people, once again, are leading the way — founding non-governmental organizations, developing apps, raising awareness, and being vocal about their own struggles with mental illness and their efforts to address their condition, in hope that others feel empowered to do the same. For example, in Kazakhstan, which has one of the highest suicide rates among adolescents worldwide, UNICEF stepped up efforts to improve the mental well-being of adolescents through a large-scale pilot programme in over schools.

    Mental Health Recovery and Resiliency, Module 1 of 4

    The programme raised awareness, trained staff to identify high-risk cases, and ensured referral of vulnerable adolescents to health specialists. Nearly 50, young people participated in the pilot with many significant improvements in well-being. The programme has since been scaled up to over 3, schools.