Opinion: poor youth mental health is costing Thailand

I know children and adolescents to be incredibly resilient, as a mother of three and in my work with Unicef. But their mental health has seriously suffered from the grief, uncertainty, isolation and stress over the past years of Covid-19 and well before that. As recent tragic cases of youth suicide in Thailand show, without early detection and access to services and support, they are in fact very vulnerable.

For 10-19 year olds in Thailand, a worrying 15% of the burden of disease (or the impact of living with a health problem) is attributable to mental disorders and self-harm, based on Global Burden of Disease's modelled estimates revealed in a new report by Unicef, the Ministry of Public Health, the Institute for Population and Social Research and Burnet Institute. Even more worrying is that the data fails to capture the true extent of all psychosocial distress felt by the 14 million children and adolescents across the country and its serious harm to their lifelong health, as mental disorders are common yet undertreated due to stigma and lack of access to screenings and support. Many millions may not meet the diagnostic criteria for a disorder, but their suffering is just as real.

Poor mental health impacts a child's ability to learn and grow in the classroom and in life, as they will struggle to pay attention, engage with their peers and cope with intense emotions. It can cost them years in critical developmental milestones and, too often, their lives. Suicide is the third leading cause of death of 15-19 year olds in Thailand. In the 2021 Global School-based Student Health Survey, a tragic 17.6% 13-17 year olds in the country had recently seriously considered suicide.

Thailand has made immense and important efforts for mental health through school programmes and health and social services, but access is far from where it should be. Government expenditure must further expand if it is to address the substantial burden of mental disorders on child and adolescent well-being. Covid-19 disruption over the past years has only heightened the mental health needs of the most vulnerable, who faced violence, bullying, loneliness and worry when isolated from family, friends, classrooms, play and any certainty of their future -- key elements of childhood and adolescence itself.

With half of all mental disorders developing before age 15, we cannot afford to fail the next generation of Thailand. It is time to amplify our whispers about their mental health needs to a collective call for the country and for society to invest further in their well-being, prevent poor mental health and the damage it can do to individuals and to society, and ensure access to quality services. The support they receive from us now in navigating these mental health challenges will shape their abilities and productivity as adults, parents and citizens of Thailand for years to come.

Unicef calls for and is ready to support a whole-of-government and whole- of-society mental health response for Thailand's young generation and those most vulnerable, who must receive the right quality of care at the right time. This means a common vision and plan, urgent investment and interventions for prevention, promotion and care -- across education, social welfare and justice sectors, not just in health. Thailand's Mental Health Act provides a strong legislative and policy foundation for such a mental health response. We must also strengthen and invest in the mental health care workforce, whether they are physicians, social workers, judicial workers or school counsellors, to ensure that enough are trained and available to reach every child and adolescent in need without delay.

The mental health challenges and lived experiences of children and adolescents, especially those who are marginalised, migrants or in conflict with the law, must also be heard and taken seriously by the adults in their lives and by policymakers. Their well-being must be protected both at home and in school -- starting with open, honest conversations with parents and teachers about issues that have been stigmatised for far too long. It means supporting parents, caregivers and children themselves with mental health literacy and equipping schools with adequate resources to identify and help students facing violence and bullying in classrooms or online.

Since the start of the pandemic, Unicef has supported free online counselling for more than 40,000 adolescents in Thailand on issues affecting their mental health. Furthermore, Unicef recognises the enormous value of child and adolescent participation in healthcare. We work with partners to carve youth-friendly spaces and opportunities for them in decision-making and to build their skills in peer counselling, so they can support each other. Within Unicef, we draw on the strengths, potential and creativity of our Young People Advisory Board, formed from diverse groups from all over Thailand, to inform our projects on mental health to be more relevant and effective for the population we serve. These examples can be replicated across sectors to ensure that policies -- from design to delivery -- meet the mental health needs of the young generation, who will very soon bear the consequences of these decisions.

A comprehensive mental health system that meets these needs and reaches every child and adolescent in their homes, schools and communities must be a national priority. For such a critical element of their potential and Thailand's future, there needs to be a decisive, coordinated change from all of us -- for more understanding, more investment and more commitment.

This piece was originally published on the Bangkok Post.

Kyungsun Kim is Unicef Representative for Thailand.