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Social Cohesion for Mental Well-Being Among Adolescents ISBN 978 92 890 4288 8

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Social Cohesion for Mental Well-Being Among Adolescents ISBN 978 92 890 4288 8 WHO/HBSC FORUM 2007 Social cohesion for mental well-being among adolescents ISBN 978 92 890 4288 8 Keywords Address requests about publications of the WHO Regional Offi ce for Europe to: ADOLESCENT Publications - WHO Regional Offi ce for Europe HEALTH BEHAVIOUR Scherfi gsvej 8 HEALTH PROMOTION DK-2100 Copenhagen Ø, Denmark MENTAL DISORDERS SOCIOECONOMIC FACTORS Alternatively, complete an online request form for documentation, health SCHOOL HEALTH SERVICES information, or for permission to quote or translate, on the Regional Offi ce web site EUROPE (http://www.euro.who.int/pubrequest). Citation advice If citing this document, please quote the following information. Whole text: Social cohesion for mental well-being among adolescents. Copenhagen, WHO Regional Offi ce for Europe, 2008. Chapter in text [example]: Babloyan A et al. Armenia: experiences of a country in transition. In: Social cohesion for mental well-being among adolescents. Copenhagen, WHO Regional Offi ce for Europe, 2008. © World Health Organization 2008 All rights reserved. The Regional Offi ce for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Where the designation “country or area” appears in the headings of tables, it covers countries, territories, cities, or areas. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specifi c companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The views expressed by authors or editors do not necessarily represent the decisions or the stated policy of the World Health Organization. This report is a compilation of background papers and case studies presented by partners taking part in the WHO/HBSC Forum 2007 process. It does not necessarily represent the views of the process coorganizers or other participants at the WHO/ HBSC Forum 2007 event (5−6 October in Viareggio, Tuscany Region, Italy) or the case study review meeting on 30−31 March 2007 in Las Palmas, Canary Islands, Spain. The WHO European Offi ce for Investment for Health and Development was set up by the WHO Regional Offi ce for Europe, with cooperation and support from the Ministry of Health and the Veneto Region of Italy. Its key responsibility is to provide evidence on, and support Member States in acting upon, the socioeconomic determinants of health. For more information regarding the contents of this report and the WHO/HBSC Forum series, please write to [email protected]. Editors: Alex Mathieson1, freelance writer and editor ([email protected]) and Theadora Koller2, technical offi cer, WHO European Offi ce for Investment for Health and Development ([email protected]) Administrative focal point: Bianca Bortot, secretary, WHO European Offi ce for Investment for Health and Development ([email protected]) Designer: Marta Pasqualato ([email protected]) 1 WHO wishes to thank NHS Health Scotland in its capacity of WHO collaborating centre for health promotion and public health development for supporting Mr Mathieson’s contribution to the report. 2 The editors wish to acknowledge the contribution of members of the Forum 2007 process Task Force (see Annex 3), as well as the guidance on case study criteria made by Eva Jané-Llopis, WHO Temporary Adviser on Mental Health Promotion and Mental Disorder Prevention, and Erio Ziglio, Head, WHO European Offi ce for Investment for Health and Development. WHO/HBSC FORUM 2007 Social cohesion for mental well-being among adolescents Contents Abbreviations and acronyms viii Foreword xii About the WHO/HBSC Forum 2007 process xiii Summary of outcomes – WHO/HBSC Forum 2007 1 1. Why address social cohesion for mental well-being among adolescents? 2 2. What is the issue? 2 3. How is the issue known about? 3 4. What factors infl uence child and adolescent mental health and well-being? 3 5. Why does this matter? 3 6. Why act now? 4 7. What lessons did the WHO/HBSC Forum process identify for policy-makers? 5 8. What immediate steps can policy-makers take? 8 References 8 Background papers 11 Mental well-being in school-aged children in Europe: associations with social cohesion and socioeconomic 12 circumstances Introduction 12 Mental well-being in Europe 13 Socioeconomic differences in mental well-being 17 Associations between mental well-being and social cohesion 19 Conclusion 23 References 24 Socioeconomic inequalities in mental health among adolescents in Europe 26 Introduction 26 Background and summary of the current state of research 26 Results on mental health and socioeconomic status from the European KIDSCREEN survey 31 Summary, conclusions and ongoing issues 38 References 40 Economic aspects of mental health in children and adolescents 43 Introduction 43 Economic consequences of child and adolescent mental illness 43 Economic evaluation of interventions to prevent and treat mental illness among children and adolescents 55 Factors which infl uence the cost–effectiveness of interventions 56 Limitations of the study 61 Conclusion 61 References 62 Case studies 65 Case studies: an introduction 66 Armenia: experiences of a country in transition 67 Executive summary 67 Social and historical context 68 Mental health and well-being among adolescents 70 HBSC survey 71 Survey results – selected indicators in relation to mental health 72 Lessons learned 74 References 77 iv Belgium (Flanders): beyond boundaries – integrating school and mental health policies 79 Executive summary 79 Mental well-being in Flanders – the 2006 HBSC survey 79 Social and policy context 84 Instruments/facilities in the school system supporting sustainable implementation of a school mental health policy 85 Contents Lessons learned 89 References 90 Finland: innovative health education curriculum and other investments for promoting mental health and 91 social cohesion among children and young people Executive summary 91 Mental health and well-being status among adolescents in Finland 92 Social and policy context 94 Policy and intervention 97 NGO investments for mental health promotion in Finnish schools 100 Lessons learned 101 References 102 Germany: adolescent mental well-being – current status and promotion and prevention initiatives 104 Executive summary 104 Mental health and well-being status among adolescents: mental health and risk behaviour among German 105 adolescents Social and policy context: German initiatives for the promotion of a healthy lifestyle and improving mental 106 well-being among adolescents Policy and interventions: school-based life-skills programmes 107 Lessons learned 110 References 110 Hungary: social cohesion for mental well-being in adolescents 112 Executive summary 112 About Hungary 112 Mental health and well-being among adolescents 113 The current situation in mental health care 116 “Children — our common treasure” – National Infant and Child health Programme 117 Lessons learned 121 References 122 Iceland: inequalities and social cohesion in psychosomatic health – individual and community processes 123 Executive summary 123 Introduction 123 Iceland as a case study 124 Method 125 Statistical analysis 127 Results 128 Discussion 128 Lessons learned 130 References 130 Ireland: social cohesion for mental well-being in adolescence 132 Executive summary 132 Introduction 133 Mental health and well-being status among adolescents 133 Social and policy context 135 Select intervention aiming to build social cohesion for mental well-being among adolescents 136 Lessons learned 139 References 139 v Lithuania: youth mental health – from research to policies, practice and partnerships 140 Executive summary 140 Mental health and well-being status among adolescents 140 Social and policy context 145 Policy 146 Intervention 147 Lessons learned 151 References 152 Portugal: from research to practice – promoting positive health for adolescents in schools 153 Executive summary 153 Introduction 154 HBSC Portuguese data 154 Migrant adolescents living in Portugal 157 Trends from HBSC national surveys 160 Policy context and intervention 161 Evaluations of health interventions in schools (2004, 2006 and 2007) 163 Lessons learned 166 References 168 Republic of Moldova: adolescent mental well-being – current situation and future trends 169 Executive summary 169 Health and health behaviours of adolescents 169 Mental health of adolescents 170 Social and policy context 172 Strategies and interventions to improve the mental health of children and adolescents 173 Lessons learned 173 References 174 Romania: facing the challenge of translating research into practice – policy and partnerships to promote 175 mental health among adolescents Executive summary 175 Introduction 175 Mental health and well-being status among Romanian adolescents
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