Mental health is everyone’s business
UNICEF conference on mental health calls for an inter-sectoral response to strengthen mental health support to adolescents and their families

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Skopje, 3 May 2023: At the national conference “Mental health is everyone’s business “, UNICEF and partners opened discussion on systemic strengthening of mental health support for children and their families, including greater investment in mental health and psychosocial support services, response in the schools and community and change in the public conversation to reduce stigma related to mental health in all settings.
"During the past years, steps have been taken in the context of raising awareness about mental health and breaking the stigma associated with it. More and more people are speaking out about their own struggles with mental health; the correlation between mental and physical health is being discussed more and more often. But obviously we still have a lot of work to do. Both as individuals and as a collective,” said Elizabeta Gjorgievska, the wife of the President of North Macedonia in her opening remarks.

Throughout their lives, children and young people experience different levels of positive mental health and well-being. According to global research, 1 in 10 of them will also experience a mental health condition.
“When we talk about mental health, we often put the emphases on medical treatment, on conditions to be diagnosed and medicated. Instead, mental health needs to be understood as a continuum. At any stage of our lives, any one of us may experience positive mental health – the ability to enjoy life and cope with good and bad days - but we may also encounter periods of serious distress. This is why, we need to have mental health services, but also we need to promote a healthy and supportive environment that nurtures the overall well-being of children, caregivers and the society as a whole,” said Patrizia DiGiovanni, UNICEF Representative.
UNICEF presented the key results of UNICEF North Macedonia programmes on mental health for children and adolescents including the main findings of two studies on mental health – first of this kind in the country – funded by USAID and conducted in partnership with University Clinic of Psychiatry during the third year of COVID-19 in mid-2022.

The objective of “The Study of the impact of COVID-19 on the mental health among adolescents and their families and caregivers in North Macedonia” and “The Study of the impact of COVID-19 on the mental health among women in perinatal period in North Macedonia” was to use data to provide evidence-based directions for building health, social, educational and economic policies and activities for strengthening mental health and well-being of children and their families.
During the pandemic, adolescents experienced much greater mental health challenges, more than adults, facing dramatic disruptions in their daily lives. The studies confirmed that prolonged social isolation, school closures, disruption of daily routines, uncertainty, concern for the health and well-being of family and loved ones, affected mental health of adolescent girls and boys. It led to the increase of depression and anxiety.
One in three adolescents reported experiencing symptoms of depression, girls being six times more likely to report symptoms of depression than boys. As many as 42 per cent of adolescents experienced moderate to severe symptoms of anxiety. They also had a higher intensity of suicidal thoughts and dysfunctionality due to depression and fear of the COVID-19 virus compared to their caregivers. However, more than half of adolescents who reported a need for mental health services did not seek out such assistance.

“Many children and adolescents struggle in silence, because of stigma or lack of initiatives that promote and protect mental health and care for those most in need. The cost of this silence can be calculated in lost human capital, which interferes with the harmony and prosperity of families, communities and nations,” said Patrizia DiGiovanni, UNICEF Representative.
The study on mental health of women in perinatal period shows that more than 54% of mothers who reported severe symptoms of depression, experienced serious impairment in mother-infant bonding which is crucial factor for the child’s health and development but also for the mental health and wellbeing of mothers.
An important aspect of UNICEF support to mental health is ensuring that all children and adolescents learn and interact in safe and secure environments free from violence. In this context, UNICEF with USAID support has been working with the Bureau for Education Development to offer schools the opportunity to promote positive mental health and well-being, build students' resilience and life skills, combat stigma, and enhance access to mental health care.

As a result, 60% of school support staff including psychologists, pedagogues and special educators were trained in a foundational Mental Health Psychological and Social Support programme. Some 3000 primary school teachers teaching in grade 1-5 were trained in a mental health module within the new National Concept for Primary Education.
With financial support from USAID and European Union, UNICEF has also supported the mental health services and tools for practitioners dealing with the most vulnerable children and families. More than hundred social sector frontline workers were provided with tools to improve personal resilience and ensure better system response in crisis situations. A helpline on mental health and psychosocial support for vulnerable children and families was also established.

In its future efforts and as a follow up to the national conference, UNICEF will continue supporting the development of a national strategy on mental health for which four main areas requiring an inter-sectoral response were identified:
Changing the public conversation and reduce stigma related to mental health in all setting: Changing the conversation and public perception on mental health and mental ill-health, and related issues of abuse and neglect.
Investment for all: Greater and better investment in mental health and psychosocial support services for all children, adolescents and families.
Promotion and prevention in the family: Support for families through programmes that promote positive parenting and nurturing caregiving, and support caregiver well-being and mental health.
Response in the school and community: Ensuring that all children and adolescents learn and interact in safe and secure environments free from violence with supportive relationships and access to mental health services for all who need them.
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The Study on the impact of COVID-19 on the mental health among adolescents and their families and caregivers in North Macedonia was conducted among adolescents aged 12-18 and their caregiver aged over 18, living in the same household who were recruited via e-mail through primary and secondary schools across the country.
The Study on the impact of COVID-19 on the mental health among women in perinatal period in North Macedonia included pregnant women and mothers of children below 1 aged 18-45 randomly selected at seven national health clinics.
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If you or someone you know is in need of mental help and psychosocial support, please call the helpline 072 912 676 for anonymous and confidential advice from the clinical psychologists at the University Clinique of Psychiatry.
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