Rapid assessment of the system's response to adolescent mental health in Tajikistan
Good mental health is an essential prerequisite for development of adolescents and their successful transition to adulthood. Adolescent girls and boys in Tajikistan, like adolescents in many other countries, must cope with puberty and age-related transitions in a context of limited access to life skills education, relevant information about mental well-being and quality adolescent-friendly mental health services. The health services that are available to adolescent boys and girls are not adapted to adolescents' needs and, in particular, mental health and psychosocial services are limited and underdeveloped in the country. In 2011, UNICEF Tajikistan commissioned a study on Prevalence and Dynamics of Suicide among Children and Young People in Sughd province, designed by Columbia University. This study calculated the estimated suicide rate for Sughd province as 12.2 per 100,000 young people aged 12 to 24 years old in 2009/10. In this age group, the female suicide rate was significantly higher than the suicide rate among young males (Figure 1). Subsequently, between 2015 and 2017, more than 175 cases of completed suicides were registered among adolescents in Tajikistan¹. Suicide is one of the worst manifestations of poor mental health among adolescents. A high suicide rate indicates a need for better support for the mental health of adolescents, mental health service provision and care in education and health settings.
In December 2016, the Government of Tajikistan launched the national programme on “Development of adolescents and their social participation” with a focus on improving adolescents' mental health in the country by improving the system for providing psychological support to adolescent girls and boys in educational and healthcare settings. Within this national programme, the Crisis Management Institute conducted a Rapid Assessment of the system's response to adolescent mental health, including suicide, with technical support from UNICEF.
The key results of the assessment revealed that, in spite of the well-developed system in place, there were critical gaps in terms of access to services. One of the major challenges is the lack of a clear mechanism of collaboration between diverse mental health services functioning in and out of the system. In this connection, the study /assessment provides an evidence base to policy makers to design a multi-sectoral referral pathway in consultation with adolescents to effectively reach out to adolescent girls and boys and mitigate the risks of suicide, especially among girls who are at higher risk.