The first speaker, Vikram Patel (Harvard Medical School), presented a lecture on how to prevent mental health problems in children. He highlighted the importance of linking epidemiological and neuroscientific data. From en epidemiological perspective, deprivation is a very significant risk factor for mental health problems, comparable to what smoking is for lung cancer. And most mental health probelms begin before the age of 24. From a neuroscientific perspective, the brain is very plastic in young adulthood. The prefrontal region of the brain (linked to executive decision making) matures 5-8 years later than the limbic region (linked to basic emotional reactions).
Adversities associated with poor developmental outcomes include:
Adversities associated with poor developmental outcomes include:
- Malnutrition
- Stressors
- Infections
- War and displacement
- Parental ill-health
- Abuse
Vikram Patel |
Theresa Betancourt |
So risks factors for mental health issue are primarily (1) missing interactions with relevant adults and (2) excessive, prolonged stress. How these factors impact on health depends on the life stage of the child, whether the adversities occur in the first five years of the child's life or later on in adolescence.
In the first 5 years of life, home, school, and neighbourhood are the most significant environments. Structured play has a very strong impact on the wellbeing of young children. Children whose parents play engagingly with them become better educated, more healthy adults, and they go on to earn more than children who did not receive the same attention.
The principles of structured play are:
- follow the child
- use everyday objects
- stimulate all senses
Interventions at this stage cover parental involvement, activities promoting agency and participation in schools, focus on emotional competence, reducing exposure to harmful behaviours (substance abuse). Interventions that aim at enhancing agency in young people and improving school climate have the following goals:
- Promoting social skills
- Engaging young people in decisions
- Making information accessible
- Enhancing problem solving skills
To try and overcome some of these issues there is a Wellcome Trust Public Engagement initiative in India inviting young people to talk openly about they feel: www.itisoktotalk.in