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Mental health and well-being of children and young adults

Resolution 2521 (2023)

Parliamentary Assembly
Assembly debate on 13 October 2023 (24th sitting) (see Doc. 15829, report of the Committee on Social Affairs, Health and Sustainable Development, rapporteur: Mr Simon Moutquin). Text adopted by the Assembly on 13 October 2023 (24th sitting).See also Recommendation 2263 (2023).
1. The enjoyment of the right to health, as recognised by numerous international and regional instruments, such as the International Covenant on Economic, Social and Cultural Rights and the European Social Charter (ETS No. 35), is fundamental for the well-being of every human being. This right also encompasses, as an essential component, the right to mental health: a state of mental well-being which allows the individual to realise their potential, cope with the normal stresses of life and work, and participate in their community.
2. Children and young adults today face a world characterised by multiple crises and much uncertainty. The Covid-19 pandemic had a devastating effect on their mental health and well-being. However, challenges to their mental health and well-being were already present before the pandemic. Today’s young generation has, in addition, lived through the global financial crisis and its repercussions (including misguided austerity measures), a cost-of-living crisis, uncertainties in the job market (inter alia linked to advances in machine learning and artificial intelligence) and a war in Europe. Moreover, global transformations such as the ever-intensifying climate crisis, the ageing of populations, digitalisation and rising inequalities have created significant uncertainties about the future young people and unborn generations can expect.
3. The imposition of restrictions related to Covid-19 adversely influenced the mental health of many individuals. The main victims, however, are reported to have been children, adolescents and young adults, who were disproportionately affected by the disruption in education, social isolation, economic instability and general uncertainty about the future. Their well-being and life satisfaction steeply declined during this period, thus putting them at a higher risk of developing mental health problems. Within this group, children and young people from disadvantaged socio-economic backgrounds, persons with disabilities, LGBTQI+ (lesbian, gay, bisexual, transgender, queer and intersex) people, minorities, refugees and undocumented migrants undoubtedly suffered the most. The surge in mental health problems which occurred during the pandemic uncovered long-standing deficiencies in the way that mental health systems are organised, managed and funded at national levels.
4. Against this background, the Parliamentary Assembly believes that States should seize this opportunity to advance with regard to improving mental health and recalls that the right to mental health includes access for all to timely and appropriate mental healthcare and treatment. A key step in this regard is to integrate mental health into national health systems, especially primary and community-based healthcare services. The healthcare provided must be holistic and focus on treating the person as a whole, including addressing mental health, as well as social, economic and environmental factors that can impact a person’s overall well-being, rather than just their physical symptoms. It is critical to raise public awareness of issues surrounding mental health from a young age, also in order to “de-dramatise” problems related to this topic. Coercion in mental health must be phased out.
5. The Assembly welcomes the shift to a human rights-based approach to mental health and the recognition that there is “no health without mental health”. It applauds recent efforts by the World Health Organization, the United Nations and other influential global actors in recognising mental health as an integral component of health and an imperative for human rights development. Good mental health is a cornerstone for the achievement of many goals in the United Nations 2030 Agenda for Sustainable Development. Moreover, the Assembly underlines the critical importance of reducing stigma and shame associated with mental health problems.
6. The Assembly recalls that human rights do not exist in a vacuum. In this context, States’ obligations with respect to mental health include both immediate obligations and requirements to undertake deliberate, concrete and targeted actions to progressively realise other related obligations. The Assembly joins the United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, in urging States to use appropriate indicators and benchmarks to monitor progress on mental health, bearing in mind that the indicators should be disaggregated by factors including sexual orientation, gender identity, age, race, ethnicity, disability and socio-economic status.
7. In light of these considerations, the Assembly recommends that the Council of Europe member States:
7.1 build strong health systems at national level and mainstream mental health across all policies by:
7.1.1 allocating the necessary funding to establish a well-functioning, human rights-compliant mental health system and ensure the appropriate training of mental health professionals;
7.1.2 decentralising healthcare services, so that people get timely mental healthcare that meets their individual needs regardless of where they live;
7.1.3 implementing universal health coverage, thus removing financial barriers to mental healthcare, ensuring that everybody has access to these services, irrespective of their socio-economic status, ethnic background, sexual orientation, gender identity or legal status;
7.1.4 integrating mental health into primary and community-based healthcare services and treating mental health with the same attention and seriousness as physical health;
7.1.5 simplifying administrative procedures and bureaucratic processes to make them more user-friendly and provide better information to users and their carers on their rights;
7.1.6 offering holistic, multisectoral and low-threshold mental healthcare services, such as drop-in centres, community-based programmes, peer support, and phone and chat services;
7.1.7 implementing the necessary educational reforms and campaigns in order to end the stigma and misinformation associated with mental health issues, in collaboration with trusted persons and organisations in communities where this is the case;
7.1.8 providing appropriate mental health first-aid training in hospitals, schools and universities, workplaces, prisons and detention centres, and within law enforcement;
7.1.9 designing targeted and inclusive health services that meet the needs of underserved communities, in particular refugees and migrants, persons with disabilities and LGBTQI+ youth;
7.1.10 providing appropriate and necessary information, training, support and relief to families of young people struggling with mental health problems, including siblings, parents and other carers;
7.1.11 providing educational resources related to mental health to children, adolescents and young adults, as well as to their parents or other carers, in order to ensure the timely detection of mental health problems and provide information on how to maintain good mental health;
7.1.12 quickly responding to crises and emergency situations, including, but not limited to, wars, forced displacements and natural disasters, and developing national strategies on how best to support the mental health and well-being of children and young adults in such circumstances;
7.1.13 performing vulnerability screenings of refugees and asylum seekers and following the United Nations High Commissioner for Refugees (UNHCR) Handbook for Interpreters in Asylum Procedures; children should never be made to interpret the traumata of their parents;
7.2 take action to address other concerns that have an impact on the mental health and well-being of children and young adults by:
7.2.1 ensuring equitable access to quality education for children and young adults, and to meaningful work for young people;
7.2.2 reducing socio-economic inequalities and making the fight against extreme child poverty a priority;
7.2.3 empowering young people and including them in decision-making processes, taking their concerns seriously, including on issues such as the environment and racial discrimination, for which young people are the stakeholders for the future;
7.2.4 taking measures to tackle young people’s financial and employment insecurity;
7.2.5 encouraging employers to ensure an appropriate work–life balance, leaving employees, including young people, with enough flexibility and time to rest and pursue other interests;
7.2.6 taking measures to protect children and young people from being exposed to inappropriate and harmful content on social media;
7.3 take the necessary precautions to protect the mental health of children, adolescents and young adults in the event of a public health emergency or confinement period by:
7.3.1 keeping educational facilities open and functional for as long as this is possible, while taking into account the importance of protecting the population;
7.3.2 facilitating equitable access to necessary equipment and materials for at-home learning, in the event that the continuous operation of educational facilities is no longer feasible;
7.3.3 ensuring tailored follow-up and support to young people with a history of mental health needs;
7.3.4 ensuring that all measures taken to tackle the public health emergency are transparent, proportionate and in line with the best interests of the child;
7.3.5 consulting children and young adults with regard to any decision that may affect their rights, mental health and well-being;
7.3.6 disseminating information specifically targeted to a younger audience, as seen in the good practice example of Norway, where children’s press conferences were held during the Covid-19 pandemic, in which they were given the opportunity to submit questions to the relevant authorities.
8. The Assembly believes that parliaments have a responsibility to ensure that children’s and young people’s voices are listened to and incorporated into legislative processes, in order to promote a more inclusive and representative democracy. By creating spaces for dialogue and collaboration in parliaments, we, as parliamentarians, can foster an environment where children and young people feel valued and understood, and in which they can effect change. The Assembly therefore recommends that parliaments within the Council of Europe member States frequently invite children and young people to parliamentary hearings, get to know their point of view on matters that affect them and empower them in policy-making processes.