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Economic price for neglecting mental health of children is $387.2 billion a year: UNICEF

More than 13% adolescents aged 10-19 live with a diagnosed mental disorder globally

The annual loss in human capital arising from mental health conditions in children aged 0-19 is $387.2 billion, according to a new analysis.

Even before the novel coronavirus disease (COVID-19) pandemic, children and young people carried the burden of mental health conditions without significant investment in addressing them, UNICEF warned in its flagship report.

Key Points:-

  1. More than 13 per cent of adolescents aged 10-19 live with a diagnosed mental disorder globally.
  2. Prevalence rates of diagnosed disorders are highest in the Middle East and North Africa, North America and Western Europe regions, the report said
  3. Anxiety and depression make up about 40 per cent of these diagnosed mental disorders

  4. An estimated 45,800 adolescents die from suicide each year. This is more than one person every 11 minutes, among top five causes of death for adolescent boys and girls aged 10-19.

The COVID-19 pandemic and mental health

  1. Globally, at least one in seven children have been directly affected by lockdowns, according to UNICEF.
  2. More than 1.6 billion children have suffered some loss of education, with at least 463 million unable to access remote learning.
  3. UNICEF estimated that two out of five children in Eastern and Southern Africa were out of school because of the pandemic.

The disruption to routines, education, recreation as well as concern for family income and health has left many young people feeling afraid, angry and concerned for their future.

Another survey found that undergraduate and full-time students were approximately twice and four times, respectively, more likely than were postgraduate and part-time students to indicate problems associated with mental health.

The UNICEF report found that governments and societies are investing far too little in promoting, protecting and caring for the mental health of children and young people.

Governments annually spend less than $1 per person on treating mental health in some of the world’s poorest countries. Even in upper-middle-income countries, annual expenditure is about $3 per person.

The cost of inaction

The economic price for this inaction is $387.2 billion per year.

Of this, $340.2 billion reflects disorders that include anxiety and depression and $47 billion reflects the loss due to suicide.

The UNICEF report called on governments and public and private sector partners to commit, communicate and act to promote mental health for all children, protect vulnerable children and care for children facing the greatest challenges including:

  • Urgent investment in child and adolescent mental health across sectors, not just in health, to support a whole-of-society approach to prevention, promotion and care.
  • Integrating and scaling up evidence-based interventions across health, education and social protection sectors – including parenting programmes that promote responsive, nurturing caregiving and support parent and caregiver mental health; and ensuring schools support mental health through quality services and positive relationships.
  • Breaking the silence surrounding mental illness by addressing stigma and promoting better understanding of mental health and taking seriously the experiences of children and young people.

Mental health is a part of physical health. We cannot afford to continue to view it as otherwise. For far too long, in rich and poor countries alike, we have seen too little understanding and too little investment in a critical element of maximising every child’s potential. This needs to change.

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  • In a diverse country like India, where each State is socially, culturally, economically, and politically distinct, measuring Governance becomes increasingly tricky. The Public Affairs Index (PAI 2021) is a scientifically rigorous, data-based framework that measures the quality of governance at the Sub-national level and ranks the States and Union Territories (UTs) of India on a Composite Index (CI).


    States are classified into two categories – Large and Small – using population as the criteria.

    In PAI 2021, PAC defined three significant pillars that embody GovernanceGrowth, Equity, and Sustainability. Each of the three Pillars is circumscribed by five governance praxis Themes.

    The themes include – Voice and Accountability, Government Effectiveness, Rule of Law, Regulatory Quality and Control of Corruption.

    At the bottom of the pyramid, 43 component indicators are mapped to 14 Sustainable Development Goals (SDGs) that are relevant to the States and UTs.

    This forms the foundation of the conceptual framework of PAI 2021. The choice of the 43 indicators that go into the calculation of the CI were dictated by the objective of uncovering the complexity and multidimensional character of development governance

    The Equity Principle

    The Equity Pillar of the PAI 2021 Index analyses the inclusiveness impact at the Sub-national level in the country; inclusiveness in terms of the welfare of a society that depends primarily on establishing that all people feel that they have a say in the governance and are not excluded from the mainstream policy framework.

    This requires all individuals and communities, but particularly the most vulnerable, to have an opportunity to improve or maintain their wellbeing. This chapter of PAI 2021 reflects the performance of States and UTs during the pandemic and questions the governance infrastructure in the country, analysing the effectiveness of schemes and the general livelihood of the people in terms of Equity.

    Growth and its Discontents

    Growth in its multidimensional form encompasses the essence of access to and the availability and optimal utilisation of resources. By resources, PAI 2021 refer to human resources, infrastructure and the budgetary allocations. Capacity building of an economy cannot take place if all the key players of growth do not drive development. The multiplier effects of better health care, improved educational outcomes, increased capital accumulation and lower unemployment levels contribute magnificently in the growth and development of the States.

    The Pursuit Of Sustainability

    The Sustainability Pillar analyses the access to and usage of resources that has an impact on environment, economy and humankind. The Pillar subsumes two themes and uses seven indicators to measure the effectiveness of government efforts with regards to Sustainability.

     

    The Curious Case Of The Delta

    The Delta Analysis presents the results on the State performance on year-on-year improvement. The rankings are measured as the Delta value over the last five to 10 years of data available for 12 Key Development Indicators (KDI). In PAI 2021, 12 indicators across the three Pillars of Equity (five indicators), Growth (five indicators) and Sustainability (two indicators). These KDIs are the outcome indicators crucial to assess Human Development. The Performance in the Delta Analysis is then compared to the Overall PAI 2021 Index.

    Key Findings:-

    1. In the Large States category (overall), Chhattisgarh ranks 1st, followed by Odisha and Telangana, whereas, towards the bottom are Maharashtra at 16th, Assam at 17th and Gujarat at 18th. Gujarat is one State that has seen startling performance ranking 5th in the PAI 2021 Index outperforming traditionally good performing States like Andhra Pradesh and Karnataka, but ranks last in terms of Delta
    2. In the Small States category (overall), Nagaland tops, followed by Mizoram and Tripura. Towards the tail end of the overall Delta ranking is Uttarakhand (9th), Arunachal Pradesh (10th) and Meghalaya (11th). Nagaland despite being a poor performer in the PAI 2021 Index has come out to be the top performer in Delta, similarly, Mizoram’s performance in Delta is also reflected in it’s ranking in the PAI 2021 Index
    3. In terms of Equity, in the Large States category, Chhattisgarh has the best Delta rate on Equity indicators, this is also reflected in the performance of Chhattisgarh in the Equity Pillar where it ranks 4th. Following Chhattisgarh is Odisha ranking 2nd in Delta-Equity ranking, but ranks 17th in the Equity Pillar of PAI 2021. Telangana ranks 3rd in Delta-Equity ranking even though it is not a top performer in this Pillar in the overall PAI 2021 Index. Jharkhand (16th), Uttar Pradesh (17th) and Assam (18th) rank at the bottom with Uttar Pradesh’s performance in line with the PAI 2021 Index
    4. Odisha and Nagaland have shown the best year-on-year improvement under 12 Key Development indicators.

    In the Scheme of Things

    The Scheme Analysis adds an additional dimension to ranking of the States on their governance. It attempts to complement the Governance Model by trying to understand the developmental activities undertaken by State Governments in the form of schemes. It also tries to understand whether better performance of States in schemes reflect in better governance.

    The Centrally Sponsored schemes that were analysed are National Health Mission (NHM), Umbrella Integrated Child Development Services scheme (ICDS), Mahatma Gandh National Rural Employment Guarantee Scheme (MGNREGS), Samagra Shiksha Abhiyan (SmSA) and MidDay Meal Scheme (MDMS).

    National Health Mission (NHM)

    • In the 60:40 division States, the top three performers are Kerala, Goa and Tamil Nadu and, the bottom three performers are Uttar Pradesh, Jharkhand and Bihar.
    • In the 90:10 division States, the top three performers were Himachal Pradesh, Sikkim and Mizoram; and, the bottom three performers are Manipur, Assam and Meghalaya.

     

    INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS)

    • Among the 60:40 division States, Orissa, Chhattisgarh and Madhya Pradesh are the top three performers and Tamil Nadu, Telangana and Delhi appear as the bottom three performers.
    • Among the 90:10 division States, the top three performers are Manipur, Arunachal Pradesh and Nagaland; and, the bottom three performers are Jammu and Kashmir, Uttarakhand and Himachal Pradesh

     

    MID- DAY MEAL SCHEME (MDMS)

    • Among the 60:40 division States, Goa, West Bengal and Delhi appear as the top three performers and Andhra Pradesh, Telangana and Bihar appear as the bottom three performers.
    • Among the 90:10 division States, Mizoram, Himachal Pradesh and Tripura were the top three performers and Jammu & Kashmir, Nagaland and Arunachal Pradesh were the bottom three performers

     

    SAMAGRA SHIKSHA ABHIYAN (SMSA)

    • West Bengal, Bihar and Tamil Nadu were the top three States amongst the 60:40 division States; while Haryana, Punjab and Rajasthan appeared as the bottom three performers
    • In the case of 90:10 division States, Mizoram, Assam and Tripura were the top three performers and Nagaland, Jammu & Kashmir and Uttarakhand featured as the bottom three

     

    MAHATMA GANDHI NATIONAL RURAL EMPLOYMENT GUARANTEE SCHEME (MGNREGS)

    • Among the 60:40 division States, the top three performers are Kerala, Andhra Pradesh and Orissa and the bottom three performers are Madhya Pradesh, Jharkhand and Goa
    • In the 90:10 division States, the top three performers are Mizoram, Sikkim and Nagaland and the bottom three performers are Manipur and Assam