Valentina Baltag and Chiara Servili
Mental health problems make a significant contribution to morbidity and mortality in adolescents worldwide. To address mental health in adolescents policy response should…
Abstract
Purpose
Mental health problems make a significant contribution to morbidity and mortality in adolescents worldwide. To address mental health in adolescents policy response should intertwine the life course approach and the ecological model that positions adolescents in the context of multifactorial influences. The purpose of this paper is to describe policy response at four levels: multisector policies and interventions, health systems policies and interventions, evidence-based clinical interventions and actions to monitor progress. It aims to analyse the implications for adolescent mental health of key recent global commitments including the sustainable development goals (SDGs) and the Global Strategy for Women’s, Children’s and Adolescents’ Health.
Design/methodology/approach
Multisector policies and interventions on determinants of adolescent mental health and well-being are drawn from the Global Strategy for Women’s, Children’s and Adolescents’ Health. Key health systems actions are derived from the Comprehensive Mental Health Action Plan (2013-2020). In both cases, policies and interventions are made specific for provisions relevant to adolescents. Examples of implementation of policies and interventions are drawn from a World Health Organization (WHO) review of national policy documents found in WHO MiNDbank. A list of indicators to monitor progress is being proposed based on Mental Health Atlas and WHO indicators for adolescent health.
Findings
With some notable exceptions, the mental health of adolescents is not adequately addressed by national health policies. There is a considerable body of evidence on the effectiveness of policies and interventions, and recent global commitments give new hope for promoting adolescent mental health through a multisectoral response, within which the health sector has an important role to play. Global reporting mechanisms, including the Mental Health Atlas, should be “adolescent-sensitive”, meaning that adolescent specific impact, outcomes, inputs and determinants should be measured, reported and acted upon.
Originality/value
This paper analyses the meaning specific to adolescents in the policies and interventions promoted in the SDGs, the Global Strategy for Women’s, Children’s and Adolescents’ Health and the Comprehensive Mental Health Action Plan (2013-2020). For the first time a four-levels policy response specific to adolescent mental health is put together: multisector policies and interventions, health systems policies and interventions, evidence-based clinical interventions and actions to monitor progress.
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Valentina Baltag and Miriam Levi
The purpose of this article is to produce a taxonomy of organizational models of school health services (SHS) in the WHO European Region, and to reflect upon the potential of each…
Abstract
Purpose
The purpose of this article is to produce a taxonomy of organizational models of school health services (SHS) in the WHO European Region, and to reflect upon the potential of each model to be effective, equitable, responsive and efficient.
Design/methodology/approach
The authors used data from the WHO survey to identify organizational models. To produce a taxonomy of organizational models, three features of SHS organization were analyzed – the presence of health personnel specifically dedicated to school health services provision (school nurse and/or school doctor); the statutory involvement of other health professions in SHS provision; and the proximity of service provision to pupils (school-based or not school-based).
Findings
There are five organizational models of school health services in the Member States of the WHO European Region: dedicated school-based, dedicated community-based, integrated with primary care, mixed school-based, and mixed community-based. Preliminary reflections show that school based models are more likely to produce better outcomes in terms of effectiveness, equity, responsiveness, and efficiency.
Research limitations/implications
The WHO European Region has 53 Member States; the data are therefore incomplete and conclusions are limited to the 37 respondent countries.
Practical implications
Knowledge on performance of various models of service provision may inform decision-makers in the process of reforms.
Originality/value
This is the first attempt to produce a taxonomy of organizational models of school health services based on data from 37 countries, and to investigate the potential of each model to achieve desirable health system objectives.