Integrating mental health and psychosocial support into primary health care for children and adolescents in the Middle East and Northern Africa

Mental health is one of the most neglected health issues globally. Before COVID-19, the World Health Organization (WHO) estimated that 10–20 per cent of children and adolescents worldwide experienced poor mental health, with half of mental health conditions beginning by age 14.

The aim of this multi-country study was to understand how MHPSS for children, adolescents and caregivers can be effectively integrated and delivered through primary health care in the MENA region.

This project was conducted in Egypt, Jordan, Kuwait, Lebanon, Libya, and Saudi Arabia.

Objective

Primary health care provides a critical platform for: identifying and responding to mental health needs; delivery of key interventions to address risk factors for poor mental health, and; engagement with communities and families to support health promotion and mental health literacy.

Most mental health conditions can be effectively diagnosed and managed by non-specialist providers through primary care, that is also likely to be more accessible, affordable and acceptable to children and their families, less stigmatising that institutional-based care, and with greater capacity to provide person-centred care and support.

However, integration of Mental Health and Psychosocial Support (MHPSS) into primary health care remains a challenge, contributing to high unmet needs for mental health services and support.

The Global Burden of Disease Study in 2019 estimated that around 1 in 6 adolescents aged 10-19 years are living with a mental disorder in the Middle East and Northern Africa (MENA) region, with suicide the fifth leading cause of death of 15-19 year- olds.

Timeline

April 2022–July 2023.

Approach

Phase one

This phase included:

• synthesis of available national-level data to describe the mental health needs (outcomes and risks) of children and adolescents aged 0-18 years in 20 countries
• review of national mental health policies/plans for 20 countries to identify the current (or potential) roles and responsibilities for primary health care in delivering MHPSS for children and adolescents (mapped against global and regional MHPSS frameworks).

Phase two

This phase included in-depth qualitative inquiry conducted in six countries to:

• explore current challenges and opportunities to strengthen delivery of MHPSS through primary health care
• identify the supports and capacity building steps required for implementation of MHPSS through primary health care through a systems-strengthening lens
• explore linkages between primary health care and other key sectors (including child protection and education) needed to support MHPSS.