Child and adolescent mental disorders: the magnitude of the problem across the globe.
OBJECTIVE
Describe objectively the global gaps in policy, data gathering capacity, and resources to develop and implement services to support child mental health.


METHODS
Report on the World health Organization (WHO) child and adolescent mental health resources Atlas project. The Atlas project utilized key informants and was supplemented by studies that focused on policy. This report also draws on current epidemiological studies to provide a context for understanding the magnitude of the clinical problem.


RESULTS
Current global epidemiological data consistently reports that up to 20% of children and adolescents suffer from a disabling mental illness; that suicide is the third leading cause of death among adolescents; and that up to 50% of all adult mental disorders have their onset in adolescence. While epidemiological data appears relatively uniform globally, the same is not true for policy and resources for care. The gaps in resources for child mental health can be categorized as follows: economic, manpower, training, services and policy. Key findings from the Atlas project include: lack of program development in low income countries; lack of any policy in low income countries and absent specific comprehensive policy in both low and high income countries; lack of data gathering capacity including that for country-level epidemiology and services outcomes; failure to provide social services in low income countries; lack of a continuum of care; and universal barriers to access. Further, the Atlas findings underscored the need for a critical analysis of the 'burden of disease' as it relates to the context of child and adolescent mental disorders, and the importance of defining the degree of 'impairment' of specific disorders in different cultures.


CONCLUSIONS
The recent finding of substantial gaps in resources for child mental health underscores the need for enhanced data gathering, refinement of the economic argument for care, and need for innovative training approaches.
Belfer
Myron L
ML
Department of Social Medicine at Harvard Medical School, Boston, MA 02115, USA. myron_belfer@hms.harvard.edu
D000293:Adolescent; D016497:Adolescent Health Services / Q000191:economics / Q000458:organization & administration*; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000458:organization & administration*; D002675:Child, Preschool; D017281:Cost of Illness; D003625:Data Collection; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D016021:Epidemiologic Studies; D014943:Global Health; D006291:Health Policy; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D038801:International Classification of Diseases; D007391:International Cooperation; D001523:Mental Disorders / Q000191:economics / Q000453:epidemiology* / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration*; D015995:Prevalence; D011640:Public Policy; D000078329:Workforce; D014944:World Health Organization