The majority of children in sub-Saharan Africa face a life of poverty, inadequate educational opportunities and poor mental health. These factors hinder their ability to develop into healthy adults, live an improved quality of life and fulfill their life aspirations.
Up until now, virtually all social and health interventions for children have focused on the major causes of mortality to the neglect of mental health issues and social problems that have serious consequences for children’s growth and development and society at large. One in every five children and adolescents has a recognizable and treatable mental disorder and approximately 50% of adult psychiatric illness begins before age 14. Furthermore, children constitute an age group which should be targeted for effective mental health promotion, prevention, early identification and treatment.
In sub-Saharan Africa, children who live in ‘Exceptionally Difficult Circumstances’ such as street children, child labourers, sex slaves, child soldiers, and children within the criminal justice system abound. These affected children lack access to mental health care. Maternal mental health problems are much higher in low-income countries and the impact on infants and children goes beyond delays in psycho-social development to public health problems such as low birth weight, reduced breast feeding, severe malnutrition, increased episodes of diarrhoea and lower compliance with immunization schedules.
Attainment of three of the Millennium Development Goals is related to a reduction in the impact of child and maternal mental health problems:
MDG 3: Promoting gender equality and empowering women
MDG 4: Reducing child mortality
MDG 5: Improving maternal health
Despite the identified burden of mental health problems in children, there are very few services for child and adolescent mental health care in sub-Saharan Africa and a lack of trained professionals. There is also no regular or coordinated training of health professionals for child and adolescent mental health care. What this means is that the majority of African children with disabling mental health problems go unrecognized and untreated and children within the community do not have access to mental health promoting services or environments. Sub-Saharan Africa has a young population with over 50% being children or adolescents. There is therefore an absolutely critical need to supply the sub-Saharan African region with well-trained, competent professionals to meet the emotional and behavioural health needs of children, adolescents and their families.
The establishment of a Centre of Excellence for Child and Adolescent Mental Health through which training, research and service can be provided will respond to this urgent need by providing the highly skilled personnel who will conduct the much needed research and meet the training needs of community professionals who have contact with children and adolescents in schools, institutions, primary care and other community settings.
Programmes emanating from this Centre of Excellence would fill the current void where there is no regular or coordinated training for evidence-based child and adolescent mental health care in sub-Saharan Africa. The development and implementation of training, service and research programmes in child and adolescent mental health (CAMH) will identify and train leaders for CAMH for the sub-Saharan African region. Developing a variety of CAMH training programmes, geared towards the needs of the region would help to increase the likelihood of professionals remaining in the region to carry out CAMH care.