PLoS Medicine – Policy Forum :: Global child and adolescent mental health: The orphan of development assistance for health

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PLoS Medicine
http://www.plosmedicine.org/
(Accessed 10 March 2018)
Policy Forum
Global child and adolescent mental health: The orphan of development assistance for health
Chunling Lu, Zhihui Li, Vikram Patel
Policy Forum | published 09 Mar 2018 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002524
Summary points
:: One-quarter of disability-adjusted life years (DALYs) for mental disorders and substance abuse is borne by those 24 years old or younger, the age group that accounted for more than 40% of the world population. Using the aid activities database from the Creditor Reporting System (CRS), we estimated the level of development assistance for child and adolescent mental health (DAMH_CA) in 132 developing countries between 2007 and 2015.
:: The total amount of DAMH_CA with a primary target on child and adolescent mental health was US$190.3 million over the 8 years, accounting for 12.5% of total development assistance for mental health (DAMH) and 0.1% of development assistance for health (DAH).
:: The largest investments in DAMH_CA over this 8-year period were disbursed to the humanitarian assistance sector for children and adolescents in disasters or conflicts (US$77.2 million [41% of DAMH_CA]), followed by the sector of government and civil services (US$58.6 million [31%]), the health sector (US$38.0 million [20%]), and the education sector (US$15.6 million [8%]).
:: Donors invested little in child and adolescent mental health, in both absolute amount and fraction.
:: The donor community should substantially increase DAMH_CA to establish and enhance the capacity for delivering mental health care to this demographic group.

Background
More than 40% of the world population is 24 years old or younger, the vast majority of whom live in low- and lower middle–income countries [1]. Globally, a quarter of disability-adjusted life years (DALYs) for mental disorders and substance abuse is borne by this age group [2], and about 75% of mental disorders diagnosed in adulthood have their onset before the age of 24 years [3]. Most children and young people in developing countries, however, do not have access to mental health care.
Lack of financial commitment is amongst the major barriers for improving access to mental health interventions in developing countries. Unsurprisingly, the least resourced regions and countries in the world rely heavily on development assistance, typically from high-income countries or foundations, to support the health sector. Our previous study on development assistance for mental health (DAMH) demonstrated that DAMH remained low both in absolute terms and as a proportion of development assistance for health (DAH) between 2007 and 2013 [4].
This analysis extends our previous analysis by investigating development assistance for child (below age 10) and adolescent (between age 10 and 24) mental health (DAMH_CA). We tracked the level of DAMH_CA in 132 countries between 2007 and 2015…