Mental health of children and adolescents after a pandemic. Should it be a topic of the Polish presidency of the EU Council?

The topic of child and adolescent psychiatry was discussed by experts in the context of the Polish Presidency of the Council of the European Union, which will begin on January 1, 2025. This area could become one of the priorities of the presidency, as was emphasized by representatives of the Ministry of Health during previous IRSS conferences. As Malgorzata Bogusz, president of the Institute for the Development of Social Affairs and a member of the European Economic and Social Committee (EESC), stressed, the discussion of a priority on the mental health of children and adolescents has already appeared during previous presidencies of the Council of the European Union.

"The issue of child and adolescent mental health was flagged as important by the previous trio of member states. One of the priorities of the Spanish presidency in early 2023 was child and adolescent psychiatry, while the Belgians referred to mental health in the workplace. After the COVID-19 pandemic, we need to pay particular attention to adequate mental health care for children and adolescents to ensure their long-term health and mental well-being," said Margaret Bogusz.

As he said at the opening of the conference, Prof. Dr. med. and n. o zdr. Marcin Sobczak, vice-rector for science and technology transfer at the Warsaw Medical University, the scale of the problem related to mental health assistance for the youngest patients is growing.

"We have increased the number of youngest patients awaiting professional care, but we have not increased the number of specialists. On the one hand, we have a huge demand to take care of our young patients, on the other hand, the number of specialists is unfortunately still insufficient," Prof. Sobczak noted.

Prof. Boleslaw Samolinski, MD, head of the Department of Public and Environmental Health and the Department of Environmental Hazard Prevention and Allergology at WUM, chairman of the Health Area Priorities Subgroup of the Polish Presidency of the Council of the EU in 2011, stressed that the health care system is facing a sudden increase in demand for mental health assistance.

"Something like this has not yet been experienced by humanity, so that problems affecting children, adolescents and adults in the sphere of mutual communication and psychological well-being are growing so rapidly, exponentially. These are extremely disturbing phenomena," Prof. Samolinski said.

Also Justyna Mieszalska, president of the Medical Center of the Warsaw Medical University, stressed the scale of the problem, citing data according to which it must be recognized that the mental state of Polish youth is alarming.

"A survey conducted by the Office of the Children's Ombudsman shows that only six out of ten children consider their lives joyful. Young people are also not satisfied with their lives, and even say they never feel satisfied or feel so very rarely," Justyna Mieszalska stressed.

Dr. Aleksandra Lewandowska, a national consultant in child and adolescent psychiatry, stressed that experts have diagnosed which areas need further work.

"The last few years, related to the implementation of the new model of psychiatric care for children and adolescents, clearly show where we are and what we still lack. The new three-tier model was created under difficult conditions, as it was the time of the COVID-19 pandemic. However, if it had not been implemented in parallel with the time of the pandemic, we would be in a very difficult situation. Data from the National Health Fund clearly show that the number of children and adolescents requiring specialized assistance in the area of mental health has more than doubled, but at the same time access to specialized care has also more than doubled." - The national consultant in child and adolescent psychiatry noted.

Dr. Aleksandra Lewandowska also noted that much has changed in terms of accessibility to specialists.

"There has been increased interest in working in the field of child and adolescent psychiatry. The number of specialists is growing every year - in 2023 the number of trainees has increased by 63 people compared to 2022, and the number of specialists by 25 people," - Dr. Lewandowska stressed.

Prof. Tomasz Wolańczyk, MD, head of the Department of Developmental Age Psychiatry at Warsaw Medical University and the Clinical Department of Developmental Age Psychiatry at UCK WUM, also referred to the number of psychiatrists in Poland, noting that their shortage is not the only problem in the system.

"In Poland, we have one psychiatrist for every 12,000 children, which is meeting the requirements of the World Health Organization. This is exactly as many as there should be, yet we have huge queues. That's why the reform was created, to de-psychiatrize a bit. By over-psychiatrizing problems, we deprive children and adolescents of help, because if a teenage patient goes to a psychiatrist, he usually gets medication. However, he doesn't get community help, he doesn't get family help, he becomes a defined patient," Prof. Wolanczyk said.

Prof. Teresa Jackowska, MD, president of the Polish Pediatric Society, referred to the role of prevention and also touched on the topic of too early inclusion of psychiatric care.

"We want to treat tooth decay by pulling teeth. And we need to cure tooth decay by prevention, and this does not exist in Poland. Psychiatric care is the final stage, the end of care. We should diagnose in the population of children who do not require psychiatric care, but need to talk. Conversations among peers, conversations at school, conversations among teachers. Prevention is peer relationships and relationships within the family." - Prof. Jackowska pointed out.

Prof. Janusz Heitzman, MD, of the Committee on Clinical Sciences of the Polish Academy of Sciences and vice president of the Polish Psychiatric Association, also noted the key role of prevention and education in the mental health of children and adolescents.

"We can't talk about the mental health of children and young people, forgetting that the role of the adult world is to educate, to teach about values, to teach the possibility of communication. Without this, we will have all the time a feeling in children that adults are helpless. What is happening in pediatric and psychiatric wards is evidence of the helplessness of the whole system, but at the same time of the child, because we do not teach children to be responsible for themselves either." - Prof. Heitzman stressed.

Dominik Kuc, a board member of the GrowSpace Foundation, noted that more and more young people are reaching out for mental health help.

"An increasing number of young people are struggling with mental health problems in the wake of the COVID-19 pandemic, and experts and specialists point out that the pandemic itself and distance learning was not the only cause. On the other hand, it was a catalyst that accelerated certain phenomena and showed us which elements for the younger generation are a priority at this time in the area of both the health care system and the education system," - Dominik Kuc noted.

He also stressed that the increase in the number of psychiatrists and child psychiatrist specialists is a positive trend, but other people working with children and adolescents should not be forgotten.

"The issue of access to school psychologists and psychologists is important. These are people who do not provide therapy to young people, but are able to detect and monitor mental health conditions at the level of a specific school," Dominik Kuc added.

Maciej Karaszewski, director of the Treatment Department at the Ministry of Health, speaking about prevention, also noted the issue of easy access to stimulants by young people, as well as the impact of the digital world on interpersonal relationships.

"Children learn how we adults behave. We can't resent children sitting on their phones when we do it constantly. If we don't talk to children, they won't learn to talk either. If we only communicate with our phones, children will do the same. Education at school will not help in this case - this is the responsibility of parents." - Maciej Karaszewski stressed.

Magdalena Zając of the Parents for the Climate Foundation stressed that there are many scientific studies saying that environmental factors affect children's mental health.

"Surrounding themselves with polluted air, children can experience symptoms such as depression, anxiety or nervousness. Also important is the scarcity of nature, which is caused by confining our children to homes and electronic gadgets. As parents, we provide too little space for children to be in nature, surrounded by wildlife and animals. Studies say that children who are in nature are 55 percent less likely to suffer from mental disorders in adulthood," Magdalena Zając said.

Source: PAP Mediaroom | Institute for the Development of Social Affairs (IRSS)