Bayarmaa* is 15 years old and having a tough time being an adolescent in rural Mongolia. While she has many friends and is doing well in school, Bayarmaa faces a lot of peer pressure from friends, unwanted sexual attention and pressure from boys and family violence at home.
“My parents do not really pay attention to me, and I don’t really have anyone to talk to,” she explains. “I don’t talk to my friends about what is happening. So I come here, to the Adolescent Friendly Health Center, and get counselling and support from professionals”.
Since starting to come to center three years ago she has said it has made a lot of difference. “The service is very good and the advice is helpful,” she says. “One of the issues at home is that I am not close to my parents and I don’t talk to them. I was advised to share some small funny stories with them. I did and it helped create a warmer environment with them and we talk more now”.
Bayarmaa is lucky that she was able to receive support and talk to someone about the issues she was facing. In many parts of the country there are very few, if any, mental health services. Even in her town, services are limited. “There are social workers and doctors at school, but they don’t have time to see students,” she says. “They are not professional and often cannot provide us with the support we need”. Sadly in Mongolia many children miss out on the help they need when dealing with mental health issues.
UNICEF and partners identified the need for increased and improved adolescent focused mental health services. In response, UNICEF supported an intensive training of nearly 100 people working directly with adolescents, such as doctors, social workers, teachers and public health specialists, to improve their capacity to deliver mental health services to adolescents in Khuvsgul Aimag (province), northern Mongolia.
Dr. Oyuntsetseg specializes in adolescent health care and works at the Adolescent Friendly Health Center. She attended the training and believes that there is a real need for further training and greater investment of resource into adolescent focused mental health services.
“There is a high demand for counselling and mental health services, and this is only increasing,” Dr. Oyuntsetseg says. “There had been a number of devastating cases of self-harm and suicide among adolescents in the province. We really need to reach these adolescents and be able to provide them with the help they need”.
|Dr Oyuntsetseg in front of the Adolescent Friendly Health Center|
@ UNICEF Mongolia/2015
Following the training there was a dramatic increase from 2,050 the year before to 4,730 of cases of mental health services being provided to adolescents. In the center Dr. Oyuntsetseg works at they had 862 clients come for counselling and other mental health services.
These numbers are likely to have increased because more services are available. Before the training only 21 places provided counselling services to adolescents, whereas afterwards there were 53 locations including hospitals, schools, and health centers.
Despite this Dr. Oyuntsetseg believes more is needed. “More services are needed, especially in rural and remote areas,” she explains. “If possible I would like all the local and soum (sub-province) doctors to be trained, so that they can provide support and services to the adolescents in their local communities.”
A growing public health crisis
UNICEF Mongolia’s Adolescent Specialist Bolorchimeg Dagva says the increasing demand for mental health services by adolescents is a growing nationwide public health issue.
“Over 20 per cent of adolescents aged 13 to 15 have considered committing suicide during the past 12 months in Mongolia, and nine per cent have attempted suicide at least once according to “Global School-based Student Health Survey-2013” explains Bolorchimeg. “The adolescent mental health issue in Mongolia is a real crisis that can have life-long impacts”.
“We know that adolescents in good mental health, or receiving support for mental health issues, perform better at school and are more likely to successfully make the adjustment to adulthood and become productive members of society,” she says. “However, when mental health issues are left unassisted they can lead to lower education outcomes, unemployment, risk-taking behavior, self-harm, all which can have long-term negative effects.”
“Investing in adolescent mental health programs and services must be a higher priority on our political agenda and more resources are needed, if we are going to give adolescents the support they need during this vital time,” Bolorchimeg argues. “The training was a good first step, but more, much more, is needed. For example the training could be carried out in other parts of the country, increasing the local capacity to support and address adolescent mental health issues. The problem is the lack of funding”.
*Name has been changed to protect identity.
Zetty Brake, Communications and External Relations Officer, UNICEF Mongolia