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.
Increasing services
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.
Author
Zetty Brake,
Communications and External Relations Officer, UNICEF Mongolia
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