Children’s mental health worsens, and the country slips into solutions – 03/29/2023 – Daily life

The mental health of children and adolescents has worsened with the Covid-19 pandemic, cases of school violence have also increased, but public policies to combat it are far below the needs of this public, with few psychosocial support centers and half of schools without school health coverage.

The alert is from a document by the Ieps (Institute of Studies for Health Policies) and the Cactus Institute. The material was delivered last week to representatives of the Executive and Legislative, with the recommendation of ten actions for mental health policies in schools.

The report, obtained by Sheetwill be published in April.

Last Monday (27), a 13-year-old teenager stabbed teacher Elisabeth Tenreiro, 71, to the state school Thomazia Montoro, in Vila Sônia, west of São Paulo.

Among the proposals made by the institutes to the Executive are the expansion of the coverage of the PSE (Programa Saúde na Escola) and the surveillance and monitoring of the mental health of children and adolescents. Since August 2022, Brazil has suffered more than one attack each month in schools.

Instituted by the federal government in 2007, the PSE is carried out in the municipalities through a partnership between the health and education departments, but today it only covers 55% of basic education schools in the country, which serve 35% of students in this stage of teaching.

“We don’t need to reinvent the wheel. There is a provision in the SUS for this articulation between the areas of health and education. We just need to move forward”, says Dayana Rosa, specialist in institutional relations at Ieps.

In addition to coverage, another problem pointed out by the document is that the Ministry of Health’s programming for PNE health actions in schools, in the years 2023 and 2024, does not include prevention and mental health promotion activities.

The Ieps document points out that, due to the pandemic, there was a worsening of children’s mental health, with increased rates of suicide, violence, self-mutilation, school dropout, among others

In 2013, the prevalence rate of mental disorders in this public was between 10.8% and 12.7%. Data from Unicef ​​(United Nations Children’s Fund) show that, in 2021, 56% of adults reported that their teenagers had one or more symptoms related to mental health. More than a quarter (28%) report sudden mood swings and instability.

According to the report, cases of school violence have also increased. In the first two months of the 2022 school year, when they returned to face-to-face classes, 4,021 cases of physical aggression were recorded in state teaching units in the country, 48.5% more compared to the same period in 2019, the last of face-to-face classes before the health crisis. School dropout rates of students with mental disorders vary between 43% and 86%.

“Experts have warned of widespread suffering that the country is experiencing, an epidemic of mental disorders. This happens in a context of incitement to hatred and devaluation of life. This was the example that children and adolescents have had in recent years” , says Rose.

Since 2001, with the enactment of the Psychiatric Reform Law, the country has been slipping into the creation of a mental health policy aimed at children and adolescents.

The number of Caps i (Psychosocial Care Centers for Children and Adolescents), for example, is much lower than the centers for adults. In 2012, for example, there were 1,643 Caps for adults and 172 for children and young people. Last year, there were 2,551 against 258, respectively.

Distribution across the country is also very uneven. In Roraima and Acre, for example, there is no equipment. “It is historical negligence, a lack of understanding that children and adolescents are psychic subjects as well, that they are in a phase of formation of personality and skills and that interventions are necessary, including at school, where they spend most of their time”, says Rose.

Within the Legislative, the Ieps document calls for approval of the bill establishing the National Policy for Psychosocial Care in School Communities. Proposed in 2021 by Senator Alessandro Vieira (Cidadania-SE), the project has already been approved by the Senate and has been in the Chamber for a year.

There is an expectation that it will be approved this Wednesday (29) by the education commission. Afterwards, it needs to be analyzed by the Social Security and Family, Finance and Taxation and Constitution and Justice and Citizenship committees. Finally, it will go to the plenary.

“The purpose of this national policy is to cover the entire school community, not just the student. It also thinks of education professionals who are on the front line, organizes a little the care already provided by the SUS in the PSE and in the psychiatric reform”, he says. the Ieps specialist.

Another important point of the project is the provision of monitoring of mental health in schools by the federal government, with annual reports. “Mental health has never been a priority and it’s happening. We have to prioritize. There is no health without mental health. If we don’t go down this path, using the structures that already exist, these tragedies will continue to happen”, says Rosa.

The ten recommendations for mental health policies in schools

To the executive branch

1. Expand coverage of the School Health Program (PSE)

2. Include mental health prevention and promotion actions in the PSE in the 2023/2024 cycle

3. Carry out evaluation and monitoring studies of the PSE and encourage the creation and promotion of lines of research on the mental health of children and adolescents

4. Include, together with the IBGE (Brazilian Institute of Geography and Statistics), questions about the students’ perception of public mental health policies in the National Survey of Health in Schools (Pense)

5. Resume and maintain spaces for dialogue and construction of public mental health policies for children and adolescents, ensuring the participation and protagonism of children and adolescents

6. Expand surveillance and monitoring of the mental health of children and adolescents

To the Legislative Branch

7. Approve bill nº 3.383/2146, which institutes the National Policy of Psychosocial Care in school communities, including all education professionals in an intersectoral way and generating updated data

8. Supervise the Executive Power regarding the implementation of health and education actions, mainly with regard to the coverage of the PSE and Child and Adolescent Psychosocial Care Centers (Caps i)

9. Direct parliamentary amendments for qualification in child and adolescent mental health for professionals in basic education and primary health care

10. Ensure that the Multi-Year Plan (PPA) includes expansion of coverage of the School Health Program (PSE)