The Children’s Mental Health Promotion Platform, created by Vital Strategies in a partnership with Instituto Cactus and RD Saúde, gathers intersectoral data that show whether a given territory has a more or less favorable environment for their youth population’s mental health.
December 2024 – Children and adolescents’ mental health is an issue of growing global concern. Data from the World Health Organization (WHO) indicate that one in every seven people from 10 to 19 years old suffers from some kind of mental illness, such as depression, anxiety or behavioral disorders, which are among the main causes of disability in this age group. Beyond that, suicide is the third leading cause of death for youths aged 15 to 29. In Brazil, it is estimated that between 10% and 20% of the youth population suffers from mental illnesses and, among these, between 3% and 4% need intensive care.
According to the Pan American Health Organization (PAHO), 50% of mental health conditions have developed by the age of 14 and 75% by 24. However, 80% of these conditions remain without proper diagnosis or treatment, highlighting the urgent need of prioritizing children and adolescents’ mental health in public policies.
Besides a prevention-minded look at children and adolescents, effective public policies need to consider that mental health is the result of several factors. “A person may be more or less prone to developing mental illnesses depending on the environment in which they were born, the care they received during early childhood, their access to quality health services and education, their level of protection related to violence and even whether they reside in a place with good access to green areas,” explains Luciana Sardinha, Deputy Director of Noncommunicable Diseases at Vital Strategies Brazil and responsible for the project.
In this context, data that show public administrators which environmental factors are most harmful to mental health in the territory are essential, helping to prioritize resources for the areas that most need them and that help prevent the onset of illness.
To handle this complexity, Vital Strategies, Instituto Cactus and RD Saúde created an innovative tool called Children’s Mental Health Promotion Platform. Based on a composite index, the tool is a synthesis of 29 indicators which evaluate risk and protective factors for mental health. They are data from the most varied public sources in Brazil, from areas such as health, education, social assistance and public security, recognizing that all these dimensions have a fundamental role in the promotion of mental health.
The tool, of exclusive use for public administrators, presents the mental health promotion index for Brazil, for its 26 states and the Federal District, and for each of the 5,570 Brazilian municipalities. Through an interactive platform, it is possible for the administrator of each territory (mayors, governors, ministers or secretaries of health, education, security or others) to dive into a panorama of which aspects need greater investment and improvements which positively affect their population’s mental health.
“It is necessary to adopt an intersectoral approach, in which the various areas of the administration work together, focused on mental health promotion and prevention of illness. These issues tend to be more visible in the health sector, which works directly with people who are already ill. However, the prevention of these illnesses involves several sectors, who need to work in an integrated manner with a view to prevention,” explains Maria Fernanda Resende Quartiero, founder and director-president of Instituto Cactus. “Promoting mental health not only improves people’s quality of life, but also represents a paradigm shift by reducing spending on illnesses and redirecting resources to investments which enhance well-being,” adds Maria Fernanda.
About the Platform
The Children’s Mental Health Promotion Platform allows administrators to choose whether they want to view the index for Brazil or those for the states and municipalities. It is possible to view the general index, which is a synthesis of 29 indicators that, according to the scientific literature, describe factors that affect children and adolescents’ mental health, contributing to illnesses or their prevention. The index may be viewed for 2019, 2020, 2021 and 2022, allowing the evaluation of a critical period, which was the COVID-19 pandemic and their effects on the population’s mental health. Evaluation of the index, which ranges from zero to 100, reflects the local reality, with zero being the least favorable environment for good mental health and 100 being the most favorable.
Besides the general index, it is possible to view the index for domains, that is, five categories which gather indicators for the same area. The domains and their respective indicators are listed below:
Sociodemographic Factors: Human Development Index (HDI); GDP per capita; social prosperity; ratio of dependence (relation between potentially active and inactive populations); and rate of childhood mortality.
Positive Social Relations: Social Vulnerability Index (IVS); Urban Infrastructure; Percentage of students served by the National School Feeding Program; Percentage of mothers in the role of heads of household, with incomplete basic education and at least one child below 15 years of age; Proportion of children enrolled in daycares and pre-schools; Proportion of schools with sports courts; and Rate of age-grade distortion in Basic Education.
Stressful Events: Proportion of live births of mothers aged 10 to 19 years; Rate of mortality due to external causes, using the codes X85-Y09, which correspond to assaults, in accordance with the International Classification of Diseases (ICD); Rate of mortality due to causes fully attributable to alcohol use; Rate of mortality due to self-inflicted wounds; Rate of mortality due to mental and behavioral disorders; Rate of notification of child labor; and Rate of notification of interpersonal violence.
Access, Use and Demand of Health Services: Vaccine coverage (BCG and Polio); Total health spending per inhabitant; Proportion of live births whose mothers did not have prenatal consultations; Rate of coverage of Psychosocial Care Centers (CAPS); and Dispensing rate of industrialized medicines related to mental health.
Morbidity in Health: Proportion of live births with low birth weight; Rate of AIDS incidence; Rate of hospitalizations due to malnutrition; Rate of hospitalizations due to mental and behavioral disorders; and Rate of notification of self-inflicted violence.
Example of usage
When looking at the general and domain indexes for their territory, public administrators may dive into data to identify which areas of public administration need more development to improve the environment for the promotion of the youth’s mental health. We may compare two territories that have the same general index, but, when analyzing the domains, it is possible to observe different needs for investment and improvements.
For example, two states with a 48.9 index. The first has the “Stressful events” domain as their lowest index, at 36.9, at the same time as their “Access, use and demand of health services” has the highest value, at 60.
The second state has the “Sociodemographic” domain as their lowest index, at 36.2, while their highest is also “Access, use and demand of health services”, at 67.
This example shows how, despite the index being the same in both states, the need for priority investments in specific areas is different for each administration, based on what they need to improve.
A state administrator may also see the municipalities in which a certain area needs more investment. For example, in a state in which the “Access, use and demand of health services” domain is at 60, it is possible to find municipalities in which the domain is at 21.7, much lower than the state, therefore, demanding greater care for improvements.
About Vital Strategies
Vital Strategies is a global health organization that believes all people should be protected by strong and equitable health policies and systems. We partner with governments, communities and organizations around the world to reimagine public health so that health is supported in all the places we live, work and play. The result is millions of people living longer, healthier lives around the world.
About Instituto Cactus
Instituto Cactus is a non-profit human rights and philanthropic entity which acts independently to expand and qualify the mental health ecosystem through projects focused on care for illness prevention and mental health promotion.
About RD Saúde
RD Saúde is a comprehensive health ecosystem, with 3,000 drugstores across Brazil and health businesses which share the same purpose: to contribute to a healthier society. Its journey began in November 2011, a result of the merger between Droga Raia and Drogasil, growing until it became the largest drugstore chain in Brazil and expanding beyond pharmaceutical retail, integrating B2B solutions and digital platforms.
More information
Analítica Comunicação – Communication consultancy at Vital Strategies
Gabriela Scheinberg – gabi.scheinberg@analitica.inf.br – (11) 98111-9294
Raíza Dias – raiza.dias@analitica.inf.br – (11) 95272-3944
Wilma Loures – wilma.loures@analitica.inf.br – (11) 96324-6565
Mauricio Esposito – mauricio.esposito@analitica.inf.br – (11) 99915-7583
Erica Benute – erica.benute@analitica.inf.br – (11) 99185-7078