Pulling back formality, promoting younger voices and valuing human connection to bring about change
(14 November 2019) The lights have dimmed on the inaugural Leading Minds gathering – UNICEF’s new global conference series to highlight burning issues affecting children and young people in the 21st century – but the notes of Vivaldi and Mozart played by students of the Music Academy of Fiesole at the opening ceremony continue to linger in the air, playing counterpoint to the voices and energy of the many young participants who attended, and who, for three days, shared the reins of an unusual high-level expert conference, helping to change it into an authentic forum for human dialogue, experience exchange, and commitment for action.
At Leading Minds 2019 young people were empowered to talk about mental health issues and renowned international leaders and thinkers respectfully listened to them, to receive guidance and to understand the scope of the problem in different contexts. In so doing, a new model of thought leadership may have been created, from which there may be no turning back.
Executive Director of UNICEF, Henrietta Fore, delivering her opening remarks at the Leading Minds 2019 conference at UNICEF Innocenti in Florence, Italy.
“Young people talk now about mental health in a way they never did before,” said Henrietta Fore, UNICEF’s Executive Director. “As young people are grappling with these issues – and most of the problems start when you are as young as 14 – we need more science, more from the practitioners, from the young themselves, as well as from country programmes, to understand whether successful options can be scaled up. We need to incorporate mental health into primary health care, as well as build the necessary public and political will.”
Emanuela Claudia Del Re, Deputy Minister of the Italian Ministry of Foreign Affairs and Development Cooperation, which provided principal financial support for the Conference, remarked on the need for early action and evidence-based intervention incorporated within multisectoral interventions, and highlighted the importance of empowering people with mental disorders.
Dr. Tedros Adhanom Ghebreyesus, Director General of the World Health Organization, which co-hosted the conference, after remarking that child mental health is everyone’s business, mentioned four key steps needed to address such a serious challenge: break the silence, eliminate stigma, strengthen services and tend to their needs. “Children living in poverty, or exposed to war, violence at home, or other difficult life situations, are particularly vulnerable,” Dr. Tedros said. “Very few of these young people have access to the mental health services they need. There is no health without mental health.”
Dr. Vikram Patel, Pershing Professor of Global Health and Social medicine at Harvard Medical School, inspired the audience by delivering a passionate and probing keynote speech whose words resounded high and clear among the attentive participants of all ages. “We must stop thinking of mental health in binary and biomedical terms only,” he explained. “Everyone, everywhere is on a mental health spectrum. The elephant in the room on global mental health is adverse childhood experiences and we must start talking about it.”
Dr Vikram Patel, Pershing Professor of Global Health and Social Medicine, Harvard Medical School, delivering the keynote address at Leading Minds 2019 conference at UNICEF Innocenti in Florence, Italy.
Dr. Patel’s talk was riveting. One felt it was a master’s degree in global mental health delivered in 30 minutes. He spoke about the lack of focus on youth mental health as a major gap; the complexity of an issue that doesn’t fit simply into a biomedical model; the interaction of environmental factors with developmental processes; the need to look for solutions which lie outside the health sector. He also encouraged researchers to explore new avenues, such as scoping the economic benefits of mental health support for adolescents and youth. Finally, he remarked how answers cannot be found without systematic data on the incidence of mental health among youth.
Leading Minds 2019 was truly a symphony of many perspectives, multiple sectors both public and private, civil society, academia. And bringing it all together was the tonal note created by the voice and agency of young people leading the dialogue and holding mental health care-givers accountable.
The young advocates - making up a sizable segment of the whole - held the audience spellbound, from the first morning when they described their lived and learned experiences, and how these have fueled them to develop social entrepreneurial models of support for others – including peer support and advocacy.
Young mental health advocates participating in the Leading Minds 2019 conference recount lived and learned experiences in coping with mental health challenges and mobilizing action to promote young people's well-being.
“Youth don’t want to just be put on a stage,” indigenous youth leader Victor Lopez-Carmen, from the United States said loudly. “They want to be part of processes, so they can go back to their communities and give back.”
Youth leaders directed their asks to Leading Minds participants on how to change the game on mental health through better youth participation. “What we need is to absolutely be included and radically accepted,” Lopez-Carmen continued. “We also need to be fully resourced as advocates.”
They had very clear ideas about what they wanted. “For the youth mental health agenda to advance,” said Josiah Tualamali’i, co-founder of the Pacific Youth Leadership and Transformation Council in New Zealand, “Number one, place the youth voice at highest level. Number two, include stories of hope. Number three, think beyond clinical. And number four, use multiculturally informed approaches. Let’s see if we can all embed these principles.”
And to whomever asked why they wanted to participate in Leading Minds 2019, the simple answer of Satvik Sethi, CEO of Runaway App, summed it up: “My personal mission is to make the world happier, and that's why I'm here today".
(left to right) Youth advocate Mohammed Zurak of Ghana and Professor Olayinka Omigbodun of Ibadan University, Nigeria in a Leading Minds breakout session on intergrating mental health services into primary health care programmes.
During the breakout sessions academics, young activists and policy makers, all tied on ‘Leading Minds aprons’ which injected a light-hearted but powerful visual metaphor of everyone working as equals. Together they confronted the main gaps in evidence, practice and services and shared their proposals to overcome barriers.
Professor George Patton of the University of Melbourne shared data gaps in youth mental health indicating only 6.7 per cent global coverage in adolescent mental health prevalence data, with 124 countries having no data at all. He also outlined adolescent brain development and how mental health problems emerged as interaction between developmental processes and the environment. “Better mental health,” he concluded, “begins with better metrics. Not just measurement of mental health, but of risk factors too.”
Professor Gordon Harold of the University of Sussex explained the difference between nature vs nurture and the importance of caring parents. “Genes matter, but environment matters too, and they work together to determine the mental health state,” he concluded.
Doctor Olyainka Omigbudon from the University of Ibadan talked about a revolution in mental health to firmly put it on public health agenda. “Insecurity in Nigeria grows because mental health has not been addressed,” she said. “The biggest thing we can do is integrate mental health into maternal health care to support children.”
Miranda Wolpert, (left) Professor at University College London and mental health lead at Wellcome Trust, moderating at the opening day panel on civil society and foundation action for young people's mental health at the Leading Minds 2019 conference at UNICEF Innocenti in Florence, Italy.
Civil society and private foundations shared how they were increasingly involved in advancing research, interventions, and advocacy on mental health of children and youth. Miranda Wolpert of the Wellcome Trust set out 3 key challenges to support young leaders and advocates: 1. Paying young people for their input into our mental health projects; 2. Making young people active voices, not just purveyors of experience; 3. Helping to create career pathways for young advocates.
Maria Hauerslev of NCD Child in the United States, remarked on the importance of including young people at all levels. “Adults cannot really capture the reality that adolescents live in. We need to listen to them.”
Sarah Kline of United for Global Mental Health in the United Kingdom, focused on how countries must change the way they approach mental health: “Mental health is fragmented. We need a unified voice.”
After three days of intensive discussion about pressing issues, challenges and priority actions to better support mental health for young people around the world, the conference drew to a close. Only then did many realize that the co-hosts - UNICEF and WHO - had not dominated the proceedings; in fact, they had consciously pulled back to make space for all sectors and viewpoints to interact and learn.
Charlotte Petri Gornitza, Deputy Executive Director, UNICEF and Peter Salama, Executive Director for Universal Health Coverage, WHO conduct the final recap and discussion on next steps at Leading Minds 2019 at UNICEF Innocenti in Florence, Italy.
It was left to the final moments for leading executives of UNICEF and WHO to sum up. Peter Salama, WHO’s Executive Director for Universal Health Care, thanked youth leaders for all they had taught him over the last three days and recognized their strong leadership during the meeting.
Charlotte Petri Gornitzka, Deputy Executive Director of UNICEF, suggested that WHO and UNICEF could play a servant leadership role in supporting all stakeholders and linking people, through practice and research, to build a global movement to address global mental health. “Every person in this room has dealt with a mental health issue or has a close friend or family member who has. No one is untouched by it,” she ended.
Leonardo Bencini, Minister Plenipotentiary, Italian Ministry of Foreign Affairs and Development Cooperation appreciated the high-level discussion held in the conference and reconfirmed the commitment of the Italian Government in supporting the Leading Minds conference to become the rich and powerful face-to-face gathering on pressing issues facing children each year.
Chantelle Booysen of The Lancet Commission for Global Mental Health frm South Africa addressing the final plenary recap session of Leading Minds 2019 at UNICEF Innocenti in Florence, Italy.
But the most impressive wrap-up speech was delivered by Chantelle Booysen, young mental health advocate from Durban, South Africa, who issued an urgent call for global action to support and protect mental well-being for children and young people. Her three 'quick win' next steps lit up the internet within moments: 1. Full and direct participation of young people; 2. Increase investments in prevention and early intervention; 3. Strengthen mental health education in schools and universities.
Leading Minds 2019 ended where it started, with the words from young leaders who, for three days had been central protagonists of an international gathering, demonstrating active leadership, infecting everyone with their wisdom and passion, and getting equal or greater time on the global stage. Something that no participant will easily forget.
(The statements and comments included in this article come from unedited notes of conference rapporteurs and from notes taken by third party participants that were made available to UNICEF Innocenti. The statement attributed to Henrietta Fore has been reproduced from her official prepared remarks for the conference.)