Publications

Mental disorders affect about 1 in 7 children and adolescents worldwide, with 50% arising before the age of 14. Despite the high burden and early onset, most conditions remain unrecognized and untreated. We mapped evidence on the effectiveness of child and adolescent (ages 0-19) mental health and psychosocial support interventions in low- and middle-income countries within the last 12 years and identified 697 records from 78 countries.

The field is reactive rather than proactive, with most interventions focusing on treatment rather than promotion or prevention. Most mental health research is conducted in educational settings and focuses on early and late adolescence. Research on early childhood interventions as well as evidence to address the mental health and psychosocial needs of children in humanitarian settings are scarce.

Mental health intervention research lacks diversity: less than one third of studies and reviews focused on specific population groups. Despite the known potential for digital interventions to overcome a range of barriers, the field is understudied with very limited evidence across all outcomes. In 60 countries, no research was identified. There were also important geographical disparities and research gaps in West and Central Africa.

This report recounts the journeys of a group of adolescents through the COVID-19 pandemic in Italy, one of the first countries to be affected by the virus. It is the first product of an in-depth qualitative study that aims to understand the experiences of children and young people from their point of view and through their words.

The data for this project were collected online between February and June 2021 with 114 participants between the ages of 10 and 19, who attended lower and upper secondary schools in 16 regions of Italy, and included children and young people who identify as LGBTQI+, unaccompanied and separated children, and adolescents from socio-economically disadvantaged backgrounds. 

According to children and youth in Canada, what were the negative and positive impacts of the COVID-19 pandemic on their lives? How did they experience changes in their relationships; daily schedule; time at home; use of technology; or feelings of anger, worry, loneliness or gratitude? How were these experienced by marginalized groups, including LGBTQ+ and Indigenous children and youth?

To date, research on Canadian children’s and youth’s experiences during the pandemic has lacked a broad exploration of their own perspectives. This qualitative study, however, was informed by three child and youth advisory teams, with input from 10 focus groups; 23 semi-structured interviews and a total of 74 young people (10–19), from four provinces and one territory.

The report concludes with a set of 4 policy recommendations – by its participants – addressed to federal, provincial/territorial and local governments, as well as to school districts, and child and youth service sectors.

Best of UNICEF Research showcases the most rigorous, innovative and impactful research produced by UNICEF offices worldwide. While evidence highlights emerging issues, it also informs decisions and provides policy and programme recommendations for governments and partners, to improve children's lives.

This year, Best of UNICEF Research celebrates its 10th edition. It features 12 research projects that the selection panel concurred deserved special recognition for delivering results for children in 2022. How? By informing decision-making, shaping policy, raising public awareness, driving social change, and giving children and young people a voice on the issues that affect them most through participatory research.

These endeavours showcase both the power of innovation in the face of emergency and crisis, and the virtues of agility, endurance and scalability. They also offer solutions and ways to learn from each other. Each piece of research offers a set of adaptable tools: validated methodologies; templates for emergency response plans; methods of monitoring and measuring progress; and examples of successful collaboration between stakeholders. 

Mental health conditions affect about 1 in 7 adolescents globally. In the context of COVID-19, the importance of mental health and psychosocial support for all has been undoubtedly confirmed. Despite the increased attention to mental health issues, there is a dearth of evidence on what determines child and adolescent mental health, who is most at risk, and what works to foster mental health across contexts, cultures and distinct population groups.

This conceptual framework aims to inform research on child and adolescent mental health. It incorporates children’s developmental stages and the dynamic environment in which they live and grow. Informed by a review of existing theoretical frameworks on mental health and child development, this framework integrates elements of the socio-ecological model; the life course approach; the social determinants of health approach; and Innocenti Report Card’s Worlds of Influence Framework. Combining diverse aspects of these frameworks and approaches, we propose an integrated model to guide UNICEF’s research in this area. 

Adolescents face unique vulnerabilities related to their health, schooling and the intensification of gender socialization. As the next generation next in line to become adults, their transition has major implications for the future health, economic growth and well-being of nations. Yet, children and adolescents have low rates of social protection coverage globally – a missed opportunity for investment.

This report examines how social protection can promote adolescent well-being and facilitate safe and productive transitions to adulthood in lower- and middle-income countries. Focusing on government, non-contributory programmes, the following questions are examined: 1) whether and how current non-contributory social  protection programmes are adolescent-sensitive and 2) what is the impact of non-contributory social protection programmes on adolescents.

COVID-19 lockdowns have significantly disrupted the daily lives of children and adolescents, with increased time at home, online learning and limited physical social interaction. This report seeks to understand the immediate effects on their mental health. Covering more than 130,000 children and adolescents across 22 countries, the evidence shows increased stress, anxiety and depressive symptoms, as well as increased alcohol and substance use, and  externalizing behavioural problems.

Children and adolescents also reported positive coping strategies, resilience, social connectedness through digital media, more family time, and relief from academic stress. Factors such as demographics, relationships and pre-existing conditions are critical.

 To ensure children and adolescents are supported, the report recommends building the evidence on the longer-term impact of the pandemic on child and adolescent mental health in low- and middle-income countries, including vulnerable populations.

COVID-19 is a crisis like no other in modern times. It has reached every population and community. While the evidence base is still nascent, this report looks at the impacts of disasters and past epidemics – such as Ebola, HIV, SARS/MERS and Zika – on child and adolescent mental health and psychosocial wellbeing, and examines how these insights can guide policies and progammes to support children, their families and communities during the current pandemic.

COVID-19 – its associated public health responses and social and economic impacts – is likely to have multiple deleterious effects on mental health, including elevated risks of anxiety and depression, trauma, loss of family and friends, violence, loneliness and social isolation. However, this pandemic also offers opportunities for positive coping and resilience.

While there is no magic formula to address the mental health and psychosocial impacts of crises, there are proven and promising interventions from past experiences to mitigate the impact today – especially for the most vulnerable children and adolescents. These include social protection, caregiver skills and support, community and social support, life skills and school based programmes, and specialized care, to name a few.

While there has been a global rush to generate rapid evidence on COVID-19 mental health impacts among adults, limited evidence exists on the potential impacts on children.

This is the protocol for our rapid review that seeks to (i) understand the immediate impact of COVID-19’s first wave on the mental health of children and adolescents (0–19 years); and (ii) apply lessons learned from this pandemic to mitigate the impacts of future health crises.

The key research questions of this review are: 

• What has been the immediate impact of COVID-19 and associated containment measures on the mental health and psychosocial well-being of children and adolescents?
• How and which risk and protective factors have affected mental health during COVID-19 and have they varied across subgroups of children and adolescents?

The impact of COVID-19 on the mental health of children and youth has been near ubiquitous. Resilience factors are significant in enhancing and supporting mental health in the COVID-19 era. Our first COVID-19 Quarterly Thematic Digest presents research highlights from our growing Children and COVID-19 Research library.  

In this inaugural digest we spotlight 11 studies on mental health that were all generated in the first half of 2021. These research papers address an array of subjects related to the impact of COVID-19 on child and youth mental that include disorders such as anxiety, depression, suicide ideation and compulsive internet gaming, as well as risk factors such as HIV or refugee status, and responses such as art therapy and parenting and caregiver programmes. These studies have been undertaken in a range of countries and regions and include several multi-country analyses.

A new look at children from the world’s richest countries offers a mixed picture of their health, skills and happiness. For far too many, issues such as poverty, exclusion and pollution threaten their mental well-being, physical health and opportunities to develop skills. Even countries with good social, economic and environmental conditions are a long way from meeting the targets set in the 2030 Agenda for Sustainable Development. Focused and accelerated action is needed if these goals are to be met.

The evidence from 41 Organisation for Economic Co-operation and Development (OECD) and European Union (EU) countries tells its own story: from children’s chances of survival, growth and protection, to whether they are learning and feel listened to, to whether their parents have the support and resources to give their children the best chance for a healthy, happy childhood. This report reveals children’s experiences against the backdrop of their country’s policies and social, educational, economic and environmental contexts.

This rapid review collates and synthesizes evidence on the child protection impacts of COVID-19 and previous pandemics, epidemics and infectious disease outbreaks. It provides lessons for global and national responses to COVID19 and recommendations for future research priorities.

The evidence on the impacts of pandemics and epidemics on child protection outcomes is limited and skewed towards studies on the effects of HIV/AIDS on stigma. There is also some evidence on the effects of Ebola on outcomes such as orphanhood, sexual violence and exploitation, and  school enrolment, attendance and dropout. The evidence on other pandemics or epidemics, including COVID-19, is extremely limited.

There are various pathways through which infectious disease outbreaks can exacerbate vulnerabilities, generate new risks and result in negative outcomes for children. Outcomes are typically multi-layered, with immediate outcomes for children, families and communities - such as being orphaned, stigmatization and discrimination and reductions in household income - leading to further negative risks and outcomes for children in the intermediate term. These risks include child labour and domestic work, harmful practices (including early marriage), and early and adolescent pregnancy.

Lessons from previous pandemics and epidemics suggest that the following could mitigate the child protection risks:

• Responding to children in vulnerable circumstances, including orphans (e.g. throughpsychosocial interventions focused on improving mental health and community-based interventions that provide families with resources and access to services)
• Responding to stigmatization and discrimination (e.g. throughinformation and communication campaigns and support from public health systems, communities and schools)
• Investing in social protectionenable livelihoods during outbreaks and to counteract shocks
• Promoting access to health, protective and justice services, which may be restricted or suspending during infectious disease outbreaks
• Ensuring continued access to education, particularly for girls, who may be adversely affected

There is a high burden of proof for data collection during the current COVID-19 outbreak than there would be in normal circumstances. Evidence generation strategies during and after the COVID-19 crisis should consider rigorous retrospective reviews and building upon monitoring, evidence and learning functions of pre-existing programmes – particularly where there is ongoing longitudinal data collection. There should also be efforts to synthesize evidence from existing research on the effectiveness of interventions that respond to the key risk pathways identified in this review.

• The research brief can be found here.
• Access the Evidence Gap Map on child protection and violence outcomes here.
• Access the study protocol here.