International alliance promotes children's mental health

It is widely accepted that schools have an important role to play in promoting children's physical health. They organise sports programmes, give guidance on healthy living and, in some countries, provide nutritious meals for their children.

Yet many parents and teachers are alarmed by the suggestion that schools also have a role to play in promoting children's mental health. Teachers say: we're educators, not health workers. Parents say: we don't need to worry about mental health, our children are fine.

The International Alliance for Child and Adolescent Mental Health and Schools - Intercamhs - is working to change this perception, and to help governments, schools, health professionals and teachers to recognise the benefits of ensuring that children are mentally healthy.

The provision of school mental health services is sometimes shown as an upside down triangle. At the top, every child can benefit from health promotion programmes. Down at the bottom, relatively few children need treatment. The trouble is that many countries concentrate their resources on treating the few, despite the fact that prevention is better and cheaper than cure.

Intercamhs' President Prof Louise Rowling, from the University of Sydney in Australia, set out to challenge this imbalance.

'I wanted to expand the thinking about school mental health, to include the whole range. There is a lot of literature about the pointed end of the triangle, children who need treatment, but in Australia we had been looking at a much broader perspective, the top of the triangle, and I wanted to get mental health promotion for school children on to the international agenda. I believe in the power of networks to get things done. Mental health is a global issue and so we needed a global network.'

Intercamhs has grown over the past four years and now has more than 300 members, who come from 35 countries and a wide range of professional backgrounds. It organises seminars and workshops, and promotes exchange of ideas and practice through its newsletters and website.

The initial idea for the organisation came from the United States, but Prof Rowling was determined that it would be truly international, and the Advisory Board now has members from Azerbaijan, Australia, Canada, Germany, Iceland, Jamaica, New Zealand, the UK, the US and Vietnam.

'Being international, we get a lot of debate and dialogue about how to go about things,' she says. 'We're not dominated by one country's view of school mental health, and our website gets 10,000 hits a month from all over the world.'

After many years working in the field of school mental health, and five years as President of the Health Promoting Schools Association of Australia, Prof Rowling believes that awareness of the issue is growing all the time. But she also thinks that much work has still to be done.

'School mental health is just not on the radar screen for a lot of the world mental health community,' she says bluntly. 'So, I certainly don't think we have got there yet - the low income countries are a real challenge.'

Although Intercamhs pays a lot of attention to mental health promotion, the fact is that some children will develop serious problems. For instance, there is growing international concern about the numbers of older children who are affected by depression, self harm and eating disorders, and youth suicides in some countries are worryingly high.

'It's not the role of schools to organise therapy, but maybe it is the role of the school to link to other community resources, so that if a child needs help it can get it quickly,' says Prof Rowling. 'Intercamhs recognises that we need to work in partnership with schools, not imposing our ideas on them. This is quite different to the attitude that is often adopted by people who come with a purely health perspective. We understand schools and we value teachers.'

Partnership for Children has been a member of Intercamhs from the outset, and designed and hosted its first website. Director Chris Bale still sits on the Advisory Board.

'Of all the international agencies to which we belong, Intercamhs is the most directly relevant to our work,' he said. 'At a mental health conference, we can struggle to focus attention on children, and at an education conference we can struggle to focus attention on mental health. In Intercamhs, everyone is focused on the same issue.'