Promoting mental health and emotional well-being among children and youth: a role for community child health?

‘Teenage suicides double as the future crumbles’ with collapse of the economy in Argentina (Arie 2002). Schizophrenia ‘linked to racism’, a study reveals among ethnic minorities in London (Boydell et al . 2001). The promotion of emotional well-being focuses on improving environments (social, physical, economic) that affect emotional well-being and enhancing the ‘coping’ capacity of communities as well as individuals (Wood & Wise 1997). What improvements in the ‘environment’ are required, and how does one ‘enhance coping’ in order to promote emotional well-being? What is the role of those working in community child health in promoting mental health and emotional wellbeing? Most of the research on the determinants of the health and well-being of populations have focused on physical health problems, particularly mortality and life expectancy (Marmot & Wilkinson 1999). There is less research on the ‘upstream’ (socioeconomic) determinants of mental health problems, and even less on emotional well-being and enhancing ‘coping’ or promoting resilience. Examples of upstream determinants of mental health problems include good evidence linking the prevalence of mental health problems of children and young people to income, educational status and family structure (Sawyer et al . 2001). Male youth suicide has been linked to such upstream determinants as relative unemployment rates. Suicide has increased with increasing ratio of youth to overall unemployment rates (Morrell et al . 2001). A significantly higher risk of suicide in Australia over the past century was shown to be associated with conservative governments compared with social democratic government tenures (Page et al . 2002).