Promotion

age children are concerned the WHO has called on all countries to take up the Health
Promoting Schools concept and it is reasonable to assume it has influenced the take
up by countries worldwide. A recent initiative has seen the publication of a number
of documents on mental health which set an agenda and provide a summary of the
evidence of mental health promotion interventions.
Given the links between social disadvantage and mental health indicators, strategies
to reduce disadvantage and achieve greater equity are of major importance.
Strategies proposed to reduce poverty include various types of debt release tied to
specific actions within countries and more and better aid and efforts to increase the
fairness of world trade. The millennium goals listed in Chapter 3 provide a point of
reference for countries although progress towards them is slower than projected.
Policy which addresses the rights of children is an important influence on many
activities which bear on children’s mental health. The key document is the United
Nations Convention of the Rights of the Child (United Nations 1989) which is legally
binding and to which 102 countries were signatories by 2003. It addresses conventional
issues relating to children such as welfare and protection but also focuses on less usual
ones such as participation and citizenship rights. While widely supported it has also
been criticized for assuming the ‘universality of a free-standing, individual child who is
to be protected and socialized into a culture according to liberal democratic principles’
(Stevens 1995, in Griesel et al. 2004: 282). An alternative document has been produced
for Africa, the African Charter on the Rights and Welfare of the Child, which takes into
consideration both rights and responsibilities and came into force in 2000.
National
INFANCY AND CHILDHOOD 89
Parallel with the international domain there are policies specifically designated as mental
health plus other policies which impact directly or indirectly on children’s mental
health. Policy actions can be designed to influence the mental health of all children
or vulnerable groups. Aynsley-Green et al. (2000) have said that there is an urgent need
for children and adolescents to be explicitly recognized at all levels of health policy. In
all aspects of health promotion there have been comments about the lack of active
involvement of children in identifying needs and planning initiatives. As noted by
Hart-Zeldin (1990, in Kalnins et al. 2002: 224), ‘policy documents typically address the
health needs of children in terms of directives of what must be done for children, not
with children’.
In the UK it is the Children’s National Service Framework which is most relevant to
this chapter (DoH 2004). This sets out a vision and 11 national standards designed to
lead to general health improvement, redress health inequalities and improve the quality
of services for children. Standard 9 specifically focuses on mental health and ill
health although most of the other standards can be linked, in some way, to mental
health. The Framework is a ten year programme which requires substantial changes in
various areas of practice. It provides evidence-based guidelines for practice which will
require multi-agency responses.
Given the very strong links between social inequalities and mental health major
emphasis is required on policies designed to achieve greater equity and reduction of
inequalities. Countries will differ on what are seen to be key areas for action. In the UK