The Silent Betrayal: How States Systematically Fail the Mental Health Rights of Children and Adolescents -By Fransiscus Nanga Roka

Governments across the continents adore protective language. They sign treaties, roll out campaigns, commemorate awareness days and profess to be the best role models for “the future of our children.” But the slogans hide a much grimmer reality: states have an abysmal record of protecting children and adolescents’ right to mental health care, often by design. It is embedded in the very architecture of public policy.

Kids do not wake up one day and make the decision to be mere numbers in a report. The problem arises when the adults in charge of institutions privilege delay over nurture, stigma and perception more than science or progress; surveillance as your safety net instead of support to become successful predators if given a chance pennies on infrastructure budgets for ceremonies preparing us for adulthood. The outcome is that children suffering from mental anguish are helped only when it has deepened into a crisis, which becomes the global system. What could have been averted becomes pathologised, criminalised or overlooked by then.

This is not only a health systems issue. It is a human rights scandal.

The right to health (including mental), is not a wishful aspiration. There is an obligation to make this legal and moral. But for millions of children and adolescents mental health care is still an inaccessible, unaffordable luxury or simply dangerous to ask about based on social contexts. In too many countries, a child is also more likely to be punished than helped and excluded rather than included; diagnosed but then dropped from properly-coordinated care. Mental health rights promise evaporates altogether for poor families, rural communities and children with disabilities refugees or those who live in conflict zones.

The hypocrisy is staggering. The states are probably most visible where they do the least good. They managed children’s behaviour at schools, evaluate their performance studies and policing discipline while sounding alarm bells regarding juvenile delinquency or digital addiction or dwindling resilience. However, when the cost of investment in school counselors and community mental health infrastructure or trauma-informed services and family-based interventions is at hand those very same states find budgets to be a real language barrier.

Let us be upfront with what too many officials would prefer to obscure: culpable neglect is ultimately political. Underfunding is political. The lack of child psychiatrists, psychologists and in-school supports or crisis services itself is political. The fact that mental health care has not been integrated in primary care is political. Letting people exist in bullying environments, abuse spaces, online exploitation and violence, displacement crisis conditions of war’s trauma shutters intolerable levels of academic achievement pressure without doing the political work to build a system with serious shields is. What invariably gets cast as unfortunate paucity is, in fact, a matter of public option.

And children pay for those decisions with their sleep, concentration, mood, relationships and sometimes even their lives.

In mental health, states are crueler: they often want to see evidence of distress before they’ll allow you access. A child must reach a level of trouble such that the classroom is disrupted, parent becomes concerned, medical emergency status or risk to life occurs before any note taken in system. In other words, crisis is a means to ration support. You teach prevention in theory and abandon it by practice.

And, this is governance at its most cynical. Holding conferences are less expensive than hiring counselors. Issuing statements is easier than training teachers. Politically safer to lift up youth resilience than acknowledge that many children are living through experiences no child should be. The term “resilience” has too often been a euphemism for neglect.

Through the lens of inequality, however, this injustice can appear all the more egregious. Wealthy families can buy therapy privately, access specialist opinions or transfer pupils to schools with better resources. Marginalized families cannot. Their kids are abandoned to work through trauma in over-burdened, punitive or missing systems. It is not really a right if only those who can afford to access it have that right. This is a market privilege disguising as social nobility.

The digital age has exacerbated the crisis, but did not have created it. The vulnerability can be exacerbated by social media exposure, cyberbullying and algorithmic pressure along with distorting body image perception and constant comparison. Governments and Institutions often take advantage of this reality as an easy place to push the blame onto or hide behind. They point at screens instead of acknowledging poverty, domestic violence, the pressure cooker of education systems or institutional socio economic discrimination and social isolation displacement due to armed conflict first in too many countries across five continents plus systematic systematic collapse of community-based care. Technology may exacerbate suffering, but systemic abandonment paves the way.

Meanwhile, schools are having to shoulder burdens for which they were never really prepared. Educators are expected to identify psychological distress, handle trauma and keep order in the classroom while meeting academic metrics, all this as health and social protection systems have been stretched even thinner. But a number see hardly any training, very little help and even less institutional backing. In the absence of real investment, Schools are effectively tasked with taking over mental health care on a day-to day basis as children fall through the cracks and teachers struggle to keep it from happening.

What makes this failure so morally obscene is that the facts are no longer in dispute. We know early intervention works. We know that school based mental health programs can mitigate harm We know stigma delays treatment. We know trauma alters development. We know to bitterness, instability and violence poison psychological well-being. Integrated, accessible and rights-based services are proven to save lives. It is not because the world does not know; it is that enough governments do not care to do what they already know.

When states do act, it is rarely across the board. Once tragedy strikes, a suicide cluster, a school shooting or some horrible viral story childrens mental health is nowsthe top priority. Suddenly there is urgency. Panels are formed. Statements are made. Short-term initiatives are announced. However then the headlines fade, political interest turns away and kids go back to those exact same lean, cracked systems that in fact brought about their misfortune. This is not protection. It is performative governance.

A society shows its moral priorities not in what it promises children, but rather in how much money and personnel it spends to fund, staff, regulate and enforce for them when the cameras are turned off.

Until mental health is removed from the ornamental clause in policy documents, governments will not be serious about children’s rights. It has to turn into a clearly measurable responsibility. This entails integrating mental health services into universal health coverage, increasing access to care through schools and communities; scaling up the skills of professionals in this field; providing training on cultural competence and disability inclusion for all providers seeking careers in mental healthcare, holding those responsible who do not provide with access timely as required or at times deny based off biased misinformation thereby violating ethics oaths etc. This also entails listening to children and adolescents as more than passive recipients of the benevolence of adults, but rather as rights-holders whose experiences should inform policy.

The most toxic myth that floats onto this battlefield is the idea that children are naturally robust, versus which nothing can be done. Some are resilient. Many are extraordinary. But resilience is not a justification for failures of state. And why should any child have to learn psychological resiliency just in order to survive preventable neglect?

Children seldom run the institutions fail that them, so betrayal is silent. They do not write budgets. They do not pass laws. They do not design the health systems. They do not barter over international priorities. Adults do. And so when those adults repeatedly choose symbolic concern over structural protection, they are not just ignoring children’s suffering. Instead of eliminating it, they are governing in ways that reproduce it.

If it bullies and marginalizes child & adolescent mental health to secondary, optional or inconvenient status during this era then history will judge it very severely. The only right a civilization who cannot defend the minds of its youth has to pat itself on the back is that it needs no self-congratulations for having progressed.

The crisis is no longer in question. The real question remains how many more states can be permitted to courteously refer to this failure as care.

Fransiscus Nanga Roka

Faculty of Law University 17 August 1945 Surabaya Indonesia