Reforming the mental health system, prioritizing the welfare of children and integrating principles of direct democracy by 2030. This proposal is based on the information gathered from the WHO document and additional research. 1 Mental Health, Human Rights and Legislation: Guidance and Practice (2023)

Proposal for Reforming the Mental Health System

I. Guiding Principles:

• Child-Centric Approach: All reforms prioritize the mental health and well-being of children.
• Human Rights-Based: Adherence to international human rights laws, ensuring dignity and respect for all individuals.
• Evidence-Based Practices: Implementing treatments and interventions supported by scientific evidence.
• Community-Based Care: Shifting from institutionalization to community-based mental health services.
• Direct Democratic Governance: Incorporating citizen participation in decision-making processes related to mental health policies and services.

II. Key Areas for Reform:

1. Leadership and Governance:

   • Establish a national council for children's mental health, composed of mental health professionals, educators, parents, youth representatives, and citizens selected through a lottery system to ensure diverse perspectives.
   • This council will oversee the implementation of the National Children's Mental Health and Wellbeing Strategy.
   • Implement clear processes for safe expression of concerns and feedback mechanisms for both mental health professionals and patients.
   • Create working groups with the authority to enact confidential feedback.

2. Service Organization:

   • Develop a comprehensive, integrated system of care for children, including early intervention services, school-based programs, and specialized mental health services.
   • Ensure that services are accessible, affordable, and culturally appropriate for all children, including those from vulnerable populations.
   • Integrate mental health care into primary care settings to improve access and reduce stigma.
   • Establish clear communication and referral pathways between general psychiatrists, GPs, and pediatricians.

3. Workforce Development:

   • Address the shortage of mental health professionals by enhancing recruitment pathways, providing retention strategies, and integrating peer workers into clinical teams.
   • Implement training programs for health professionals, educators, and community members on child mental health issues and evidence-based interventions.
   • Ensure that mental health workers are trained in human rights-based approaches and are equipped to provide culturally sensitive care.

4. Person-Centered Interventions:

   • Promote holistic care that addresses the physical, psychological, social, and economic needs of children.
   • Offer a range of evidence-based treatments, including therapy, counseling, and alternative therapies such as art, music, and mindfulness.
   • Reduce reliance on medication and explore alternative approaches where appropriate.
   • Involve children and their families in the planning and delivery of care.

5. Addressing Social and Structural Determinants:

   • Implement policies to address social and economic factors that impact children's mental health, such as poverty, discrimination, and violence.
   • Promote mental health in schools and workplaces through prevention programs and supportive policies.
   • Ensure that children have access to safe and stable housing, education, and employment opportunities.

III. Direct Democratic Governance:

1. Citizen Assemblies:

   • Establish citizen assemblies, randomly selected from the population, to deliberate on mental health policies and make recommendations to the national council.
   • These assemblies will ensure that the voices of citizens are heard in the decision-making process.

2. Referendums and Initiatives:

   • Implement mechanisms for citizens to propose and vote on mental health legislation and policies through referendums and initiatives.
   • This will empower citizens to directly shape the mental health system.

3. Participatory Budgeting:

   • Allocate a portion of the mental health budget to be decided by citizens through participatory budgeting processes.
   • This will allow citizens to prioritize mental health services and programs that are most important to them.

IV. Implementation and Monitoring:

• Develop a national roadmap with an actionable implementation plan to improve the mental health system for children.
• Establish a system for monitoring and evaluating the effectiveness of reforms and making adjustments as needed.
• Regularly collect data on children's mental health outcomes and use this data to inform policy and practice.
• Ensure transparency and accountability in the implementation of reforms.

V. Transition to Direct Democracy by 2030:

• Gradually increase the role of citizen assemblies, referendums, and participatory budgeting in mental health governance.
• Educate citizens about direct democracy and empower them to participate in decision-making processes.
• Foster a culture of civic engagement and participation in mental health governance.

This proposal provides a framework for reforming the mental health system to prioritize the well-being of children and integrate principles of direct democracy. By implementing these recommendations, we can create a mental health system that is more effective, equitable, and responsive to the needs of all children.