Young people’s mental health and psychosocial wellbeing in a fragile setting: formative study to strengthen community mental health systems in Myanmar

Partners: Burnet Institute Myanmar, Burnet Institute Australia, Liverpool School of Tropical Medicine, South Australian Health and Medical Research Institute [opens new tab], Professor Tin Oo (National Program Manager for Mental Health, University of Medicine, Yangon – retired) and Dr Lei Lei Khaing (Assistant National Program Manager for Mental Health – retired)

This study is being conducted as part of the formative phase of a three-year development project funded by the Australian government and led by Burnet Institute Myanmar. The project aims to co-design and pilot a community-based model of mental health and psychosocial support (MHPSS) that is resilient and accessible to young people.

Background to the study

There are currently very limited data describing young people’s mental health needs in Myanmar. A systematic review of adolescent mental health led by Burnet found that prior to 2019, one in four school-going 13-17 year-olds in Myanmar reported symptoms of depression and one in ten suicidal ideation, with suicide among the leading causes of death.

There are also limited qualitative studies exploring the specific needs of young people, with one study conducted in 2016 in conflict-affected areas reporting that behavioural problems and symptoms of depression were priority mental health needs of children and adolescents. Prior to the political crisis, risk factors for poor mental health, including exposure to violence and peer victimisation, were also prevalent.

Although mental health care has been identified as an important area in the National Health Plan, it is also the weakest health care in Myanmar. The recent crises in Myanmar are likely to have substantially increased young people’s mental health needs and resulted in a heightened need for strengthened community-based mental health systems. In conflict-affected areas, and more recently following the military coup, non-state actors and community-based providers have filled critical service delivery gaps in the context of health system collapse and the need for politically-neutral services.

Research questions and objectives

The primary research question is ‘what are the mental health and psychosocial wellbeing needs of young people aged 16-24 years in Myanmar post-coup, and what is needed to strengthen an accessible and resilient community-based model of mental health and psychosocial support?’ The study aims to strengthen the community mental health system, recognising that the traditional mental health system has been significantly disrupted and there is a heightened need for community-based MHPSS that is flexible, accessible and responsive. The formative study will not only improve understanding of the mental health needs and existing coping mechanisms of young people to identify priorities for intervention. It will also explore the existing community-based supports and structures, service-delivery preferences, and capacity-needs of non-state actors to understand what is needed to strengthen the non-state community system for mental health in this fragile setting.

The specific objectives are to:

• Explore young people’s perspectives of mental health and psychosocial wellbeing, including:
  1. Attitudes, beliefs and norms related to mental health
  2. Factors at individual, family and community-level that contribute to poor mental health or enhance psychosocial well-being
  3. Existing coping mechanisms and community supports for mental health, and additional or improved supports needed at community-level
  4. Service-delivery preferences (how should these supports be provided and what features would make them accessible and acceptable to young people)

• Examine the perspectives of parents and community-level service non-state actors with respect to priority mental needs of young people and the resources needed to improve mental health and psychosocial support at community-level

• Adapt and pilot the new UNICEF Measurement of Mental Health Among Adolescents (MMAP) tool, and quantify young people’s mental health needs (mental health conditions, impairment, care-seeking)

Image: Adolescent girls in rural project area 1. Courtesy of Maung Aye Chan