Rahul Mehra is UNESCO Chair for Global Health & Education and Chairman, Tarang Health Alliance

Unfortunately no action has been taken by the Union government to address the issue of children’s mental health since 2007. Recent studies report that 30-40 percent of students in India suffer serious mental health issues

Iattended the American School Health Association Conference convened in Pittsburgh, USA (October 15-18). The conference was attended by educationists engaged with school health programs in the US. They included school health teachers, nurses, administrators from several state boards of education and CDC (Centre for Disease Control) — established by the Federal government in 1946. Most delegates were from the US with a few from other countries. I was the sole delegate from India.

Although several topics of interest were discussed, the two most important are discussed below.

Mental health. CDC conducts a Youth Risk Behaviour Survey (YRBS) of middle and high school students from private and public (government) schools across the US every second year. This survey was started in 1991 to monitor health-risk behaviour of school students. YRBS 2023 covered 20,000 class IX-XII high school students from 155 American schools. The questionnaire included queries related to mental health, substance abuse, nutrition, sexual health, violence, safety, social health and technology addiction. The most startling finding of YRBS was that 40 percent of students reported they “felt so sad or hopeless almost every day for two weeks or more in a row that they stopped doing some usual activities of the past 12 months”. Depression among girls was higher than among male students.

The only silver lining of the survey is that it reports a slight improvement from two years ago, when the same questions were asked. A major reason for improvement is that the mental health education program developed by CDC and/or states is now compulsory in most states. Some of the presentations discussed ways and means to improve mental health. The consensus was that social interaction, physical activity, sleep, nutrition, focused activities, communion with nature, gratitude and compassion contribute healthily towards mental well-being. Factors that harm mental health are excessive academic pressure, bullying, lack of support system, excessive use of social media and substance abuse. 

Such mental health surveys are not unknown in India. But the last time India conducted a similar survey was in 2007. The Global School Health Survey (GSHS) was developed by the World Health Organisation (WHO) in co-ordination with Unicef and Unesco. Even 17 years ago, 25.5 percent of students aged 13-17 reported that they “felt so sad or hopeless almost every day for two weeks or more in a row that they stopped doing their usual activities of the past 12 months”.

Unfortunately, no action has been taken by Government of India to address the issue. Since then the mental health of children has worsened. Recent small-scale studies have reported that 30-40 percent of students in India suffer serious mental health issues. This is the root cause of the high number of suicides within India’s students’ community, frequently reported by the media. 

Further neglect of this issue can’t be condoned if India aspires to become a developed country by 2047. It’s imperative that health education is made compulsory in every school across the country. This will require a health education curriculum for each grade level that addresses the mental, social and physical health of children. Secondly, a countrywide health assessment/survey needs to be initiated and frequently updated.

New health education standards. To teach K-12 students any subject such as maths, science, language in every country has set benchmarks to guide curriculum development, instruction and assessment. In the US, a coalition of professional groups prescribe American health education standards. The standards mandate the health knowledge and behaviour benchmarks that must be attained. Recently it has set eight new standards for children’s physical, mental and social health.

The eight standards mandate that students have (i) functional health knowledge (ii) analyse the influence of family, peers, culture, social media, technology and other determinants on health behaviour (iii) demonstrate health literacy by accessing valid and reliable health information, products and services to enhance health (iv) demonstrate effective interpersonal communication skills to enhance health (v) demonstrate effective decision-making skills for health enhancement (vi) demonstrate effective goal-setting skills for health enhancement (vii) demonstrate observable health and safety practices and (viii) advocate behaviour that supports personal, family, peer, school and community health.

It’s clearly stated that prescribed performance indicators must be met at the end of class II, class V, class VIII and class XII and are designed to progressively challenge students to safeguard health at appropriate age and development levels. On the other hand in India, health is not an educational discipline and therefore there are no standards. To improve the health of the nation, health education needs to be on a par with other education subjects. When that happens, we will develop our own health education standards.