Children’s and youth mental health in all policies?: a document analysis

Abstract

Background: Given the extent of mental ill health among children and youth, as well as the complexity and interconnection of determinants of mental health, effective governance, including local-level policies, is of utmost importance. This study explores how municipal governing documents address the promotion of mental health in children and youth and the prevention of mental ill health and suicide. Methods: A document analysis was conducted. The websites of Sweden’s 290 municipalities were searched for governing documents addressing mental health, mental ill health, and suicide concerning children and youth. In total, 377 documents were retrieved and analysed using content analysis. Results: The findings show that children and youth mental health was addressed in a variety of municipal governing documents, ranging from specific plans for individual schools to plans for public health and urban development. In the documents, the following patterns were found: i) specific identification of groups among children and youth; ii) accountability for the promotion of mental health and prevention of mental ill health; and iii) prevention methods. Overall, municipalities identify specific groups vulnerable to mental ill health but target “all” children and youth. The primary actor for prevention is the school, which should work with evidence-based programmes focusing on psychoeducation. Conclusions: The documents contain contradictions. Vulnerable groups were identified in the documents, but they were not specifically targeted in the measures taken. Municipalities also strive to educate children and youth in mental health despite identifying issues at a societal level.