Promoting child and adolescent mental health in transitional countries: A case study of Azerbaijan

Following the European Ministerial Conference in 2005, mental health became a key issue on the political agenda in Europe (WHO, 2005). As a result governments of transitional countries in Eastern Europe and the former Soviet Union signed the WHO Mental Health Declaration and Action Plan for Europe demonstrating commitment to developing and implementing national policies and programmes addressing child and adolescent mental health (CAMH). The governments are expected to report on their progress before 2010, however, there has been no documentation of any significant progress made in Azerbaijan or its neighboring countries. This study presents a systematic analysis and critical review of the WHO strategies aimed at promoting CAMH; using Azerbaijan as a case example, the study assesses their applicability to the transitional countries, and identifies the areas of concern and potential barriers based on the environmental, socio-economic and political factors that influence CAMH interventions. The WHO proposed interventions have evidence primarily from the developed Western countries with a very different economic, political and cultural climate. Further, the WHO guidelines call for resource- and labor-intensive programs requiring high awareness in the community, strong government commitment, highly trained professionals and substantial funding. The question is, to what extent is a country like Azerbaijan—recently coming out of the economic crisis of post-Soviet Union collapse—able to adopt WHO strategies which primarily emphasize individual changes and responsibility as opposed to changes at the community level? This study advocates for developing more ecological, structural and potentially cost-efficient strategies applicable to transitional economies.