The document outlines recommendations to strengthen mental health and psychosocial support (MHPSS) systems and services for children and adolescents in the East Asia and Pacific region. It identifies three packages of priority actions: 1) Accessible and responsive services for mental health conditions, 2) Prevention of mental health conditions in the immediate social context, and 3) Mental health promotion through an enabling and safe environment. For each package, it recommends priority actions in the short term (2 years), midterm (2-5 years), and long term (5 years). It also identifies the leading and supporting roles and responsibilities of different sectors including health, education, social welfare, and justice.

1. 2022
Strengthening Mental Health and Psychosocial
Support (MHPSS) System and Services for
Children and Adolescents in the East Asia
and Pacific Region
MHPSS 2022
An infographic to complement the country report

2. i
Overview of MHPSS
4
Overview of Project Approach
5
Package of Priority MHPSS Actions
6
Table of Contents
2
MHPSS 2022
Table of Contents
Table of Contents
Table of Contents
2

3. MHPSS 2022
Recommendations for Strengthening the
Multi-Sectoral Mental Health System
16
Priority Actions: Short Term, Mid Term and
Long Term Priority of Actions
13
3
Recommended Sectoral Roles and
Responsibilities
10

4. OVERVIEW OF
MHPSS
01 — A tiered and multi-sectoral package of
services
To deliver these services
Required to ensure a multi-sectoral mental health system
Required for child and adolescent mental health and
psychosocial wellbeing
Funded by
UNICEF
02 — The systems, structures and
resources needed
Health, social welfare, justice and education – and the role
of other relevant ministries/agencies, NGOs, young people
and youth organisations, communities and the private sector
03 — Multi-sectoral roles and responsibilities
The AIM of this project was to identify how MHPSS can be implemented for children and
adolescents aged 0-18 years in the East Asia and Pacific region.
04 — The legislative, policy, institutional, capacity
building steps
Involved 4
Countries
Thailand
Malaysia
Philippines
Papua New Guinea
MHPSS 2022 4

5. Consolidated country and regional guidance
and recommendations for implementations
Desk-based review: Current
situation for children and
adolescents
To prioritise actions and propose
sectorial roles
2054
659 191
1204
Articles were
retrieved
Articles were
removed for
duplication
Articles were removed
for eligibility
Articles were included
for literature review
Consultation workshops:
Stakeholder
=72
Key informant interviews
with stakeholders
To explore roles, recommendations for
implementation and actions to strengthen
multi-sectoral system
=25
Participants:-
Health sector
Education sector
Social welfare sector
Justice sectors
Translational workshop
Refine the recommendations following
key findings
=27 Participants from country TAG and
other key sectorial stakeholders
OVERVIEW OF PROJECT APPROACH
OVERVIEW OF PROJECT APPROACH
MHPSS 2022
Development of the conceptual framework
Aim: To define priority actions and potential sectoral roles.
Country level analysis
Aim: Identify the support needed to strengthen a multi-
sectoral mental health system.
1
2
3
a b
d
c
5
Participants:-
Government
Non-government organisations
(NGOs, youth and deaf youths)

6. MHPSS 2022 6
PACKAGE OF PRIORITY MHPSS ACTIONS
FOR CHILDREN AND ADOLESCENTS
Accessible and
responsive
services for
mental health
conditions
01
Prevention of
mental health
conditions in the
immediate social
context
02
Mental health
promotion:
ensuring an
enabling and safe
environment
03

7. Accessible and Responsive Services for
Mental Health Conditions
PACKAGE OF PRIORITY MHPSS ACTIONS FOR
CHILDREN AND ADOLESCENTS
SCREENING
AND EARLY
IDENTIFICATION
MANAGEMENT OF
CLINICAL AND
SUB-CLINICAL
MENTAL HEALTH
CONDITIONS
CONTINUING
CARE
MHPSS 2022
01
STRONG REFERRAL PATHWAYS
Establish referral criteria
and mechanisms both
within the health system
and sectors
Strengthen self-referral
through helplines/
hotlines/online
Integrate mental
health into physical
health services
Establish inclusive child,
adolescent and family-friendly
services
Deliver community-based and mobile
services for under served children and
adolescents
ACCESSIBLE AND INCLUSIVE MENTAL HEALTH SERVICES
CONTINUING CARE FOR THOSE WITH MENTAL HEALTH CONDITIONS
Provide person-centred
care to support
recovery and
rehabilitation
Ensure ongoing
participation in
education
Provide education
and support for
parents
Refer
RESPONSIVE CARE FOR MENTAL
HEALTH DISORDERS
Establish specialist
clinic for mental
health treatment
and care
Provide mental
health residential
rehabilitation
services
7
Strengthen screening of pregnant
and postpartum adolescent girls
SCREENING HIGHER RISK
CHILDREN AND ADOLESCENTS
Strengthen screening of
children/adolescents with high risk
behaviours and high-risk exposures
EARLY IDENTIFICATION OF MENTAL
HEALTH CONDITIONS
Train and sensitize school-based
counsellors, social workers, frontline
and community-based health workers
to identify, support, refer children and
adolescents with mental health needs
RESPONSIVE CARE FOR SUB-
CLINICAL CONDITIONS
Establish child and
adolescent:
Specialist
support
Specialized services
and support for
families
Establish:
Therapy
Case management

8. Prevention of Mental Health Conditions
in the Immediate Social Context
PACKAGE OF PRIORITY MHPSS ACTIONS FOR
CHILDREN AND ADOLESCENTS
BUILD
INDIVIDUAL
ASSETS OF
CHILDREN AND
ADOLESCENTS
BUILD PSYCHOSOCIAL
COMPETENCE OF
PARENTS AND CARERS
ENSURE SAFE
AND ENABLING
LEARNING
ENVIRONMENTS
MHPSS 2022
02
Provide guidance and support to schools on
effective interventions following
crisis (including suicide in the community)
Provide training and resources
to education-based workers
Implement programs to support
mental health and well-being of
education-based workers
STRENGTHEN
POSITIVE PEER
SUPPORT,
INCLUDING ONLINE
SOCIAL PLATFORM
EDUCATION STAFF CAPACITY
SOCIAL AND EMOTIONAL LEARNING,
RESILIENCE, AND PROBLEM-SOLVING
SKILLS
TARGETED INTERVENTIONS FOR CHILDREN AND
ADOLESCENTS AT RISK
Implement universal approaches in
multi-settings that focus on:
social and emotional
learning
positive behaviors
social connectedness
effective problem
solving
help-seeking behaviour
Deliver intensive programs with
counselling and referral to
services for screening and
further care.
Provide guidance and
support to schools on
effective interventions
following crisis
SAFE, STABLE PARENTING AND ATTACHMENT
Implement programs to raise awareness about: Identify and address
mental health needs of
parents / guardians /
carers
Nurturing
Care
Positive
Parenting
Non-violence
POSITIVE PEER RELATIONSHIPS
Establish and
support peer-to-
peer groups and
youth clubs
ADDRESS PEER-VICTIMISATION
Implement school policies
that :-
Develop or
strengthen online
social networks that
promote mental
health literacy
Integrate
education on
digital civility and
literacy into the
school curriculum
OPTIMAL SCHOOL ENVIRONMENT
Implement a whole-of-
education approach to
mental health promotion
Implement a whole-of-
education approach to
address violence and bullying
Implement school
substance-use policies and
education programs
Promote teacher-parent
communication on the
safety and wellbeing of
children and adolescents
8
Promote respectful
peer relationships
Address peer-to-peer
violence and
harassment

9. Mental Health Promotion: Ensuring an
Enabling and Safe Environment
PACKAGE OF PRIORITY MHPSS ACTIONS FOR
CHILDREN AND ADOLESCENTS
COMMUNITY
ENGAGEMENT
AND
PARTICIPATION
MHPSS 2022
03
LEGISLATION TO PROTECT WITHIN THE MENTAL HEALTH SYSTEM
Prohibit physical restraint of children and
adolescents with acute mental conditions
in all settings providing services or care
Adopt protections to ensure that
deprivation of liberty is a last resort, for
the shortest appropriate period, and
subject to periodic review
COMMUNITY-BASED MENTAL HEALTH PROMOTION
Implement
campaigns to
address mental
health-related
stigma and
discrimination
Build capacity of
adolescents and provide
opportunities for them to
participate in planning,
design and evaluation of
MHPSS policy and
programs
Train community-
based workers,
religious, community
leaders, and
educators to raise
awareness about
mental health
POLICIES, STRATEGIES AND PLANS
Adopt a national mental
health strategy that
details the multi-tiered
and multi-sectoral vision
and plan for mental health
Integrate mental health into
early childhood
development, juvenile
justice and justice health
policies and plans
Adopt a multi-sectoral
national suicide-
prevention plan
POLICIES, STRATEGIES AND PLANS FOR CHILD AND ADOLESCENT MENTAL HEALTH
LEGISLATION AND ACTIONS REQUIRED FOR EFFECTIVE MENTAL HEALTH SERVICES
Address the barriers in accessing
mental health care.
Adopt policy that defines high-
quality mental health care
Adopt legislation that ensures
childrens' and adolescents’ right to
access mental health services.
Adopt legislation that mandates access to
mental health care for children and adolescents
who are deprived of liberty, in conflict with the
law, or in out-of- home placements
Address legislation that denies access to
mental health care for migrant, displaced or
other marginalised children and adolescents
Remove legislation that criminalizes
suicide or attempted suicide
SUPPORTIVE
MENTAL
HEALTH-
RELATED
POLICIES AND
LEGISLATION
POLICIES, PROGRAMS AND LEGISLATION TO PROTECT FROM HARM AND DISCRIMINATION
Prohibit :
Prevent and eliminate
child labour
The association and recruitment
with armed forces/groups
Forced marriage of adolescents
under the age of 18 years
Adopt legislation that: Implement social
protection
programs with a
focus on families
and carers
Adopt legislation to prohibit discrimination on:
gender identity
sexual orientation
decriminalise consensual
sexual acts
gender
race
ethnicity
religion
disability
nationality
political affiliation
geographic location
All forms of violence against
children and adolescents
restricts access to lethal weapons
specifies the minimum age of
criminal responsibility
specifies the minimum age of
purchase of substances (alcohol
and other drugs).
9

10. Accessible and
responsive services
for mental health
conditions
MHPSS 2022
RECOMMENDED SECTORAL
RECOMMENDED SECTORAL
ROLES AND RESPONSIBILITIES
ROLES AND RESPONSIBILITIES
LEADING ROLE SUPPORTING ROLE
Screening those at risk
Referral systems and
mechanisms
Multi-disciplinary case
management and support
Establishing specialised and
clinical services
Establishing residential
services
1.
2.
3.
4.
5.
Early identification of those with
mental health conditions or risks
Ongoing education participation for
those with mental health conditions
1.
2.
Community-based and
outreach services
Establishment of residential
rehabilitation services
1.
2.
Referral linkages and
mechanisms
1.
Screening those at risk
Referral systems and
mechanisms
Multi-disciplinary case
management and support
1.
2.
3.
Screening for certain subpopulation
who are under the purview of the
justice sector
Referral linkages and mechanisms
Specialised services and supports
1.
2.
3.
HEALTH
(LEAD SECTOR)
EDUCATION
SOCIAL
WELFARE
SOCIAL
WELFARE
EDUCATION
JUSTICE
10

11. Prevention of mental
health conditions
MHPSS 2022
RECOMMENDED SECTORAL
RECOMMENDED SECTORAL
ROLES AND RESPONSIBILITIES
ROLES AND RESPONSIBILITIES
LEADING ROLE SUPPORTING ROLE
1. School and education-based
programs and approaches:
-Mental health promotion
-Social and emotional learning
-Positive peer relationships
-Violence and bullying
-Substance use
-Teacher-parent communication
2. Establishing youth and peer
support groups
3. Digital literacy and civility
education
4. Performing targeted
interventions
5. Establish optimal school
environment
EDUCATION
(LEAD SECTOR)
SOCIAL
WELFARE
1. Parenting programs
-To build skills in nurturing and
responsive care, and non-violent
discipline
1. Raise awareness about positive
parenting
1. Training of educators on
mental health and providing
school-based interventions
2. Support to mental health
approaches in education
3. Digital literacy
4. Intensive interventions to
address risk factors
5. Identify and address mental
health needs of parents /
carers
1. Support to mental health approaches in
education
2. Establishing youth and peer support
groups
3. Digital literacy
4. Intensive interventions to address risk
factors
1. Supporting intensive interventions to
address risk factors
EDUCATION
HEALTH
SOCIAL
WELFARE
JUSTICE
11

12. Mental health
promotion
MHPSS 2022
RECOMMENDED SECTORAL
RECOMMENDED SECTORAL
ROLES AND RESPONSIBILITIES
ROLES AND RESPONSIBILITIES
LEADING ROLE SUPPORTING ROLE
1. Legislation mandating access
to mental health care, including
removing mandatory parental
consent requirements
2. Legislation mandating access
to mental health care for
children and adolescents
deprived of liberty and in out-of-
home placements
3. Legislation and policies to
prohibit violence, harm,
discrimination
1. Integrating mental health into early
child development, child protection
1. Policy and standards for high quality mental
health care
2. Training and community-based programs to
address stigma and discrimination
1. Integrating mental health into education
policies
1. Integrate mental health of children
and adolescents into juvenile justice
and justice health policy and plans
2. Protection for children and
adolescents in the mental health
system
1. Support legislation and
policies to protect children and
adolescents from violence and
harm
2. Identifying barriers in access to mental
health services for marginalized groups
3. Social protection programs for families
4. Training and community-based programs
to address stigma and discrimination
5.Capacity building adolescents to support
participation
1. Capacity building in adolescents to
support participation
JUSTICE
(LEAD SECTOR) JUSTICE
SOCIAL
WELFARE
SOCIAL
WELFARE
HEALTH
HEALTH
EDUCATION
EDUCATION
12

13. Accessible and Responsive Services for
Mental Health Conditions
01
MHPSS 2022
priority actions: short
term, midterm and long
term
Short term: 2 years
Midterm: 2 to 5 years
13
Specialised clinical mental health
treatment and care, specialised
support, case management and
therapy by multi-disciplinary team
Strengthening self-
referral through
helplines/hotlines/online
Person-centred care and specialised
services and support to families of
children with complex behaviours, in
social services and justice settings
Screening those with high-risk
behaviours and exposures
including pregnant and
postpartum adolescent girls
1
3
2
4
Long term: 5 years
Community-based and mobile
services for hard to reach
population
Sensitize school-based counsellors,
social services, and community
workers to identify, support, and
refer those with mental health needs
Integrate mental health into
physical health services
Ongoing participation in
education for those with
mental health problems
Establish referral criteria and
mechanisms within the health
sector and between sectors
Residential rehabilitation
services
Inclusive services for child,
adolescents, and family
Guidance and support for
schools on effective
interventions following crisis
1
6
5
4
3
2
7 8
Education and support for parents of
children and adolescents with mental
health needs
1

14. MHPSS 2022
priority actions: short
term, midterm and long
term
14
Establish peer-to-peer groups
and youth clubs for both in-
school and out-of-school
2 Implementing selective intensive
school-based and out-of-school
programs packaged with
counselling and referral to services
4
3
2
1
5 6
Design and implement school
substance use policies
Provide training and resources
for teachers to provide the best
environment for children
Promote teacher-parent
communication on the safety
and well-being of children
Implement universal psychosocial
interventions that focus on building
social and emotional skills
Implement whole-school
approach to mental health and
well-being
Implement a 'whole school/
education' approach to tackle
violence and bullying
2
1
3 4
Design and implement parenting
programs focused on building
skills to support nurturing care
Identify and address the
mental health needs of
parents/guardians/carers
Raise awareness on nurturing
care, positive parenting, and
non-violent discipline.
Addressing digital and non-
digital peer victimisation
Support teacher well-being
Midterm: 2 to 5 years
1
Prevention of Mental Health Conditions
in the Immediate Social Context
02
Short term: 2 years
Long term: 5 years
6 Guidance and support for
schools on effective
interventions
5

15. MHPSS 2022
priority actions: short
term, midterm and long
term
15
3
1
2
Provide capacity-building for
adolescents in the planning
and design of MHPSS
Design and deliver stigma
and discrimination
reduction campaigns
Train community health
workers, community
volunteers, adolescents,
religious leaders and educators
to raise awareness about
mental health to address
harmful social norms
Short term: 2 years
3
2
1
Implement policies and programs
that protect children and adolescents
from harm and discrimination
Implement laws that protect
children and adolescents within
the mental health system
Adopt legislation and actions
required for effective mental
health services
Long term: 5 years
2
1
3 Integrate mental health into
the policy and plan of the
education sector
Adopt a national mental health
strategy/policy that details the
multi tiered and multi-sectoral
vision and plan
Integrate mental health into
early childhood development,
and social protection policies,
strategies and plans
Midterm: 2 to 5 years
Mental Health Promotion: Ensuring an
Enabling and Safe Environment
03

16. Ensure “mental health in all policies” with more explicit
Expand existing national mental health policy, and develop specific child and
adolescent mental health policy
Amend Article 8(2) of the Federal Constitution to include protection from
discrimination on the basis of disability, including protection for children with
developmental disorder
Review legislative and regulatory barriers to access mental health and psychosocial
support services
Improve dissemination of MHPSS-related policies and plans across sectors and to
administrative and implementation agencies
Mental health legislation to include specific protections and considerations for
children and adolescents, including clearer rights with respect to consent to mental
health care and removal of mandatory requirements for parental consent
Legal protections against all forms of harm and discrimination, including
decriminalisation of suicide and prohibition of all forms of corporal punishment
Social protection policy, with a focus on children and families
Policies and strategies to reach out-of-school children and adolescents, and other
marginalised groups
Multi-sectoral implementation plans and guidance with clear roles, responsibilities
and accountability at all levels
Multi-sectoral mental health plans at subnational level to support coordination and
implementation
recognition and actions
Strengthen:
Develop:
RECOMMENDATIONS FOR STRENGTHENING
RECOMMENDATIONS FOR STRENGTHENING
The Multi-Sectoral Mental Health System
Legislation and Policy Key Recommendations
MHPSS 2022 16
1
Leadership and Governance Key Recommendations
2
Build capacity of District Offices in MHPSS to support local
Develop subnational implementation plans for MHPSS that clearly articulate sectoral
roles and responsibilities, and are aligned with national goals and strategies for mental
health
A high-level multi-sectoral national steering committee, led by the Ministry of Health,
with representation from all key sectors, authority and resources to drive action
Local multi-sectoral committees to support coordination and implementation of the
priority MHPSS package
planning, coordination and resource allocation
Establish:

17. Develop models and standards of child and
Integrate MHPSS into other health services at community level
Transition to integrated community-based services that span the three tiers of MHPSS
Establish more community centres that provide safe spaces for children and adolescents
and provide MHPSS information and services
Build on existing school-based models to strengthen responsive care, as well as key
preventive actions
Identify barriers and service-delivery preferences for marginalised and underserved
communities, particularly strategies needed to reach out-of-school children and
adolescents, and those living with disability
Two-way referral mechanism between primary and tertiary care
Online and digital service delivery models that link mental health promotion, positive peer
relationships, parenting programs, and responsive care
Protocols within justice settings to support delivery of MHPSS and protect children and
adolescents from psychological harm, and strengthen linkages with health and social
welfare agencies
adolescent-centred health services for mental health
Strengthen:
Service Delivery Key Recommendations
RECOMMENDATIONS FOR STRENGTHENING
RECOMMENDATIONS FOR STRENGTHENING
The Multi-Sectoral Mental Health System
MHPSS 2022 17
3
Define clear multi-sectoral indicators to monitor MHPSS
Establish a national, independent monitoring body (or technical advisory committee)
with cross-sectoral representation, reporting to the Ministry of Health, to monitor MHPSS
programs
Standard operating procedures across agencies to support coordinated care of children
and adolescents engaged in child protection or justice settings
Standardise a system to support NGO engagement in MHPSS
Clear guidance and protocols for early identification, screening and referral, with clearly
defined roles and accountability of key actors
A national, standard referral protocol across health, education, social welfare, justice and
other settings that also supports communication back to primary providers
A national, standard mental health education curriculum for all levels of education
Justice-related protocols to minimise harm to children and adolescents who come into
contact with the justice sector
Guidance, protocols and procedures with respect to delivery of child and adolescent-
friendly mental health services, including parental consent and trauma-informed
approaches
Continuous evaluation of accreditation of mental health workforce
performance
Develop:
Strengthen:
Standards and Oversight Key Recommendations
4

18. Mental Health Workforce Key Recommendations
Undertake further detailed mapping of the multi-sectoral mental
Integrate and strengthen pre-service mental health training for health, education, social
welfare and justice sector providers
Strengthen job aids, tools and protocols to support key MHPSS roles
More explicitly integrate MHPSS actions into the defined roles and performance indicators
of key cadres (teachers, counsellors, social workers, justice officers)
Collaboration across sectors at national-level to facilitate development, planning and
support of the mental health workforce
Remuneration and job security / career pathways for social workers, psychologists and other
mental health professionals
Updated in-service training for non-specialist health providers, teachers, counsellors,
psychologists, social workers, police aligned with clearly defined MHPSS roles and ensure
that this training is ongoing to support continuous development
Mental health training for community members to raise mental health awareness
Steps to support professionalisation of the social service workforce (this could also include
school counsellors)
Mechanisms for support supervision of the mental health workforce through multi-
disciplinary teams, support networks, and services and supports to address mental health of
providers
health workforce and existing mental health competencies to identify gaps
Improve:
Provide:
Establish:
RECOMMENDATIONS FOR STRENGTHENING
RECOMMENDATIONS FOR STRENGTHENING
The Multi-Sectoral Mental Health System
MHPSS 2022 18
5
Budget and Financial Key Recommendations
Aim for MHPSS budget allocation of 2.1% of the national health budget
Define a detailed minimum-services package for child and adolescent
Establish a national cross-sectoral planning body, and cross-sectoral budgeting
committees for MHPSS to coordinate budget requests and processes
Increase support for subnational and local government units
Consider establishing a public fund
Mental health services within national insurance schemes
A national mental health goal in social and economic plans, and/or as a primary program
within the Ministry of Health
mental health addressing responsive care, prevention and promotion that can be costed
Include:
6

19. Participation Key Recommendations
Build capacity and increase opportunities for young people and
Strengthen engagement between government agencies, community, and youth
groups to ensure MHPSS approaches meet local needs and support implementation
Include youth and parent representatives in subnational committees, and/or
establish child and adolescent task forces to support planning
Formal roles for youth and parent representatives on national mental health
committees or similar bodies, such as the National Coalition for Mental Wellbeing
Mechanisms for feedback and complaints, including for feedback on non-health
settings and in child and adolescent-friendly formats
youth organisations to participate in MHPSS policy and planning
Establish:
RECOMMENDATIONS FOR STRENGTHENING
RECOMMENDATIONS FOR STRENGTHENING
The Multi-Sectoral Mental Health System
MHPSS 2022 19
7
Data, Information and Research Key
Recommendations
Include mental health indicators in routine health information systems,
Integrate child and adolescent mental health indicators into routine information
systems of education, social welfare and justice sectors
Improve mechanisms for timely analysis, reporting and sharing of data within and
across sectors
Invest in further research and support local research capacity to understand demand-
side needs, barriers and service-delivery preferences, build the evidence for specific
actions, and evidence of effective implementation models
A national suicide and self-harm surveillance system
A child protection information management system that is accessible within and
across sectors
A user-friendly platform “one stop shop” across sectors, to enable harmonised
collection, use and sharing of data
and provide age and sex-disaggregated data
Establish:
8

20. We would like to thank the Director General of Health Malaysia
for his permission to publish this infographic