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HealthUN Committee issue recommendations for children with mental health problems in Germany

UN Committee issue recommendations for children with mental health problems in Germany

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The United Nations Committee on the Rights of the Child completed its review on the implementation of human rights for children in Germany. The Committee issued updated Recommendations to be implemented in the next five years. The Recommendations touch on all aspects of children’s rights, from civil rights and liberties of children to how to appropriately deal with children struggling with ADHD or behavioural issues.

The United Nations Committee on the Rights of the Child monitors the implementation of the Convention on the Rights of the Child (UN CRC). The UN CRC is the most important international human rights instrument for children. It sets out the main, globally valid, rights of children, including the right to protection against violence, the right to education, participation and equal treatment and the right to leisure time, relaxation and play. These rights are universal, which means they apply to all children. 192 countries – almost every country in the world – have signed the United Nations Convention on the Rights of the Child.

Every five years the implementation of these rights set out in the Convention is reviewed for each country having ratified the convention. Next in line was Germany. In 2019 the German Federal state cabinet approved a report prepared by its central administration reporting on the progress made in Germany. The report was submitted to the UN CRC Committee in 2020 and was then followed by a review, questions and answers and supplemented by further information from Civil society, and the German Institute for Human Rights.

In September the German state party then met with the UN CRC Committee in Geneve, and during a full day’s meeting had an intensive dialogue on the implementation of human rights for children in Germany, as of today.

One of the issues considered was mental health. The UN CRC Committee already during the last review of Germany in 2014 had raised a concern “about the increase in the prescription of psycho-stimulants to children and about excessive diagnoses of Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD), and in particular:

(a)      The over prescription of the psycho-stimulant methylphenidate;

(b)      The forced removal of children who are diagnosed/misdiagnosed with ADHD or ADD from their families and their subsequent placement in foster care or psychiatric hospitals, where many of them are treated with psychotropic medication.”

The UN CRC Committee with this concern issued recommendations to deal with the matter. These resulted in many actions taken in Germany. It was now time to consider the results.

As part of the questions raised during the September 2022 meeting, UN CRC Committee Experts raised the question on ADHD overdiagnosing and use of psychotropic drugs in Germany in present time.

The German Representative of the Ministry of Health as part of the German state party delegation to the UN CRC meeting answered the question. The representative confirmed this had been an issue with the German Federal government.

She added that “we looked in to this and there were many measures taken for example information and awareness raising campaigns for specialists and local population and the clinical guidelines were further developed and made more tangible. As a result, the prescription of stimulants has gone down in 2014-2018, there was a reduction of approximately 40 percent.”

The representative added in concluding this issue, that “The government therefore is not assuming that ADHD is systematically overdiagnosed in Germany at present.”

The UN CRC Committee experts noted this, and issued a new relevant recommendation to Germany considering all the information available.

The UN CRC Committee recommends that Germany:

”(a) Strengthen efforts to improve children’s mental well-being, including by developing community-based mental health services and counselling and preventive work in schools, homes and alternative care facilities;
(b) Ensure the early and independent assessment of any initial diagnosis of mental health problems, ADHD and other behavioural issues, and provide such children, their parents and teachers with appropriate non-medical, scientifically-based psychiatric counselling and specialist support.””

It gives Germany the steps to take over the next five years to continue the implementation of human rights for children.

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