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Doc. 10408
22January 2005
Teenagers in distress: a social and health-based approach to youth malaise
Recommendation 1632 (2003)
Reply from the Committee of Ministers
adopted at the 912th meeting of the Ministers’ Deputies (19 January 2005)
The Committee of Ministers has considered Recommandation 1632 (2003) on teenagers in distress: a social and health based approach to youth malaise, and wishes to give the Assembly the following information:
A. General remarks
1. The Committee of Ministers shares the Parliamentary Assembly’s concerns and is prepared to support social and health programmes aimed at promoting teenage welfare both at the Council of Europe and national levels. However, the Committee of Ministers would stress that it considers adolescence not as a “problem age” but as a period rich in the learning of new skills and acceptance of new challenges; it is a time that can create a fresh perspective on adulthood and society in general, which is necessary for progress in any community. The Committee would consequently urge all those involved in social and health policies to adopt a positive approach to the teenage years, recognise young people’s value as a human resource and their potential to contribute to the relevant discussions, and involve them in making decisions concerning them.
2. Nevertheless, it is widely acknowledged that adolescence is an increasingly difficult period of one’s life. Contemporary societies have high expectations of their teenagers as future adults, and tend to forget their specific demands and rights, namely the rights of the child. The main thing to remember is the formative function of adolescence, in which risk plays a major role, and often a positive one. What one must prevent is excessive risk, which is the response to a malaise and is the subject of the Parliamentary Assembly’s preoccupation in this respect.
3. This means that adolescence is not a private matter but rather a social issue that necessitates responses other than simple knee-jerk criticism of the youngsters’ general behaviour. Teenagers in distress require particular attention taking account of who and what they are during this crucial period in human development. Teenagers can therefore be regarded as a vulnerable group to whose well-being the health profession has a major contribution to make. The European Health Committee (CDSP), to which the Committee of Ministers has transmitted this Recommendation, has shown intense interest in it, has backed a number of the Assembly’s analyses and is hoping to draw the Assembly’s attention to the relevant studies and proposals which it has produced.
4. It is important to stress that direct, personal work with young people and the attentive ear, which they require at such times, facilitate an understanding of their difficulties, attitudes and modes of behaviour. This is an approach which the Council of Europe has followed out in its Youth Sector activities.
5. The social cohesion field has also promoted youth participation. In this connection, one should mention the Forum for Children and Families, which has invited at least six different teenagers to each of its seven meetings, asking them for their views on all the issues studied on an equal footing with the adults present. A second example is the work on young people in disadvantaged urban areas. These two activities have revealed the extent of young people’s anxiety about their future, their great need for trust and reliable reference points, and their immense appreciation of the work done by health professionals with teenagers when they respect the latter’s specific identity. This particularly concerns children’s ombudspersons, who are highly rated in the member states.
6. In conclusion of this part of the reply, the Committee of Ministers wishes to draw the Assembly’s attention to the fact that it has attached to its reply the opinions of its three bodies, the European Health Committee, the Advisory Council on Youth Questions and the Pompidou Group. These opinions contain ample information on the work of these bodies relevant to the concerns of the Assembly.
B. Comments on paragraphs 10 ii, iii and iv d and e, and 11 ii, iii and v of the Recommendation
7. In connection with the social cohesion sector’s analyses of and responses to teenage malaise, the Committee of Ministers would like to mention two publications based on the above-mentioned activities (recently published with financial support from the two Secretary General’s integrated projects). One is entitled “Children, participation, projects – how to make it work!”, and the other “Youth and exclusion in disadvantaged urban areas: addressing the causes of violence”. Both these publications highlight the idea that in order to prevent distress among teenagers they must be integrated into projects of relevance to their living and school environments; they must be involved in developing such projects and given the feeling of belonging and being affiliated to the society which provides the basis for their citizenship.
8. Where the intergovernmental sector’s plans are concerned, one project is aimed at developing support policies in the member states for parental action in the overriding interest of the child, each policy being tailored to the age of the young person in question. This new project, which has been elaborated by the European Committee for Social Cohesion (CDCS), acknowledges the disorientation experienced by children, using the definition set out in the United Nations Convention on the Rights of the Child, namely persons under the age of eighteen, and also the widespread confusion on the part of their parents, in view of the multitude and diversity of opportunities available but also the challenges to be taken up and the risks run by youngsters in modern societies. The project may also develop activities to be included in the new transversal programme which will be introduced in 2005 on “Violence and children”. The project on parenthood will provide children with support and protection from violence, self-inflicted violence and the negative influences of parents, third persons, or society as a whole, particularly the media and the market, on individuals under the age of eighteen.
9. Moreover, the social cohesion and youth sectors are aware of the need to address certain matters in close cooperation. In September 2004, a brainstorming session was organised to identify the key fields and questions in childhood and youth policies that must be dealt with in a coordinated manner. At the end of this meeting, the experts formulated recommendations, which pointed out the need to create synergies between the different sectors concerned and to associate civil society. The establishment of a sustainable space of dialogue and long-term cooperation between the Steering Committees of both sectors, as for example a Forum, would allow these sectors to arrange joint meetings on a regular basis in order to share information, exchange views and develop cooperation on issues of common interest. The experts have also identified a number of transversal domains and issues for future cooperation, such as the promotion of healthy lifestyles among children and young people, the prevention of violence, children's rights and support for parents (parenting).
10. The Committee of Ministers will consider carefully any proposals submitted to it in the future aimed at improving co-ordination on this issue, within both the member states and the Council of Europe itself.”
Appendix 1 to the reply
Comments of the Advisory Council on Youth Questions (DJS-CCJ)
on Parliamentary Assembly Recommendation 1632 (2003)
With regard to Parliamentary Assembly Recommendation 1632 (2003) on teenagers in distress: a social and health-based approach to youth malaise, the Advisory Council on Youth recognises that, in general, there is a significant rise in the group of youths who are willing to expose themselves to risk and who engage in “extreme” behaviour whilst often being aware of the calculated risks involved.
A major youth study (Youth at Risk (1999), by Prof. Flemming Balvig, University of Copenhagen) has established that a majority of young people accepts some level of calculated risk in their everyday lives as a fact over which they have little or no influence. Crime statistics point to the fact that young people between the ages of 16 and 24 are the group that is most likely to be involved in violence, either as victims or offenders.
The Advisory Council is well aware of the grave situation as regards suicides and an increase in drug use amongst young people, and welcomes Recommendation 1632 (2004) as a useful step towards securing the place of young people in society. Member states should further address the very serious problems facing the youth of Europe, whilst recognising the contribution of youth organisations to efforts to effectively develop and carry out prevention measures.
In particular, the Advisory Council welcomes the signal to member states to increase their focus on early warning systems and to take signs of high-risk-taking behaviour among young people more seriously.
The need for prevention and support programmes is greater than ever, as young people are more differentiated in their culture, values and needs, as far as ensuring their successful transition to adulthood is concerned.
Resources are scarce; it is the opinion of the Advisory Council that prevention policies and measures are often very general, and not directed in the most effective way at specific target groups having particular needs regarding information, aid and support. The measures taken should therefore be even more specific in their approaches and methods, in order to ensure the best possibilities of reaching the target groups.
Furthermore, the Advisory Council would like to draw attention to the fact that youth NGOs in many Council of Europe member countries are currently actively working on these issues, and would encourage further invitations by the authorities to such NGOs to assist and cooperate with them in the development of efficient prevention measures. Many member countries have already relevant NGOs working in the field with valuable experience in issues including violence prevention (peer-group education, mentor programmes, etc.), and drug prevention and drug abuse/harm reduction initiatives (peer-group education, self-help groups, telephone help-lines and voluntary open counselling).
Appendix 2 to the reply
Opinion adopted by the European Health Committee (CDSP) Bureau
on Parliamentary Assembly Recommendation 1632 (2003)
1. The CDSP welcomes the Assembly Recommendation as yet another contribution to the CDSP continuous efforts to promote health equity and improve health status of all Europeans in general, and of vulnerable populations in particular.
2. The CDSP agrees with the diagnosis of the situation of teenagers and shares the concerns of the Parliamentary Assembly. It concludes, however, that the youth is characterised not only by the exposure to many health and social risks, but also by the great capacity to repair resulting damages. This creates a sound policy basis for targeted interventions, as proposed by the Parliamentary Assembly recommendation.
3. CDSP agrees that insight into, and understanding of the causes of risky behaviour, will be helpful to develop coping strategies and a capacity for better “life management”. It notes that this is generally true for all people along their whole life cycle. The approach based on the notion of the social cohesion and strategies resulting thereof might be useful in solving the problems of the youth.
4. With regard to the strategies proposed to the member states, the CDSP finds them sound, pragmatic and implemental.
5. The CDSP draws attention to its own activities, which may contribute to developing such strategies:
a. The Recommendation Rec(2001)12 on the adaptation of health care services to the demand for health care and health care services of people in marginal situations, which crowns the series of the recommendations on vulnerable populations. It calls for developing a coherent and comprehensive policy framework, based on principles of equity, human dignity and participation. To protect and improve the health of people in marginal situations the Recommendation proposes a multi-sectoral approach to preventive action, to create supportive environments for the social re-integration, to avoid stigmatisation and to increase knowledge base. Measures adopted to improve access for the vulnerable serve also the general population, including some groups of teenagers.
b. Recommendation Rec(2000)5 on the development of structures for citizen and patient participation in the decision-making process affecting health care is a good guide to empower the teenagers in their roles of active citizens and patients.
c. Recommendation Rec(2001)13 on developing a methodology for drawing up guidelines on best medical practices offers a comprehensive approach and a practical instrument for developing the best practice guidelines, as proposed in point 11.iii in the Parliamentary Assembly Recommendation.
d. Recommendation Rec(2004)17 on the impact of technologies on health care – the patient and internet contains a number of proven solutions in the domains of stress-reduction, suicide prevention and mental health promotion. Anonymous help-lines, professionally monitored peer-to peer chat forums, quick access to psychological support and quality-assured information are already used by many teenagers. The Recommendation informs member states how to use modern communication technologies to the benefit of individual users and the health system as such.
e. Attention is drawn to the activities of the European Network of Health Promoting Schools, an ongoing successful joint project with the World Health Organisation and the European Union, which may serve as a perfect vehicle to implement some of the measures proposed by the Parliamentary Assembly.
6. The CDSP welcomes the intention behind the proposal to consider young people as a particularly vulnerable group. In light of the remarks made in the point 2, the CDSP proposes to treat the youth as one of the possible target groups of additional specific policies, rather than a particularly vulnerable group. The actual health policy priorities depend heavily on the demographic, social and economic situation in the member states.
7. The CDSP is willing to contribute to developing further any necessary policy measures to address the problem of the youth, in particular within the frame of the new policy to create integrated projects, cross-cutting along all the structures of the Council of Europe.
Appendix 3 to the reply
Comments of the Pompidou Group
on Parliamentary Assembly Recommendation 1632 (2003)
The Pompidou Group, the Council of Europe Partial Agreement dealing with drug problems, has been concerned throughout its work with the risks and harm to young people caused by illegal substances. It is therefore delighted that the Assembly is addressing the issue.
It would point out in this connection that the Group operates on several levels. First, it contributes to the school surveys carried out periodically since 1995 in 27 European countries in conjunction with the Swedish Council for Information on Alcohol and Other Drugs (CAN). The surveys are designed to obtain comparable, standardised data. The aim of the project is to compare alcohol and drug use among pupils up to the age of 16, monitor and compare trends in different countries and provide an incentive for preventing alcohol and drug use among young people. The findings of the last survey, conducted in spring 2003, will be published towards the end of 2004. The data obtained may be used, inter alia, in the course of the evaluation of the European Union's action plan on drugs and the impact of the World Health Organisation’s Declaration on Young People and Alcohol. An assessment of the impact of the ESPAD project revealed a keen interest in the subject in the media and among politicians, who made widespread use of the data collected when framing their policies. It was therefore decided at the Pompidou Group Ministerial Conference in Dublin in October 2003 to continue with the Group's contribution to the ESPAD project as part of the Group's 2003 - 2006 work programme.
The Group was not, however, content to help observe drug use among young people, but carried out numerous preventive activities. Prevention will remain a priority aspect of its 2003 - 2006 work programme. To this end, the Group is planning to involve young people themselves and their parents more closely so that it is better able to target preventive measures and thereby make them more participatory and democratic.
This approach was developed, in particular, at the seminar that the Pompidou Group held in Helsinki in 2002 on the theme "Targeted drug prevention: how to reach young people in the community". The seminar showed to what extent active youth participation can help to mobilise young people when it comes to devising, implementing and assessing prevention programmes. In the light of this beneficial experience, the Pompidou Group organised, for the first time, a "European Consultative Forum for Drug Prevention", held in the Russian Federation on 6-7 October 2004, which was attended by young people, politicians and experts.
The Pompidou Group has also included in its work programme a number of activities designed to help and support parents, who are actively involved in primary prevention and who are increasingly considered to play an important role, starting when their children are very young, when they can help to lay the foundations that make for more effective prevention. To this end, the aim will be to provide them with direct access to information and support of professional quality, which they are often lacking.
Lastly, the Pompidou Group will be paying attention to the situation in rural and outlying areas, where there is often a lack of stimulation, motivation and prospects for young people, which leads to a high level of drug use. At the same time, the professionals and authorities responsible for the problem in these areas lack opportunities for contact, exchange and cooperation with other professionals and institutions, which makes preventive action even more difficult. Given the situation, the Pompidou Group is planning to develop a pilot scheme for the parents of vulnerable children and professionals in these rural and outlying areas, which could be based on the use of the Internet.