A member of South Sudanese Ministry of Health Rapid Response Team takes a nasal sample from a woman at her home after she came into into contact with a confirmed COVID-19 case, in Juba, South Sudan, April 14, 2020. Photo AFP

JUBA - More than 800,000 doses of the AstraZeneca COVID-19 vaccine should be delivered to South Sudan by the end of the month according to a South Sudanese health ministry official.  
 
Doctor John Rumunu, director-general for preventive health services at the national health ministry said the vaccine will first be administered to the country’s most vulnerable populations.
 
Rumunu told reporters in Juba Sunday that South Sudan met all of the requirements necessary to acquire the vaccine.
 
“I’m happy to let you know that the 864,000 doses are from AstraZeneca, and AstraZeneca is using the same chain like we are using for the routine vaccination, meaning you need fridges that can keep vaccines in conditions of two to eight degrees centigrade. We have that all over the country,” he said.
 
Rumunu said COVAX (COVID-19 Vaccines Global Access) assessed all vaccines and determined that AstraZeneca was best suited to South Sudan’s capacity to preserve the vaccine.
 
Concerns have been raised over the safety and efficacy of preserving COVID-19 vaccines in hot climate countries like South Sudan, concerns triggered primarily by misinformation circulating on social media platforms such as WhatsApp and Facebook.
 
Dr. Guyo Guracha, the World Health Organization’s emergency coordinator in the South Sudan capital Juba, said AstraZeneca is safe to use in South Sudan.
 
“There should be no worry about safety and efficacy because we have an elaborate mechanism in place as WHO and the country also has its own. Many countries also will be looking at it on their own, independently,” Guracha said.
 
Health Ministry spokesperson Dr. Loi Thuou strongly advised the public against sharing misleading information about COVID-19 vaccines on the internet.
 
“We need to be very careful in handling and sharing that information with, let’s say innocent people, who may not necessarily have their own analytical capacity. I mean, if someone really wanted to actually do something against Africa or black race, why should it be through vaccines?” Thuou said in Juba.
 
Africans are consuming many other common drugs from the Western world like malaria medications such as Artimisin, according to Thuou.
 
He urged South Sudanese to practice social distancing and follow other preventative measures to prevent transmission of the virus in markets and other places where people congregate.
 
“Part of the reason why partial lockdown is mandatory is the behavior of our people. If you go to Konyokonyo [marketplace]… before partial lockdown was declared, you will not have a sense that there’s COVID-19 in this country, people are just mingling [in the] crowd and nobody cares, hardly people wear masks,” said Thuou.
 
Health officials are reporting a rapid jump in the number of COVID-19 cases in parts of South Sudan, particularly Central Equatoria state, which in recent days reported more than 300 new cases.
 
As of Sunday, South Sudan registered 4,609 positive COVID-19 cases, 861 active cases, 66 deaths and 3,692 recoveries. - David Mono Danga, Voice of America

Photo RIA Novosti / Dmitry Korobeinikov

• One in five students (4.62) in a virtual class of 22 are now experiencing mental health difficulties, an increase of 20% in just 10 months.
• One in five teachers say they have witnessed at least one of their students showing suicidal (16%) and self-harm (21%) behaviours.
• Untreated mental health conditions of children stuck on NHS mental health waiting lists are costing schools and specialist education services £69 million a year. 

Teachers say that five students in a virtual class of 22 (1 in 5) are now experiencing mental health difficulties as a consequence of the pandemic, an increase of 20% in just ten months. Meanwhile, half of all teachers (56%), including 46% of teachers in primary school, have feared that at least one of their students will come to harm while waiting for mental health treatment over the last year, compared to one third (32%) in 2018, new figures show. 

The survey of 500 teachers by youth mental health charity stem4 reveals the true extent of the children's and young people's mental health crisis in Britain. Over the past five months, one in five teachers say they have witnessed at least one of their students showing suicidal (16%) and self-harm (21%) behaviours.

Nearly nine in ten (88%) teachers say they have seen pupils suffer with anxiety, and almost half (46%) have witnessed a student with depression. Other common problems include emotional and behaviour disorders (ADHD), aggression and concentration issues (41%), eating disorders (22%), addiction (12%), obsessive compulsive disorders (OCD) (11%), and post-traumatic stress disorder (PTSD) (8%).    

Most teachers predict that the longstanding mental health crisis will bring schools and colleges to breaking point as young people suffer from the effects off the pandemic. 68% of teachers point to isolation and loneliness, 41% to family difficulties, 47% to academic worries and 33% to food poverty. 

Teachers now refer one in three (29%) students with mental health difficulties to NHS mental health services [Children and Adolescent Mental Health Services (CAMHS)]:

-      34% say referrals are routinely rejected because they do not meet the threshold of severity.

-      31% say waiting lists are closed in their area;

-      29% say referrals are refused because local NHS mental health services have not resumed at full capacity as a result of the pandemic. 

When it comes to students who are accepted for treatment, teachers warn that three in ten (30%) of their pupil referrals are stuck on waiting lists for 9 weeks or more.  This leads half (48%) of teachers to describe existing health and social care services for students with mental health problems as very or extremely inadequate. 

As mental ill health among students rises, and NHS waiting lists continue to grow, the survey – which covered primary schools, secondary schools, and further education colleges across the UK – paints a picture of patchy mental health resources and limited referral pathways for the most vulnerable young people. 

Teachers say only half (47%) of students with mental health difficulties are able to access the treatment they need to get well, leaving schools to bear the mounting costs of children's and young people's untreated mental health conditions.   A quarter (25%) of teachers say they tell parents to find their own expert mental health support for their child, and 17% tell parents to pay to see someone privately if they can afford to do so.  

Back in 2018 government proposals to improve mental health provision for young people included funding for a senior mental health lead in every school.  The stem4 survey shows that less than half (44%) of schools and colleges currently have a teacher designated as mental health lead.  Just over a quarter (27%) of schools offer some form of early one-to-one counselling, and only (9%) have a comprehensive mental health literacy programme in place. 

Dr Nihara Krause, Consultant Clinical Psychologist, founder of stem 4, and creator of apps Calm Harm, Clear Fear, says:

"In July 2020 NHS Digital found that 1 in 6 5-16-year-olds had a probable mental disorder, an increase by a third in three years – from 1 in 9 in 2017.   This survey suggests that this official figure underrepresents the reality of what is happening nationally. 

"Since the start of the pandemic stem4 has recorded over 540,000 downloads of our free NHS-approved mental health apps: Calm Harm, which helps manage the urge to self-harm, and Clear Fear, which helps manage the symptoms of anxiety. Just 17% of stem4's app users are receiving treatment.   During the summer A-level exam results fiasco daily downloads rose from on average 2,000 a day to 12,000 a day.  When we emerge from this third lockdown, we will see mental health distress on an unprecedented scale. 

"Teachers witness first-hand the devastating impact that isolation, loneliness, family difficulties, education stresses and poverty is having on our children's and young people's wellbeing and mental health. The consequences of this can often be serious and life-threatening.  Teachers are desperate to help, yet the necessary early interventions and specialist services are not in place to minimise their negative effect. 

"If this government is serious about turning the tide of mental ill health in this young generation, it needs to take urgent action now. What children and young people need is access to evidence-based services at all levels, from early prevention through to expert NHS help." 

■ Untreated mental health conditions of children stuck on NHS mental health waiting lists are costing schools and specialist education services £69 million a year 

Teachers told the stem4 survey that every child and young person with an untreated mental health condition requires extra help from teachers, while their parents require support.   Teachers say they now spend 3.6 hours (average) per week dealing with the mental health difficulties of their students and monitoring children currently on waiting lists, or who have been rejected by CAMHS after referral, to make sure their conditions do not worsen.  

According to a new report published today by charity Pro Bono Economics for stem4, the untreated mental health conditions of children stuck on waiting lists for NHS mental health treatment (CAMHS), are costing public services £75 million each year. £48 million of that cost is borne directly by schools and colleges and £21 million by specialist education services. 

The remaining £6 million falls to social care and other health services.  If the analysis includes the 35% (250,000) of children and young people who had their referrals closed before they received treatment, then total costs could increase to around £210m. 

380,000 children waited an average of 7 weeks for NHS mental health treatment in 2018/19, costing public services the equivalent of £200 per child receiving treatment.  23% (87,000) of these children waited more than 12 weeks for treatment, costing public services an average of nearly £500 per child.  

■ stem4's free, evidence-based, smartphone apps

With children and young people experiencing difficulty and long waiting times in accessing effective treatments, stem4 has developed four NHS-approved smartphone apps, all based on evidence-based strategies, to help young people in the treatment of and recovery from their mental health difficulties. 

These apps – which have been funded by charities including the Paul Hamlyn Foundation and Comic Relief, and by generous donations from individuals – are free to use, and do not collect any personal data. They include:

• Clear Fear, which uses the evidence-based treatment Cognitive Behaviour Therapy (CBT) to help manage the symptoms of anxiety;
• Calm Harm, which uses the basic principles of an evidence-based therapy Dialectic Behaviour Therapy (DBT) to help manage the urge to self-harm;
• Combined Minds, which uses a Strengths-Based approach that has been shown to be effective in recovery, providing practical strategies for families and friends to support teenage mental health;
• Move Mood, which uses Behavioural Activation Therapy to help improve low mood and manage the symptoms of depression.

Dr Nihara Krause and stem4 say more needs to be done on a number of different levels to support children and young people with mental ill health issues:

• As a consequence of long delays in access to specialist resources, children's and young people's conditions worsenand they are presenting with complex mental health needs. More specialist CAMHS services with high-intensity specialists are urgently needed;
• Children and young people who have been on a waiting list for help will benefit from some sort of intermediate support. Taking the burden off teachers, this support can help monitor and motivate change before young people access treatment. Evidence-based digital support in preparation for face-to-face services may prove useful in this;
• Children and young people who are experiencing mild-to-moderate mental health difficulties require increased access to specialist early-intervention services.  Teachers are at the forefront of addressing this crisis and they need much more support;
• More than half of children and young people with mild-to-moderate mental health problems do not meet CAMHS thresholds, or wait months to be seen.  Waiting times need to be brought down to four weeks. 

■ What teachers are saying

Teachers' views on mental health provision in schools and colleges, CAMHS and local commissioned services designed to support children's and young people's mental health needs: 

"Woefully inadequate and not fit for purpose when the threshold for treatment from CAMHS is so high - you have to be suicidal before they will do anything."          Further education college, Yorkshire & The Humber 

"We are fighting a losing battle. There is never enough time to deal with the mental health of students, we can't afford extra counsellors, the NHS waits are too long."   College, South West 

"Mental health provision in schools has been cut drastically for a number of years and the current restrictions have made the situation come to crisis point."      Primary school, West Midlands 

"The government have failed children with mental health issues. Teachers have been left with the additional task of treating mental health issues for children in schools. We have no training for this, no additional time given and no money." Primary school, Scotland 

"Teachers have needed to become front line social workers and mental health specialists as well as educators and this is not sustainable or healthy for the young people or staff." Secondary school, South East 

"CAMHS is very understaffed and overused, and NHS mental health provision is simply not available."   Secondary school, London