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On 20 November 2009 the United Nations celebrates the 20th anniversary of the Convention on the Rights of the Child (CRC). The CRC is the key piece of international law for the protection and the fulfillment of the health, development, social, economic and cultural needs of all children. (United Nations)1
The anniversary of the CRC provides an opportunity for those of us working in primary care to reflect on our practice and the society we are working in, to reevaluate how we are contributing to the realisation of the theme of the CRC, that all children and adolescents should have the means and the opportunity to develop to their full potential.
The key components of the CRC are:
Capacity building in the application of the CRC as a normative and legal framework. The expectation of this component is that a ‘rights based perspective’ should be integrated into national legislation. Those of us who work in primary care mental health have a central role in ensuring that we lobby our governments and support our local and international Non‐government Organisations (NGO's) to advocate that the areas in which we practice have laws and policies that are in keeping with the CRC.We should make it a point of duty to support our colleagues who are still struggling and have no mental health laws and policies and no Children's Act. Wonca (World Organization of Family Doctors) can play it's part in this by bringing together experts in the field from all it's regions to benchmark countries against the UN standard and share good practice and provide support where it is needed.
CRC monitoring and reporting process. Continuous monitoring and audit are integral components of the process and allows governments to maintain and improve on their standards of maintaining the rights of the child. Here lies an opportunity for colleges of general practice all over the world to play their part. Working with sister colleges focused on child and adolescent health, the development of audits across organisations can be supported to enable a more holistic approach to addressing this important and complex problem. They should support family doctors to be ambassadors and advocates for the rights of the child and each college could develop the role of a child rights champion in order to further raise awareness and highlight the importance of child health in the development of our society.
Adolescents. Adolescence is a challenging period all over the world. Family doctors should continue to integrate the adolescent into mainstream clinical care by supporting their physical and emotional needs and make their practices a welcoming place for adolescents.
In order for the CRC to be realised primary care and primary care mental health needs to re‐affirm and re‐focus on the social determinants of health. The Sixty‐second World Health Assembly recognised the role of the wider social determinants of health and made a recommendation to the Director General of the WHO to call upon the international community, including United Nations agencies, intergovernmental bodies, civil society and the private sector to come together to address these wider social determinants.2 It was noted that inequalities in health continue and gaps widen.
One way to address the widening gap in health is by the strengthening of primary care through better and greater integration with other services including housing, general health, schools and vocational opportunities. Family doctors have to care for the mind and body and recognise that there can be no mental health without primary care and neither can primary care be effective without a full partnership with other parts of the healthcare systems and the wider society.3
Mental Health in Family Medicine calls on all it's friends, allies and stakeholders to reflect on what they have done so far and on what more needs to be done to meet the standards of the United Nations Convention on the Rights of the Child.