Tom Osborn: A new way to help young people with their mental health | TED

譯者: Lilian Chiu 審譯者: Helen Chang

Around the world and especially in low-resource countries

在全世界，特別是像我的祖國 肯亞這種資源不多的國家，

like my home country of Kenya,

mental health problems prevent young people

心理健康問題讓年輕人無法過著

from living independent and successful lives.

獨立、成功的生活。

I was born and raised in a small sugarcane farm.

我在一個小型的 甘蔗農場出生、長大。

Some of my early memories are those of my younger brother and I

我的兒時記憶包括我和我弟弟

walking around and pretending that we owned the sugarcane.

跑來跑去，假裝我們擁有那些甘蔗。

But most of these memories were actually from school.

不過大部分的兒時記憶 還是和學校有關。

My parents and especially my mother,

我的父母，特別是我母親，

made sure that I knew how much they'd sacrificed

確保我清楚知道他們做了 多少犧牲才讓我能接受教育，

for me to have the education

and the path to success that they did not.

有機會成功，這是他們沒有的。

They were very clear that the stakes were too high.

他們表明得很清楚， 投入的賭注太高了。

There was no room for disappointment.

沒有容許失望的空間，

There was no room for failure.

沒有容許失敗的空間。

When I was 12,

我十二歲時，

I moved to the boarding section of a local primary school.

我搬到一間當地小學的寄宿區。

Here we will wake up at 4am to a set of math problems

在那裡我們早上四點 要起床，面對一組

數學問題，且要在早餐前解決。

that we had to solve before breakfast.

We'd only go to bed, sometimes after 11,

我們還得解決晚上的 科學問題才能睡覺，

if we solved that night's science problems.

有時會超過十一點。

In high school, the pressure was even higher.

高中的壓力還更大。

The early-morning to late-night routines

除了一天早到深夜的日常，

were now supplemented by Saturday and Sunday classes.

現在還加上了星期六、日的課。

It was here in high school

是在高中的時候，

where I began to notice the personal,

我開始注到這個壓力鍋體制所造成的

emotional and behavioral toll that this pressure-cooker system

個人、情緒，及行為上的打擊，

had exerted of myself and those around me.

打擊的不僅是我，還有我身邊的人。

I noticed it, for example,

我會注意到，是在，比如當我厭倦了

when tired of cramming the production of sulfuric acid,

死背硫酸產物的時候，

I stopped taking notes or engaging with chemistry in 10th grade.

我在十年級時就不再 做筆記或好好讀化學了。

I noticed it when my friend Onsongo

我會注意到，是在我的朋友安松戈

tired that his life had been reduced to a letter grade,

厭倦了他的人生只剩下成績的時候，

had enough and quit school.

他受夠了，選擇退學。

I noticed it when a schoolmate, whom I will call Otieno,

我會注意到，是在一位同學， 就稱他為歐提安諾，

took his own life.

自殺的時候。

But all this time,

但在這段時間，

all this time, what came to mind was that this was life.

在這段時間，腦中想的 就只有「這就是人生」。

Life was trouble sleeping or sleeping too much.

人生就是難以入眠或睡太多。

Life was little interest or pleasure in doing the things that gave you joy.

人生就是去做你喜愛的事 也沒多少趣味或樂趣。

Life was constantly feeling down,

人生就是經常覺得很低落，

crushing under the weight of the feelings of hopelessness.

被毫無希望的感受給壓垮。

That was life.

那就是人生。

It was only recently, some five years after high school,

要到最近，大約是高中後五年，

that I began to realize that what we thought was life

我才開始了解，我們以為的人生

could have, in fact, been mental health problems.

有可能其實是心理健康問題。

Was it possible that we were struggling with depression and anxiety

有沒有可能，我們當時 為憂鬱和焦慮所苦，

and just didn't know about it?

只是自己不知道？

That, in fact, was the case.

事實上的確是如此。

Studies now show that almost 50 percent of Kenyan adolescents

研究指出現在有近五成的肯亞青少年

struggle with mental health problems.

都為心理健康問題所苦。

And in such a youthful country,

這個國家的人口十分年輕，

where half the population is 19 years or younger,

有一半的人口是十九歲以下，

youth mental health has now become an urgent public health priority.

青少年心理健康現在已經成為 迫切的公共衛生重點。

Over the past few years,

在過去幾年間，我一直在努力

I've been working to turn this public health problem

把這個公共衛生問題 轉變成年輕人的機會，

into an opportunity for young people

to reimagine and redefine what mental health care could look like.

來重新思考和重新定義 心理健康照護是什麼樣子。

We're doing this by tackling the three big issues

我們的做法是去處理阻擋 年輕人求助的三大問題，

that prevent young people from getting help.

One, the lack of mental health experts.

第一，缺乏心理健康專家。

Two, the stigma around mental health.

第二，心理健康的汙名。

And three, the sad reality that most mental health treatments

第三，一個讓人感傷的事實： 大部分心理健康治療

were not built and designed for young people

都不是針對外表、背景像我 這樣的年輕人所打造、設計。

who look like me and have my background.

Because we have only two clinicians for every one million Kenyans,

因為每一百萬肯亞人 只有兩位臨床醫生，

and two -- yes, only two --

此外，兩位——對，只有兩位—— 兒童及青少年精神病醫生

child and adolescent psychiatrist in the whole country,

要負責全國。

we are expanding mental health care access by training [18- to 22-year-old] Kenyans

我們在努力讓心理健康照護更普及，

做法是訓練十八到二十二歲的肯亞人

as lay providers.

成為非專業的照護提供者。

These young Kenyans are delivering evidence-based care to their peers

這些肯亞年輕人能透過 有結構有層次的模型來提供

以證據為基礎的照護給他們的同儕，

through a structured and tiered model

that ensures that all young people who want can get help.

以確保想要取得 協助的年輕人都能如願。

Because of a stigma of mental health

因為肯亞過去給心理健康 冠上的汙名至今仍然存在，

that still exists from Kenya's colonial past,

we are delivering interventions

我們所提供的介入治療 並不需要正式的心理健康診斷，

without a formal diagnosis of mental health,

and our interventions focus on building character strengths,

且我們的介入治療重點 在於建立性格優勢，

on strengthening individual autonomy

在於強化個人的自主能力，

and on improving overall human functioning and well-being.

在於改善整體 人類功能的發揮及幸福。

Because our lay providers work within the communities

因為我們的非專業照護提供者， 是在自己所屬的社區中服務，

where they come from,

in the school systems that they themselves went to

在自己就讀過的學校體系中服務，

and deliver what is truly a for-youth and by-youth mental health care treatment,

且提供的是真正 由年輕人為年輕人而做的

心理健康照護治療，

we are fixing the divide between mental health treatment

我們在努力讓心理健康治療更接近

and the social and cultural needs of the communities that they serve.

他們所服務的社區中的 社會和文化需求。

Since 2018, we have used this youth-based model

從 2018 年起，我們開始用 這個以年輕人為基礎的模型

to bring mental health care across Kenya.

將心理健康照護帶到肯亞各地。

And what we have found is that this model works.

我們發現這個模型是行得通的。

Young people are reporting reductions in depression and anxiety symptoms.

年輕人回報的憂鬱 和焦慮症狀在減少。

They’re reporting improvements in their social relationships

他們回報社交關係有所改善，

and in their views about their abilities to change the world.

也更能相信自己有能力改變世界。

And in what will make my mom happy,

還有一點是我媽媽會 很樂見的，他們也回報

they are also reporting improvements in their academic grades.

學校成績有所改善。

Mental health is not a Kenyan problem.

心理健康不是肯亞的問題。

It is not an African problem.

它不是非洲的問題。

This is a global problem.

它是全球的問題。

We need big ideas to tackle this problem.

我們需要大想法大計畫 來處理這個問題。

And our case for optimism is that our youth-oriented,

樂觀的是，我們這個年輕人 導向且著重社區的模型

community-focused model can be a template for the rest of the world.

可以當作樣板給全世界參考。

One other early memory from childhood

還有一段兒時記憶，

is a story that my grandmother, Yunita, told me.

是我祖母尤妮塔告訴我的故事。

A long time ago, before the sugarcane farms,

很久以前，

在甘蔗農場之前，

before the grass-thatched huts and the round compounds,

在茅草小屋之前，在圓形大院之前，

the animals lived happily because there was plenty in the land

動物快樂地生活著，因為土地充足，

and a future to look forward to.

也有可期待的未來。

But farming threatened the land,

但農業威脅到了土地， 突然間，未來變得毫無希望。

and the future was all of a sudden bleak.

And so the lion roared.

於是，獅子怒吼了。

But there was no water.

但沒有水。

And the elephant grunted.

大象也叫起來。

But there was no water.

但沒有水。

And the cheetah yelped,

獵豹也叫起來，

but there was no water.

但沒有水。

But when the young antelope asked them to come together

但當年輕的羚羊要牠們 集結起來建立水井，

and build a well, there was water.

就有水了，

There was a future.

就有未來了，

There was hope.

就有希望了。

This is our young antelope moment.

此刻就是我們的年輕羚羊時刻，

Let us come together and let us build a world

讓我們集結起來建造一個世界

where all young people, all over the world can flourish and thrive.

讓世界各地所有年輕人 都能夠活躍、成功。

Thank you.

謝謝。

(Applause)

（掌聲）