Cross-cultural child and adolescent psychiatry research in developing countries

Abstract

Mental disorders are currently a major source of morbidity among children and youth globally. The bulk of the epidemiological data about childhood mental health morbidity currently comes from the industrialized countries which paradoxically host a small (about 20%) proportion of global children and youth population. As the world seek to generate more data on the mental health of the teeming children and youth population in low- and middle-income countries (LMICs), cross-cultural issues need be considered. This consideration is imperative for reasons which include the high level of ethno-diversity in LMICs; the contextual issues in the conceptualization of normal (and abnormal) childhood across cultures, the cross-cultural nuances in risk and protective factors, and the plurality of nature and expression of childhood psychopathology. As much as it is imperative to do so, advancing cross-cultural child and adolescent research in LMICs will need to overcome challenges such as inclusive sampling and cultural validation of instruments developed in the industrialized countries of the West. Funding, technical resources, and publication bias are other potential challenges. These issues are appraised in this narrative review and some ways forward are proffered.

The Strengths and Difficulties Questionnaire (SDQ) in Africa: a scoping review of its application and validation

“…de Vries and colleagues [ 82 ] also recommended that the SDQ could be useful as an ‘in-country’ instrument, but that it should be used with great caution as a ‘cross-country’ comparative measurement tool. There is clearly an increasing realisation of the need for cross-cultural measurement instruments in CAMH [ 83 , 84 , 89 ]. However, we acknowledge that, to date, most CAMH screening tools have not been developed with a global user in mind.…”

“…However, we acknowledge that, to date, most CAMH screening tools have not been developed with a global user in mind. In an Africa setting this task is significant and a range of challenges will need to be considered from the subtle cultural, ethnic, pragmatics of language [ 82 , 89 ] to the large number of languages and variability of literacy levels. de Vries [ 82 ] recommended qualitative exploration of the cultural use of mental health language in order to develop mental health measurements that can capture similar global concepts appropriately and adequately in local settings.…”

“Everybody’s responsibility”: Conceptualization of youth mental health in Kenya

“…Youth mental health and help-seeking are also influenced by culture, in a dynamic process including values, norms and beliefs (Lasebikan, 2016) connected with the development, onset and continuation of mental health problems (Heim et al, 2017). Significantly for youth mental health in LMIC, the cultural context has also been shown to be inter-related with parenting functions, hence its conceptualisation by parents and other adults can have both a risk and protective impact (Atilola, 2015).…”

Family Issues in Child Mental Health

“…The pathway towards a culturally nuanced CAMH research in LAMIC will require a contextualized understanding of the concept of childhood in such regions relative to the high-income countries of the West (Atilola 2015). Similarly, service delivery needs to be culturally nuanced where the families have to be invariably involved in the treatment; culturally adapted psychotherapeutic approaches are utilized; and alternative/cultural remedies such as spiritual healing, faith healing, herbal and ayurvedic remedies, yoga, meditation, etc.…”