Priority Mental Health Disorders of Children and Adolescents in Primary-care Pediatric Setting in India 1: Developing a Child and Adolescent Mental Health Policy, Program, and Service Model

Abstract

India has a huge child and adolescent population. Psychiatric disorders are widely prevalent and the mental health needs of these children are well recognized. Nonetheless, there are no country-centric and child specific mental health policies, plans or programs. There is also a significant lack of human resources for child and adolescent mental health in India. This combination of factors makes the primary care a critical setting for the early identification, treatment, consultation and referral of children and adolescents with mental health and developmental needs. Even though the importance of primary care as a system for addressing the mental health care has been recognized for decades, its potential requires further development in India as the Child and Adolescent Mental Health Services (CAMHS) emerge and evolve. A country and child specific mental health policy, plan and program needs to be formulated as well an integrated, multi-tier CAMHS with a focus on the primary-care physicians as care providers for this population has to be developed.

Child and adolescent psychiatry: which knowledge and skills do primary care physicians need to have? A survey in general practitioners and paediatricians

“…From the perspective of the families, they often have trusted and long-standing relationships with their PCPs and prefer the lack of stigma associated with being treated by paediatricians and general practitioners [46]. The global and ongoing lack of child and adolescent psychiatrists [29,43,53,60] is another reason for primary health care utilization of mentally ill minors. Moreover, access to mental health care for adolescents is often impeded by the design of the relevant health system (e.g.…”

“…Therefore, GPs and paediatricians have a decisive role in the initial assessment and ongoing management of children and adolescents with mental health problems (e.g. recognizing symptoms early, making referrals to CAP specialists or CAP inpatient units, starting or continuing psychopharmacotherapy) [14,43,51].…”

The development of a model of training in child psychiatry for non-physician clinicians in Ethiopia

“…To develop effective mental health programs for children and adolescents in a given population, an integrated, multi-tier approach with an emphasis on primary care has been suggested [3]. Implementing such programs successfully requires the availability of trained professionals as well as a political commitment at the national level [4].…”

“…However, there is still a lack of documentation on the implementation of pre-service training in child and adolescent psychiatry by incorporating it into postgraduate training curriculum in low in-come settings [3]. …”

The Diagnostic Accuracy and Validity of the Teen Screen Questionnaire-Mental Health for Clinical and Epidemiological Studies in Primary-Care Settings

“…[3] To mitigate the years lost because of disability caused by mental illnesses, with far smaller resources available than for the high income countries, it is important to develop India-centric measures and management programs. [4] Secondly, it is important to identify the mental health problems and disorders of adolescents, as early as possible, since many of these problems have the propensity to continue into adulthood. [5] Finally, with the paucity of human resource for mental health in India, it is important to develop and validate measures to conduct epidemiological and clinical work for these maladies at the primary-care settings itself.…”