Promoting child and adolescent mental health in low and middle income countries

Abstract

Children and adolescents in low and middle income countries (LAMIC) constitute 35-50% of the population. Although the population in many such countries is predominantly rural, rapid urbanisation and social change is under way, with an increase in urban poverty and unemployment, which are risk factors for poor child and adolescent mental health (CAMH). There is a vast gap between CAMH needs (as measured through burden of disease estimates) and the availability of CAMH resources. The role of CAMH promotion and prevention can thus not be overestimated. However, the evidence base for affordable and effective interventions for promotion and prevention in LAMIC is limited. In this review, we briefly review the public health importance of CAM disorders in LAMIC and the specific issues related to risk and protective factors for these disorders. We describe a number of potential strategies for CAMH promotion which focus on building capacity in children and adolescents, in parents and families, in the school and health systems, and in the wider community, including structural interventions. Building capacity in CAMH must also focus on the detection and treatment of disorders for which the evidence base is somewhat stronger, and on wider public health strategies for prevention and promotion. In particular, capacity needs to be built across the health system, with particular foci on low-cost, universally available and accessible resources, and on empowerment of families and children. We also consider the role of formal teaching and training programmes, and the role for specialists in CAMH promotion.

Autism spectrum disorders (ASD) in Africa: a perspective

“…12 Child and adolescent mental health services, human resources and policy making in Africa It is important to pay attention to the recurrent theme of scarce child and adolescent mental health legislation, policies, services, programmes and human resources in Africa. 17,18 The need to scale up services to meet the challenges of child and adolescent mental health in Africa through mass education, personnel training, and appropriate policy formulation is imperative. The modalities stated by Patel et al 17 in meeting the challenges of scarce resources in the area of child and adolescent mental health in Africa and other low income countries is worth giving thoughtful consideration.…”

“…17,18 The need to scale up services to meet the challenges of child and adolescent mental health in Africa through mass education, personnel training, and appropriate policy formulation is imperative. The modalities stated by Patel et al 17 in meeting the challenges of scarce resources in the area of child and adolescent mental health in Africa and other low income countries is worth giving thoughtful consideration.…”

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“…38,39 Family characteristics such as conflictridden parental relationships and poor parent-child interactions (as indicated by a child's need to seek emotional support outside the family) were independent predictors, especially for depression. Also consistent with other research findings 40 is that satisfaction with one's body predicted all three mental health measures, especially among females.…”

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“…Thus, local government areas employ primary healthcare providers as first line of contact in health and related issues to the community including children and adolescents; and act as a principal point of continuation of care within the healthcare system. In Nigeria, and in most developing countries, the primary healthcare facilities are the first place of seeking for health, partly because of its nearness and accessibility to individuals and families in a community than are the secondary and tertiary healthcare facilities (Patel, Flisher, Nikapota, & Malhotra, 2008). Therefore, the primary healthcare providers play significant roles in providing "essential healthcare" to people in various communities, including some mental health-related cares.…”