Journal of Pregnancy and Child Health
Open Access

Childhood; Public Mental Health; Convergence; Healthcare

Introduction

Many kids and teenagers reside in Low- and Middle-Income Countries (LMICs), where access to mental health care is scarce and Adverse Childhood Experiences are common (ACEs). The development of child mental health services is focused on addressing developmental impairments, emotional disorders, and disruptive behaviour problems, which collectively account for a significant portion of children's mental health issues. In light of the ethno-diversity in LMICs, Child and Adolescent Mental Health (CAMH) also involves cross-cultural considerations of risk and protective variables, as well as the expression of child psychopathology. There are several obstacles to providing CAMH services in LMICs services are necessary to make the most use of their limited resources. The Lancet Global Mental Health CAMH Series, which emphasises universal and focused early childhood interventions through school and community-based programs, is also in line with global public mental health agendas aimed at reducing disparities in mental ill health by taking social determinants of CAMH into consideration. Building the capacity of primary care clinicians is a key component of such integration and task sharing initiatives, which have been shown to improve psychosocial outcomes in children. Situational factors in India, such as abuse and neglect of institutionalized children and protection violations among those children, as well as a social audit that revealed gaps in the implementation of the juvenile justice law's provisions relating to mental health and rehabilitation, have recently brought CAMH issues to the attention of the general public [1, 2].

In response, a novel national initiative known as SAMVAD (Support, Advocacy & Mental health interventions for Children in Vulnerable Circumstances And Distress) was established by the Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), a tertiary-level mental healthcare institution, under the Ministry of Health and Family Welfare. SAMVAD is an enhanced and scaled-up version of what was originally a community-based CAMH service initiative and is funded by the Ministry of Women and Child Development (MoWCD), Government of India. Through the utilization of integrated approaches to children's wellbeing, this one-of-a-kind programme acts as a resource for the nation, increasing access to the availability of child and adolescent mental health and protection support and services. The SAMVAD model is distinctive in that it uses trans disciplinary approaches to enable solutions to complex CAMH problems through dialogue and capacity-building of stakeholders from various disciplines. It operates in four verticals: Care and Protection, Education, Mental Health, and Law and Policy. Using methods that draw on specialised knowledge, SAMVAD provides services such as research, training, and capacity building while also incorporating the many perspectives that define the systemic and sectoral priorities of various stakeholders working with children. To provide advances in CAMH awareness and capacitybuilding, SAMVAD employs cutting-edge teaching and learning techniques of participatory, creative, and skill-based pedagogies [3-5].

The core components of child mental health and protection work that are pertinent to LMICs are covered in SAMVAD's essential training programme, including: sensitivity to children and childhood experiences; application of child development concepts; identification of vulnerability and protection risks and contexts; communication and counselling techniques with children; provision of first-level responses to common child mental health disorders; and significant child law provisions. This material has been modified to meet the unique professional requirements and duties of different categories of child care providers and employees. Particularly for secondary and tertiary level child care workers across various sectors, more comprehensive and specialised programmes, such as those focusing on child sexual abuse, children in conflict with the law, and children with disabilities, as well as early childhood education, are also provided [6].

Discussion

Recent training initiatives include: the debut of India's first training programme on child forensics integrating education, mental health, and protection perspectives into interventions for children with disabilities; the percolation of CAMH and protection concerns into grassroot levels through training of the Panchayati Raj, the country's rural system of local self-government; and engagement with the nation's youth. Although a thorough investigation of the effectiveness of SAMVAD's training programmes is still in progress, there is a wealth of anecdotal evidence from child care providers that attests to the content's applicability in terms of developing skills and addressing the difficulties of field practice. The conceptual frameworks, which contain universally applicable constructs of child development, mental health, and protection, as well as the simple activity-based methodologies, which enable rollout in a standardized manner as well as flexibility to adapt the materials to specific contexts and issues, are what, however, make the training and capacity building scalable [7].

Conclusion

The development and implementation of CAMH policy presents several difficulties for LMICs. The process of overcoming every obstacle will be drawn out and challenging. Future CAMH policy promotion in LMICs will require a lot of tenacity from local and international actors, interdisciplinary innovations, and cooperation and coordination from many sectors [8-10].

Acknowledgement

None

Conflict of Interest

None

1. Adanri O (2016) Maternal Health Literacy, Antenatal Care, and Pregnancy Outcomes in Lagos, Nigeria.

Indexed at, Google Scholar

2. Adhoc Committee on Health Literacy (1999) Health literacy: Report of the Council on Scientific Affairs, America Medical Association. JAMA 281: 582-557.

Indexed at, Google Scholar

3. Ikeako LC, Onah HE, Iloabachie GC (2006) Influence of formal maternal Education on the use of maternity services in Enugu, Nigeria. J Obstet Gynaecol 26: 30-34.

Indexed at, Google Scholar, Crossref

4. Iyaniwura CA, Yusuf Q (2009) Utilization of antenatal care and delivery Services in Sagamu, southwestern Nigeria. African Journal of Reproductive Health 13: 111-122.

Indexed at, Google Scholar

5. Memon A, Khan MI, Soofi S, Muhammad S, Bhutta ZA (2013) A cross sectional Survey of newborn care practices in rural Sindh, Pakistan: implications for research and policy. Neonatal Perinatal Med 6: 137-144.

Indexed at, Google Scholar, Crossref

6. Mertler A, Vannatta AR (2013) Advanced and Multivariate Statistical Methods: Practical Application and Interpretation (5th edn).

Google Scholar

7. , Pakistan Demographic and Health Survey (PDHS) National Institute of Population Studies Islamabad, Pakistan 2006-2007.

Google Scholar

8. Rothman RL, Dewalt DA, Malone R, Bryant B, Shintani A, et al. (2004) Influence of patient literacy on the effectiveness of a Primary care-based diabetes disease program. JAMA 292: 1711-1716.

Google Scholar, Crossref

9. Shieh C, Mays R, Mc Daniel A, Yu J (2009) Health literacy and its association with the use of information sources and with barriers to information seeking in clinic-based pregnant women. Health Care Women Int 30: 971-988.

Indexed at, Google Scholar, Crossref

10. Szumilas M (2010) Explaining Odds Ratio. J Can Acad Child Adolesc Psychiatry 19: 227-229.

Indexed at, Google Scholar