Research Topic

Strengthening Child and Adolescent Mental Health (CAMH) Services and Systems in Lower-and-Middle-Income Countries (LMICs)

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About this Research Topic

When considering health care delivery, the needs of children and adolescents are often not considered separately from those of adults despite their widely variable developmental competencies and growth trajectories. The WHO Mental Health Atlas 2017 clearly articulates the need for integrated mental health services in most low resource contexts and the palpable need to address significant mental health systems and services gaps were highlighted in the WHO Child Mental Health Atlas published in 2005. Each culture offers different opportunities and unique challenges and these are particularly significant in lower-income countries and lower-and-middle-income countries (LICs and LMICs) where resource constraints influence development process. Maternal and child health programming in LMIC have become focus of acute attention due to huge burden of morbidity and mortality during child-birth and developmental challenges in early childhood due to nutritional deficiencies, teratogens, diseases such as malaria, HIV/TB and amongst communicable diseases. There is paucity of open-access assessment and measurement tools and a concomitant lack of clarity about how to assess and diagnose more context specific and environment-related problems experienced by children and adolescents. Middle childhood and adolescence on the other hand, have not received as much attention, not only in mainstream psychology and psychiatry but also in global public health discourse. Providing care for children and adolescents in MCH clinics or in pediatric clinics is neither appealing to adolescents whose issues and concerns are very varied nor is it developmentally appropriate. While resource constraints may dictate that such services be embedded within these clinics but in such instances how do we ensure that the services are developmentally informed and acceptable to adolescents? Developmentally informed mental health service delivery should incorporate several interrelated components such as educationalinfluences and transitions, relationship with peers, parental and caregiver attachment and sexual-reproductive health and rights are a few core issues.
The UN Sustainable Development Goals emphasize universal health coverage integrating health to poverty, education, access and social justiceissues (Goals 1, 3, 4, 5). These goals advocate that international collaborative partnerships (Goals 10 and 17) promoting quality education and health access for all (specifically integrated care in primary health centres) in LICs and LMICs would be the way towards strengthening CAMH. International organizations like WHO and UNICEF promote the idea of looking at youth as old as 25 years old as part of an extended adolescent period in order to understand global developmental trajectories with rigor and sociocultural sensitivity. There is also endorsement of the Care for Child Development (UNICEF/WHO, 2012) and HEADSS framework endorsed (home environment, education, activities and drug use and abuse, sexuality, suicidality and depression) (World Health Organization Accelerated Action for the Health of Adolescents, AA-HA! 2017) to appraise adolescent development in LMIC better. The Care for Child Development outlines parenting and early childhood development strategies that can be useful in contexts were resource and time constraints limit parental ability to provide care. HEADSS on the other hand suggests that any appraisal of adolescents should include home environment, education, activities and drug use and abuse, sexuality, suicidality and depression as thematics.
For this issue, we are inviting contributions focusing on global protocols on child and adolescent protection and mental health care guidelines such as WHO AA-HA!, WHO Comprehensive Mental Health Action Plan and mhGAP as ways to bolster quality mental health care and services. The utilization of these protocols to enforce best practices and culturally adapted novel treatments, implementation strategies to increase uptake of services as a way of serving the CAMH. Minoritized, neglected populations such as those living with HIV, young mothers and pregnant adolescents, LGBTQ and refugee and displaced children, children and adolescents with disabilities are also of interest to this call. The care framework for such populations is of especial interest and so is the long-term sustainment of mental health systems. Contributions focusing on the on girl-child and the gaps in addressing the unique needs and empowerment of boychild and young men for creating health and gender equity are also welcome.
Our call is specially interested in issues around the following but not restricted to the following themes:
• Critical appraisal of existing services, infrastructure and expenditure on CAMH
• Differential needs of children and adolescents
• Integrating pediatric, child & adolescent services with mental health in LICs and LMICs
• Culturally responsive diagnoses, measurement tools and treatment interventions
• Implementation studies on testing mental health education in schools and community contexts
• Global protocols and guidelines of CAMH and the local translational challenges and achievements
• School mental health and the link between school, family and the health facility
• Addressing needs of minoritized child and adolescent populations especially those explosed to conflicts, disasters and forced migration
• Theory of change around integrated, collaborative care and stepped care models
• Steps taken to address stigma and discrimination for early detection and diagnosis of mental health disorders in primary care or specialist facilities
• Conceptual framework for testing and evaluating CAMH interventions and D & I strategies at multiple levels


Keywords: Child and adolescent mental health, health services, treatment, disorders, culture


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

When considering health care delivery, the needs of children and adolescents are often not considered separately from those of adults despite their widely variable developmental competencies and growth trajectories. The WHO Mental Health Atlas 2017 clearly articulates the need for integrated mental health services in most low resource contexts and the palpable need to address significant mental health systems and services gaps were highlighted in the WHO Child Mental Health Atlas published in 2005. Each culture offers different opportunities and unique challenges and these are particularly significant in lower-income countries and lower-and-middle-income countries (LICs and LMICs) where resource constraints influence development process. Maternal and child health programming in LMIC have become focus of acute attention due to huge burden of morbidity and mortality during child-birth and developmental challenges in early childhood due to nutritional deficiencies, teratogens, diseases such as malaria, HIV/TB and amongst communicable diseases. There is paucity of open-access assessment and measurement tools and a concomitant lack of clarity about how to assess and diagnose more context specific and environment-related problems experienced by children and adolescents. Middle childhood and adolescence on the other hand, have not received as much attention, not only in mainstream psychology and psychiatry but also in global public health discourse. Providing care for children and adolescents in MCH clinics or in pediatric clinics is neither appealing to adolescents whose issues and concerns are very varied nor is it developmentally appropriate. While resource constraints may dictate that such services be embedded within these clinics but in such instances how do we ensure that the services are developmentally informed and acceptable to adolescents? Developmentally informed mental health service delivery should incorporate several interrelated components such as educationalinfluences and transitions, relationship with peers, parental and caregiver attachment and sexual-reproductive health and rights are a few core issues.
The UN Sustainable Development Goals emphasize universal health coverage integrating health to poverty, education, access and social justiceissues (Goals 1, 3, 4, 5). These goals advocate that international collaborative partnerships (Goals 10 and 17) promoting quality education and health access for all (specifically integrated care in primary health centres) in LICs and LMICs would be the way towards strengthening CAMH. International organizations like WHO and UNICEF promote the idea of looking at youth as old as 25 years old as part of an extended adolescent period in order to understand global developmental trajectories with rigor and sociocultural sensitivity. There is also endorsement of the Care for Child Development (UNICEF/WHO, 2012) and HEADSS framework endorsed (home environment, education, activities and drug use and abuse, sexuality, suicidality and depression) (World Health Organization Accelerated Action for the Health of Adolescents, AA-HA! 2017) to appraise adolescent development in LMIC better. The Care for Child Development outlines parenting and early childhood development strategies that can be useful in contexts were resource and time constraints limit parental ability to provide care. HEADSS on the other hand suggests that any appraisal of adolescents should include home environment, education, activities and drug use and abuse, sexuality, suicidality and depression as thematics.
For this issue, we are inviting contributions focusing on global protocols on child and adolescent protection and mental health care guidelines such as WHO AA-HA!, WHO Comprehensive Mental Health Action Plan and mhGAP as ways to bolster quality mental health care and services. The utilization of these protocols to enforce best practices and culturally adapted novel treatments, implementation strategies to increase uptake of services as a way of serving the CAMH. Minoritized, neglected populations such as those living with HIV, young mothers and pregnant adolescents, LGBTQ and refugee and displaced children, children and adolescents with disabilities are also of interest to this call. The care framework for such populations is of especial interest and so is the long-term sustainment of mental health systems. Contributions focusing on the on girl-child and the gaps in addressing the unique needs and empowerment of boychild and young men for creating health and gender equity are also welcome.
Our call is specially interested in issues around the following but not restricted to the following themes:
• Critical appraisal of existing services, infrastructure and expenditure on CAMH
• Differential needs of children and adolescents
• Integrating pediatric, child & adolescent services with mental health in LICs and LMICs
• Culturally responsive diagnoses, measurement tools and treatment interventions
• Implementation studies on testing mental health education in schools and community contexts
• Global protocols and guidelines of CAMH and the local translational challenges and achievements
• School mental health and the link between school, family and the health facility
• Addressing needs of minoritized child and adolescent populations especially those explosed to conflicts, disasters and forced migration
• Theory of change around integrated, collaborative care and stepped care models
• Steps taken to address stigma and discrimination for early detection and diagnosis of mental health disorders in primary care or specialist facilities
• Conceptual framework for testing and evaluating CAMH interventions and D & I strategies at multiple levels


Keywords: Child and adolescent mental health, health services, treatment, disorders, culture


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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