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Rose-Clarke K, Bitta M, Evans-Lacko S, Jokinen T, Jordans M, Nyongesa MK, Nadkarni A, Patalay P, Pradhan I, Rahman A, Taylor Salisbury T, Salum G, Vera San Juan N, Servili C, Skeen S, Sönmez CC, Verdeli H, Kumar M. Centring youth mental health discourse on low-income and middle-income countries. Lancet Psychiatry 2024; 11:671-672. [PMID: 39147454 DOI: 10.1016/s2215-0366(24)00211-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Accepted: 06/21/2024] [Indexed: 08/17/2024]
Affiliation(s)
- Kelly Rose-Clarke
- UCL Institute for Global Health, University College London, London WC1N 1EH, UK.
| | - Mary Bitta
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya; KEMRI Wellcome Trust Research Programme, Kilifi, Kenya; Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Tahir Jokinen
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Mark Jordans
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London, UK
| | - Moses K Nyongesa
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya; Department of Global Health and Social Medicine, Harvard Medical School, Cambridge, MA, USA
| | - Abhijit Nadkarni
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK; Addictions & Related Research Group, Sangath, Goa, India
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing, University College London, London WC1N 1EH, UK
| | - Indira Pradhan
- Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
| | - Atif Rahman
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Tatiana Taylor Salisbury
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London, UK
| | - Giovanni Salum
- Stavros Niarchos Foundation Global Center for Child and Adolescent Mental Health, Child Mind Institute, New York, NY, USA
| | - Norha Vera San Juan
- UCL Institute for Global Health, University College London, London WC1N 1EH, UK; Department of Targeted Intervention, University College London, London WC1N 1EH, UK
| | - Chiara Servili
- Department of Mental Health and Substance Use, WHO, Geneva, Switzerland
| | - Sarah Skeen
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
| | - Cemile Ceren Sönmez
- UCL Institute for Global Health, University College London, London WC1N 1EH, UK; College of Social Sciences and Humanities, Koç University, Istanbul, Türkiye
| | - Helen Verdeli
- Global Mental Health Lab, Teachers College, Columbia University, New York, NY, USA
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Kenya; Institute for Excellence in Health Equity, New York University Grossman School of Medicine, New York, NY, USA
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van den Broek M, Agondeze S, Greene MC, Kasujja R, Guevara AF, Kisakye Tukahiirwa R, Kohrt BA, Jordans MJD. A community case detection tool to promote help-seeking for mental health care among children and adolescents in Ugandan refugee settlements: a stepped wedge cluster randomised trial. THE LANCET. CHILD & ADOLESCENT HEALTH 2024; 8:571-579. [PMID: 39025558 DOI: 10.1016/s2352-4642(24)00130-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/24/2024] [Accepted: 05/14/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Strategies to promote mental health care help-seeking among children are needed, especially in low-income and middle-income countries and in complex settings. The aim of this trial was to compare a vignette-based, community-level, proactive case detection tool (CCDT) against standard awareness raising for promoting mental health help-seeking among children and adolescents. METHODS This stepped wedge cluster randomised trial was conducted in the Bidi Bidi, Kyaka II, Kyangwali, Omugo, and Rhino refugee settlements in Uganda. Community gatekeepers received a 2-day training session on using the CCDT to proactively detect children with mental health concerns and encourage children (or their caregivers) to use the mental health-care service run by Transcultural Psychosocial Organization Uganda. At baseline, organisations implemented routine detection or mental health awareness-raising activities. At cross-over to CCDT implementation, gatekeepers used the tool in their daily activities. The primary outcome was mental health-care service use by children and adolescents. Child population size estimates at the zone level were not available. Therefore, service use was calculated using total population size. We report the effect of CCDT implementation as an incidence rate ratio (IRR), which we produced from a model that accounts for calendar time, exposure time, and person-time. IRRs were estimated for the analysis of effect over time in the per-protocol and intention-to-treat populations. The trial is registered with the ISRCTN registry, number ISRCTN19056780. FINDINGS 28 administrative zones were selected for trial participation by October, 2021. Between Jan 1, and Nov 8, 2022, seven clusters of four zones sequentially crossed over from routine care to CCDT implementation in 1-month intervals. The CCDT was implemented by 177 trained community gatekeepers. In 9 months, 2385 children visited a mental health-care service; of these, 1118 (47%) were girls and 1267 (53%) were boys (mean age 12·18 years [SD 4.03]). 1998 children made a first or re-entry visit to a service; of these, 937 (47%) were girls and 1061 (53%) were boys (mean age 12·08 years [SD 4·06]). Compared to standard awareness-raising activities, CCDT implementation was associated with an increase in mental health-care service use in the first month after implementation (20·91-fold change [95% CI 12·87-33·99]). Despite a slight decline in service use over time in both the CCDT and pre-CCDT zones, CCDT zones maintained a time-average 16·89-fold increase (95% CI 8·15-34·99) in mental health service use. INTERPRETATION The CCDT enabled community gatekeepers to increase mental health-care service use by children and adolescents. Vignette-based strategies rooted in the community could become a valuable contribution towards reducing the mental health-care gap among children, especially when accompanied by accessible mental health-care services. FUNDING Sint Antonius Stichting Projects. TRANSLATIONS For the Arabic, French and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Myrthe van den Broek
- Research and Development, War Child Alliance, Amsterdam, Netherlands; Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - Sandra Agondeze
- Research and Development, War Child Alliance, Kampala, Uganda
| | - M Claire Greene
- Program on Forced Migration and Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Rosco Kasujja
- Department of Mental Health, Makerere University, Kampala, Uganda
| | - Anthony F Guevara
- Research and Development, War Child Alliance, Amsterdam, Netherlands
| | | | - Brandon A Kohrt
- Center for Global Mental Health Equity, Department of Psychiatry and Behavioral Health, George Washington University, Washington, DC, USA
| | - Mark J D Jordans
- Research and Development, War Child Alliance, Amsterdam, Netherlands; Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands; Center for Global Mental Health, King's College London, London, UK.
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3
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Brown FL, Yousef H, Bleile AC, Mansour H, Barrett A, Ghatasheh M, Puffer ES, Mansour Z, Hayef K, Kurdi S, Ali Q, Tol WA, El-Khani A, Calam R, Abu Hassan H, Jordans MJ. Nurturing families: A feasibility randomised controlled trial of a whole-family intervention with vulnerable families in Jordan. Glob Ment Health (Camb) 2024; 11:e51. [PMID: 38721483 PMCID: PMC11076925 DOI: 10.1017/gmh.2024.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 09/03/2024] Open
Abstract
Armed conflict and forced displacement can significantly strain nurturing family environments, which are essential for child well-being. Yet, limited evidence exists on the effectiveness of family-systemic interventions in these contexts. We conducted a two-arm, single-masked, feasibility Randomised Controlled Trial (fRCT) of a whole-family intervention with Syrian, Iraqi and Jordanian families in Jordan. We aimed to determine the feasibility of intervention and study procedures to inform a fully-powered RCT. Eligible families were randomised to receive the Nurturing Families intervention or enhanced usual care (1:1). Masked assessors measured outcomes at baseline and endline; primary outcome measures were caregiver psychological distress, family functioning, and parenting practices. Families and implementing staff participated in qualitative interviews at endline. Of the 62 families screened, 60 (98%) were eligible, 97% completed the baseline and 90% completed the endline. Qualitative feedback indicated specific improvements in adolescent well-being, caregiver distress and parenting, and family relationships. Data highlighted high participant engagement and adequate facilitator fidelity and competence. Outcome measures had good psychometric properties (most α > 0.80) and sensitivity to change, with significant changes seen on most measures in the intervention but not control group. Findings indicate the acceptability and feasibility of intervention and study procedures. Subsequent full-scale evaluation is needed to determine effectiveness.
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Affiliation(s)
- Felicity L. Brown
- Research and Development Department, War Child Alliance, Amsterdam, The Netherlands
- Research and Development Department, War Child Alliance, Amman, Jordan
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Hind Yousef
- Research and Development Department, War Child Alliance, Amman, Jordan
| | - Alexandra C.E. Bleile
- Research and Development Department, War Child Alliance, Amsterdam, The Netherlands
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Hadeel Mansour
- Research and Development Department, War Child Alliance, Amman, Jordan
| | - Anna Barrett
- Research and Development Department, War Child Alliance, Amsterdam, The Netherlands
| | - Maha Ghatasheh
- Research and Development Department, War Child Alliance, Amman, Jordan
| | - Eve S. Puffer
- Department of Psychology and Neuroscience, Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Zeinab Mansour
- Research and Development Department, War Child Alliance, Amman, Jordan
| | | | | | - Qaasim Ali
- Collateral Repair Project, Amman, Jordan
| | - Wietse A. Tol
- Section of Global Health, University of Copenhagen, Copenhagen, Denmark
- Athena Research Institute, VU University Amsterdam, Amsterdam, The Netherlands
- Arq International, Diemen, The Netherlands
| | - Aala El-Khani
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Rachel Calam
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Hana Abu Hassan
- University of California San Diego, San Diego, CA, USA
- Imperial College NHS Trust, London, UK
| | - Mark J.D. Jordans
- Research and Development Department, War Child Alliance, Amsterdam, The Netherlands
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
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Bleile ACE, Koppenol-Gonzalez GV, Orech B, Verreault K, Jordans MJD. Evaluating a Movement-Based Mental Health Promotion Intervention for Refugee Children in Uganda: A Quasi-Experimental Study. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-16. [PMID: 38564186 DOI: 10.1080/15374416.2024.2330073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Mental health promotion interventions are widely implemented in humanitarian settings and low- and middle-income contexts (LMICs), yet evidence on effectiveness is scarce and mixed. This study evaluated the movement-based mental health promotion intervention "TeamUp" in Bidibidi refugee settlement, in Northern Uganda. METHOD A quasi-experimental study including four schools (two per arm) assessed the outcomes of 10- to 15-year-old South Sudanese and Ugandan children (n = 549). Randomly allocated, they either participated in up to 11 TeamUp sessions (n = 265) provided by trained facilitators; or belonged to a control group, which continued care as usual (n = 284). Primary outcomes measured psychosocial wellbeing, friendships and attitude to school; secondary outcomes included traumatic distress, depressive symptoms, quality of life, physical health, bullying, interoceptive awareness, and irritability. Data were collected at baseline and endline. RESULTS Children joining TeamUp, showed significantly more improvements on primary outcomes: emotional and psychosocial wellbeing (Mdiff = -1.49, SE = 0.6, p = .01), satisfaction with and attitude toward school (-0.57, SE = 0.2, p = .004); and secondary outcomes: traumatic stress (2.64, SE = 0.8, p < .001), health-related quality of life (-1.56, SE = 0.4, p = .001), physical health (-0.78, SE = 0.3, p = .014) and the TeamUp mechanisms of action scale (-3.34, SE = 0.9, p < .001), specifically the subscales social connectedness (-0.74, SE = 0.3, p = .007) and sense of agency (-0.91, SE = 0.3, p = .005), compared to the control group. No significant differences were found on bullying, interoceptive awareness, irritability and depressive symptoms. CONCLUSION The results are promising for TeamUp as a mental health promotion intervention for children affected by armed-conflict, displacement and on-going adversity. Further research will need to assess the intervention's effectiveness.
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Affiliation(s)
- Alexandra C E Bleile
- Research and Development Department, War Child
- Amsterdam Institute of Social Science Research, University of Amsterdam
| | | | - Bruce Orech
- Research and Development Department, War Child
| | | | - Mark J D Jordans
- Research and Development Department, War Child
- Amsterdam Institute of Social Science Research, University of Amsterdam
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Fabio RA, Orsino C, Lecciso F, Levante A, Suriano R. Atypical sensory processing in adolescents with Attention Deficit Hyperactivity Disorder: A comparative study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 146:104674. [PMID: 38306842 DOI: 10.1016/j.ridd.2024.104674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 12/01/2023] [Accepted: 01/15/2024] [Indexed: 02/04/2024]
Abstract
Atypical sensory processing is common in Attention Deficit Hyperactivity Disorder (ADHD). Despite growing evidence that ADHD symptoms persist into adolescence, the sensory processing of individuals with ADHD in this age group is limited. The aim of this study was to assess differences in self-reported sensory experiences between adolescents with and without ADHD. One hundred thirty-eight Italian adolescents aged between 14 and 18 years (M=16.20; SD= ± 1.90) participated in the study. Sixty-nine participants with ADHD were matched by gender, age, and IQ to 69 typically developing individuals. The sensory processing of all participants was assessed using the Adolescent Sensory Profile (ASP) on the components: low registration, sensation seeking, sensory sensitivity, and sensation avoiding. Moreover, the modalities of ASP were measured: movement, vision, touch, activity level, hearing, and taste/smell. Results show that the ADHD group consistently displayed higher scores across all four components of the sensory profile compared to the control group. The subjects with ADHD also reported higher scores than the control group in all the modalities of ASP. These results confirming the presence of atypical sensory processing in adolescents with ADHD were discussed considering the Cumulative and Emergent Automatic Deficit model (CEAD).
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Affiliation(s)
- Rosa Angela Fabio
- Department of Economics, University of Messina, 98100 Messina, Italy
| | - Caterina Orsino
- Department of Cognitive, Psychological and Pedagogical Sciences and Cultural Studies, University of Messina, 98100 Messina, Italy
| | - Flavia Lecciso
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Annalisa Levante
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Rossella Suriano
- Department of Cognitive, Psychological and Pedagogical Sciences and Cultural Studies, University of Messina, 98100 Messina, Italy.
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Irwin CE. Developing Solid Measures for Mental Health Will Improve the Health and Well-Being of Young People Throughout the World. J Adolesc Health 2023; 72:7-8. [PMID: 36528363 DOI: 10.1016/j.jadohealth.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/06/2022] [Indexed: 12/23/2022]
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Carvajal-Velez L, Ahs JW, Lundin A, van den Broek M, Simmons J, Wade P, Chorpita B, Requejo JH, Kohrt BA. Validation of the Kriol and Belizean English Adaptation of the Revised Children's Anxiety and Depression Scale for Use With Adolescents in Belize. J Adolesc Health 2023; 72:S40-S51. [PMID: 36400635 DOI: 10.1016/j.jadohealth.2022.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 09/28/2022] [Accepted: 10/05/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To validate a culturally-adapted Kriol and Belizean English version of the Revised Children's Anxiety and Depression Scale (RCADS) through comparison with clinical diagnoses made using the Kiddie Schedule of Affective Disorders and Schizophrenia. METHODS Participants comprised of 256 adolescents aged 10-14 years and 15-19 years, who completed the adapted RCADS (10 depression items, 12 anxiety items) in one-on-one interviews, followed by a diagnostic assessment using Kiddie Schedule of Affective Disorders and Schizophrenia administered by trained clinicians. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratios, area under the curve (AUC), and Youden's Index were calculated for RCADS cutoffs and scores on the total scale and anxiety and depression subscales. RESULTS For adolescents aged 10-14 years (n = 161), the AUC was 0.72 for the full scale, 0.67 for anxiety subscale, and 0.76 for depression subscale. For adolescents aged 15-19 years (n = 95), the AUCs were 0.82, 0.77, and 0.83. Most depression items performed well in discriminating those with and without diagnoses. Separation anxiety items performed poorly. "Thoughts of death" were common even among adolescents not meeting diagnostic criteria. The RCADS depression subscale presented the strongest psychometric properties with adolescents aged 15-19 years (at cutoff of 13, sensitivity = 0.83, specificity = 0.77, positive predictive value = 0.47, negative predictive value = 0.95, odds ratio = 15.96). CONCLUSION The adapted RCADS-22 had acceptable categorization for adolescents aged 10-14 years and excellent categorization for adolescents aged 15-19 years; therefore, the tool is recommended for use among the latter age group. Based on sensitivity and specificity values at different cutoffs, guidance is provided to select different thresholds to suit clinical, public health, or other uses to detect and quantify adolescent depression and anxiety in Belize.
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Affiliation(s)
- Liliana Carvajal-Velez
- Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Jill W Ahs
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Health Sciences, Swedish Red Cross University, Stockholm, Sweden
| | - Andreas Lundin
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Myrthe van den Broek
- War Child Holland and Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - Juliet Simmons
- Department of Mental Health, Ministry of Health and Wellness, Belize City, Belize
| | | | - Bruce Chorpita
- Department of Psychology, University of California, Los Angeles, California
| | - Jennifer Harris Requejo
- Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York
| | - Brandon A Kohrt
- Department of Psychiatry, George Washington University, Washington, District of Columbia
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Carvajal-Velez L, Harris Requejo J, Ahs JW, Idele P, Adewuya A, Cappa C, Guthold R, Kapungu C, Kieling C, Patel V, Patton G, Scott JG, Servili C, Wasserman D, Kohrt BA. Increasing Data and Understanding of Adolescent Mental Health Worldwide: UNICEF's Measurement of Mental Health Among Adolescents at the Population Level Initiative. J Adolesc Health 2023; 72:S12-S14. [PMID: 36229402 DOI: 10.1016/j.jadohealth.2021.03.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 03/14/2021] [Accepted: 03/24/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Liliana Carvajal-Velez
- Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York, New York; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Jennifer Harris Requejo
- Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York, New York
| | - Jill W Ahs
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; The Swedish Red Cross University College, Huddinge, Sweden
| | | | | | - Claudia Cappa
- Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York, New York
| | - Regina Guthold
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, World Health Organization, Geneva, Switzerland
| | | | - Christian Kieling
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Sangath, Goa, India
| | - George Patton
- University of Melbourne and Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - James G Scott
- Child and Youth Mental Health Group, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, District of Columbia
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van den Broek M, Ponniah P, Jeyakumar PJR, Koppenol-Gonzalez GV, Kommu JVS, Kohrt BA, Jordans MJD. Proactive detection of people in need of mental healthcare: accuracy of the community case detection tool among children, adolescents and families in Sri Lanka. Child Adolesc Psychiatry Ment Health 2021; 15:57. [PMID: 34625116 PMCID: PMC8501662 DOI: 10.1186/s13034-021-00405-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/10/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Most children and adolescents in need of mental healthcare remain untreated even when services are available. This study evaluates the accuracy of a new tool, the Community Case Detection Tool (CCDT). The CCDT uses illustrated vignettes, two questions and a simple decision algorithm to support proactive community-level detection of children, adolescents and families in need of mental healthcare to improve help-seeking. METHODS Trusted and respected community members in the Eastern Province of Sri Lanka used the CCDT in their daily routine. Children and families detected as potentially in need of mental healthcare based on utilizing the CCDT (N = 157, aged 6-18 years) were invited for a clinical interview by a mental health counsellor using the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). The CCDT results were compared against the results of the clinical interview. The concurrent validity and performance of the CCDT were also evaluated by comparing the CCDT outcomes against the Strengths and Difficulties Questionnaire (SDQ). RESULTS 7 out of 10 children and families detected by community members using the CCDT were confirmed to be in need for treatment (positive predictive value [PPV] = 0.69; 0.75 when compared to the SDQ). Detections based on the family problem vignette were most accurate (PPV = 0.76), followed by the internalising problem vignette (PPV = 0.71) and the externalising problem vignette (PPV = 0.62). CONCLUSIONS The CCDT is a promising low-cost solution to overcome under-detection of children and families in need of mental healthcare. Future research should focus on evaluating the effectiveness, as well as additional strategies to improve help-seeking.
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Affiliation(s)
- Myrthe van den Broek
- Research and Development, War Child Holland, Amsterdam, The Netherlands
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | | | - John Vijay Sagar Kommu
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, USA
| | - Mark J D Jordans
- Research and Development, War Child Holland, Amsterdam, The Netherlands.
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands.
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The Measurement of Mental Health Problems Among Adolescents and Young Adults Throughout the World. J Adolesc Health 2021; 69:361-362. [PMID: 34452726 DOI: 10.1016/j.jadohealth.2021.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/09/2021] [Indexed: 11/21/2022]
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