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

Gather around the table. This may seem like an unlikely topic for a social policy report. However, the practice of shared family mealtimes is a densely packed event that bodes for either favorable or suboptimal child development. Shared family mealtimes have been associated with such diverse outcomes as academic achievement, language development, physical health, and reduced risk for substance abuse. The context in which mealtimes occur is a complex one affected by access to healthy foods, advertising and marketing to children, and feeding practices embedded in a family’s heritage. Shared mealtimes are an immensely symbolic event, not only for specifi. | THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AÍAMH Journal of Child Psychology and Psychiatry 49 3 2008 pp 313-334 doi Promoting child and adolescent mental health in low and middle income countries Vikram Patel 1 Alan J. Flisher 2 Anula Nikapota 3 and Savita Malhotra4 1London School of Hygiene Tropical Medicine Sangath India 2Division of Child and Adolescent Psychiatry and Adolescent Health Research Institute University of Cape Town UCT Red Cross War Memorial Children s Hospital South Africa and Research Centre for Health Promotion University of Bergen Norway 3Institute of Psychiatry King s College London UK 4Post-Graduate Institute for Medical Education Research Chandigarh India 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

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