A new child and adolescent mental health service in low-income countries

Abstract

A review of literature reveals that CAMHS in Low Income Countries (LIC) are variable, incomplete and insufficient as compared to those in developed, high income countries. The main reasons for this being so are a lack of: understanding of CAMH, its significance, and a CAMH policy, coordination between the available services, an overview, resources, and trained manpower. Of the above four components, something is being done in each component without understanding that purposes of CAMH are being served. Therapeutic component is obviously the least developed. The services are provided by both government and non-government organizations but their coverage of population is only partial. Mental health clinicians at hospital level may lack an inclination for and understanding of social aspects of CAMH. In India, mental health (psychiatry) is only now being accepted as a respectable medical specialty. There is a general lack of awareness of children's mental health and problems even among medical fraternity and general psychiatrists. Training in psychiatry and paediatrics may have very little of CAMH. In community, stigma, superstition, and lack of awareness of CAMH and of models of care may lead to families not seeking available, appropriate help. Government's programs for maternal and child health, child development projects, universal education, supplementary nutrition, poverty eradication, guarantied work, eradication of communicable diseases, family planning, and legislation against child labour, and specifically national mental health program are some of the programs and measures that should help the cause of CAMH. Some small scale evaluations show that CAMH is positively affected. Specialized CAMH professionals are required in large numbers. Other professionals doing CAMH work is not likely to be successful. Augmentation of and coordination between whatever services are available, developing new services under a CAMH policy, trained CAMH professionals, and increased public awareness may help.