Implementation of a Mental Health Care Package for Children in Areas of Armed Conflict: A Case Study from Burundi, Indonesia, Nepal, Sri Lanka and Sudan

In our 27th edition, we again consider psycho-social interventions with children in areas of armed conflict. Here we present this overview of a large scale child psychosocial and mental health research/practice programme, implemented in five countries. Each country project used a school population based multi-tiered model of care – with a triage system enabling children to progress as needed from first level preventive, resilience fostering interventions (the majority of children), to the second level of focused group or individual psychosocial care, to the final level of specialized care for the small minority of children with serious mental health care needs.

Systematic reviews of child focused psychosocial and mental health interventions have identified the large gaps that can exist in this field between research and practice, particularly the limited evidence-base for some interventions offered in settings affected by conflict and violence. The package of care described by Jordans, Tol and colleagues sought to address some of these issues by using a methodology incorporating a synergistic relationship between research and practice – one that would allow ‘fine tuning’ of both processes. The authors outline how research findings from the field were used to improve ongoing practice, while field practice experiences reciprocally informed allied research. In this way, the projects’ generic research/practice framework could be amended to take account of local views – for instance those relating to child resilience and well-being.

The authors consider the interplay between research and practice according to a number of key principles: the levels of support made available, the effectiveness of care provided, context sensitivity and the utilisation of pre-existing resources. The result is a thoughtful overview, highlighting successes, exploring limitations and offering suggestions for improving future research and practice with respect to prevention and the availability and longer-term sustainability of contextually appropriate child services.

Dr Linda Dowdney
February 2014 

(The article is available to download at the link below)

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