scholarly journals The Culturally and Contextually Sensitive Assessment of Mental Health using a Structured Diagnostic Interview (MINI Kid) for Syrian Refugee Children and Adolescents in Lebanon: Challenges and Solutions

2021 ◽  
Author(s):  
Vanessa Kyrillos ◽  
Tania Bosqui ◽  
Patricia Moghames ◽  
Nicolas Chehade ◽  
Stephanie Saad ◽  
...  
Keyword(s):  
Mental Health ◽  
Children And Adolescents ◽  
Lessons Learned ◽  
Assessment Tools ◽  
Refugee Children ◽  
Mental Health Stigma ◽  
Validity And Reliability ◽  
Syrian Refugee ◽  
Co Morbidity ◽  
Administration And Supervision

Elevated rates of mental health difficulties are frequently reported in conflict-affected and displaced populations. Even with advances in improving the validity and reliability of measures, our knowledge of the performance of assessment tools is often limited by a lack of contextualization to specific populations and socio-political settings. This reflective paper aimed to review challenges and share lessons learned from the process of administration and supervision of a structured clinical interview, the MINI International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) and the Clinical Global Impression (CGI) severity scale, with N=119 Syrian refugee children (aged 8-17) resident in informal tented settlements in Lebanon. Qualitative data was derived from supervision process notes on challenges that arose during assessments, analyzed for thematic content. Five themes were identified: 1) practical and logistical challenges (changeable nature of daily life, competing demands, access to phones, temporary locations, limited referral options); 2) validity (lack of privacy, trust, perceptions of mental health, stigma, false positive answers); 3) cultural norms and meaning (impact of different meanings on answers); 4) contextual norms (reactive and adaptive emotional and behavioral responses to contextual stress); and 5) co-morbidity and formulation (interconnected and complex presentations). The findings suggest that while structured assessments have major advantages, cultural and contextual sensitivity during assessments, addressing practical barriers to improve accessibility, and consideration for inter-connected formulations is essential to help inform prevalence rates, treatment plans, and public health strategies.

Lessons learned from the past on mental health care of refugee children in Serbia

2016 ◽  
Vol 25 (6) ◽  
pp. 669-672 ◽  
Author(s):  
Milica Pejovic Milovancevic ◽  
Veronika Ispanovic ◽  
Dusko Stupar
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Lessons Learned ◽  
Refugee Children ◽  
The Past

scholarly journals Cohort Profile: Biological Pathways of Risk and Resilience in Syrian Refugee Children (BIOPATH)

2021 ◽  
Author(s):  
Fiona McEwen ◽  
Cassandra Popham ◽  
Patricia Moghames ◽  
Demelza Smeeth ◽  
Bernadette de Villiers ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Demographic Data ◽  
Well Being ◽  
Health Problems ◽  
Refugee Children ◽  
Cluster Sampling ◽  
Child Gender ◽  
Syrian Refugee ◽  
Hair Samples

The BIOPATH cohort was established to explore the interplay of psychosocial and biological factors in the development of resilience and mental health problems in Syrian refugee children. Based in Lebanon, a middle-income country significantly impacted by the refugee crisis, it is the first such cohort of refugees in the Middle East. Families were recruited from informal tented settlements in the Beqaa region using purposive cluster sampling. At baseline (October 2017–January 2018), N=3,190 individuals participated (n=1,595 child-caregiver dyads; child gender, 52.7% female; mean [SD] age=11.44 [2.44] years, range=6-19]). Re-participation rate at one year follow up was 63%. Individual interviews were conducted with children and primary caregivers and biological samples collected from children. Measures include: (i) children’s well-being and mental health problems (using tools validated against clinical interviews in a subsample of the cohort); (ii) psychosocial risk and protective factors at the level of the individual (e.g., coping strategies), family (e.g., parent-child relationship), community (e.g., collective efficacy), and wider context (e.g., services); (iv) saliva samples for genetic and epigenetic (methylation) analyses; (v) hair samples to measure cortisol, dehydroepiandrosterone [DHEA] and testosterone. This cohort profile provides details about sampling and recruitment, data collection and measures, demographic data, attrition and potential bias, key findings on resilience and mental health problems in children, and strengths and limitations of the cohort. Researchers interested in accessing data should contact Professor Michael Pluess at Queen Mary University of London, UK (e-mail: [email protected]).

School-Based Mental Health

2017 ◽  
Author(s):  
Mia Everett
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Children And Adolescents ◽  
Social Stigma ◽  
Quality Care ◽  
Assessment Tools ◽  
Health Crisis ◽  
School Based ◽  
Educational Advocacy

The majority of children and adolescents in need of mental health services do not receive adequate care. Barriers to quality care include limited financial resources, social stigma, and a paucity of appropriately trained clinicians. The deleterious effects of untreated childhood mental illness have been well documented. School-based child and adolescent psychiatrists are on the front line of managing this public health crisis. Approximately 75% of mental health services for children and adolescents are provided in educational settings. The success of school-based mental health programs is contingent upon effective collaboration between the practitioner, caregiver, child/adolescent, and educator. In this chapter, a case is used to illustrate salient features of school-based psychiatric practice, including assessment tools, interventions, educational advocacy, and logistical considerations. The practice of public psychiatry in school-based settings should optimally adhere to the principles of recovery, resilience, and cultural competence.

Psychiatric Vulnerability in Adults with Intellectual Disability and Autism: A Literature Review

2017 ◽  
Vol 41 (S1) ◽  
pp. S133-S133
Author(s):  
S. Coli ◽  
D. Scuticchio ◽  
M. Bertelli
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Psychiatric Disorders ◽  
Mental Health Problems ◽  
Challenging Behaviors ◽  
Diagnostic Procedures ◽  
Health Problems ◽  
Autism Spectrum ◽  
Assessment Tools ◽  
Co Morbidity

IntroductionAdults with Intellectual disability (ID) and Autism Spectrum Disorder (ASD) are more vulnerable to mental health problems than the general population.Objectives/aimsThis study investigates presence and rate of psychiatric disorders in comparison with ID or ASD alone, and appropriateness of assessment and diagnostic procedures or tools.MethodsA systematic mapping of the literature was carried out on the basis of the above mentioned issues. The search was conducted using PubMed and ScienceDirect, according to the following keywords: psychiatric comorbidity, psychiatric disorders, autism, ASD, intellectual disability, mental health problems, adults, assessment tools, diagnosis. Twenty-eight papers were selected for pertinence to mapping issues among more than 500.ResultsMany studies show that ASD is an important vulnerability factor for psychiatric co-morbidity and for challenging behaviors (CBs) in adults with ID. Highest rates were reported for psychotic, mood, anxiety, and obsessive-compulsive disorders. Few studies show that the difference between adults with ID plus ASD and adults with only ID are not statistically significant, but for the presence of CBs in those with ID plus ASD. The disagreement of results is based on a variety of factors such as diagnostic over-shadowing, scarcity of specific assessment tools, consideration of the introspective and communication difficulties, incompleteness of medical records, and low reliability of information sources.ConclusionsAlthough low studies concordance, the literature mapping suggests the presence of ASD in ID to be associated with higher rates of psychopathology. Since the relevant implications for prevention and clinical management, further research with high-level evidence is hoped.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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