Omigbodun Olayinka
Department of Psychiatry, College of Medicine, University of Ibadan & University College Hospital, Ibadan, Nigeria.
Int Rev Psychiatry. 2008 Jun;20(3):225-35. doi: 10.1080/09540260802069276.
Despite significant gains in tackling the major causes of child mortality and evidence of an urgent need for child mental health services, resource-poor countries continue to lag behind in child and adolescent mental health service development. This paper analyses possible barriers to the development of child mental health services in resource-poor countries and attempts to proffer solutions. Obstacles identified are the magnitude of child mental health problems that remain invisible to policy makers, an absence of child mental policies to guide the process of service development, and overburdened child mental health professionals. The belief systems about mental illness also prompt help seeking in alternative health systems, thereby reducing the evidence for the burden associated with health seeking. Solutions that may support child mental health service development are the provision of adequate advocacy tools to reveal the burden, poverty alleviation, health awareness programmes, enforcing legislation, training centred within the region, and partnerships with professionals in developed countries. These solutions require simultaneous approaches to encourage service development and utilization. Reductions in child mortality in resource-poor countries will be even more dramatic in the years to come and preparations need to be made to take care of the mental health needs of the children who will survive.
尽管在解决儿童死亡的主要原因方面取得了重大进展，且有证据表明迫切需要儿童心理健康服务，但资源匮乏国家在儿童和青少年心理健康服务发展方面仍滞后。本文分析了资源匮乏国家儿童心理健康服务发展可能面临的障碍，并试图提出解决方案。确定的障碍包括：儿童心理健康问题的严重程度仍未被政策制定者所察觉；缺乏指导服务发展进程的儿童心理健康政策；儿童心理健康专业人员负担过重。对精神疾病的信仰体系也促使人们在替代卫生系统中寻求帮助，从而减少了寻求治疗负担的证据。可能支持儿童心理健康服务发展的解决方案包括：提供足够的宣传工具以揭示负担、减轻贫困、开展健康意识项目、执行立法、在该地区内进行培训，以及与发达国家的专业人员建立伙伴关系。这些解决方案需要同时采用，以鼓励服务的发展和利用。未来几年，资源匮乏国家儿童死亡率的下降将更加显著，需要做好准备以满足存活儿童的心理健康需求。
