Jones Lynne
International Medical Corps, and Developmental Psychiatry Section, Cambridge University, Cambridge, UK.
Int Rev Psychiatry. 2008 Jun;20(3):291-303. doi: 10.1080/09540260801996081.
This paper explores the issues confronting service providers setting up child and family mental health programmes in conflict, post conflict and disaster areas. Drawing on clinical experience and research in humanitarian settings, it calls for greater attention to the child's perspective, their individuality and the cultural, social and political context in which they live. It argues that those concerned with the psychopathology of children in crises should widen their frame of reference beyond narrowly defined traumatic reactions to include other mental health and psychosocial issues, including the current problems of daily life and the needs of children with pre-existing psychiatric disorders. It recommends culturally valid means of assessment, the creation of age-appropriate services and training for primary healthcare workers. Children's mental health needs in crises are varied, complex and intimately connected with their needs for security, food, shelter, education and family connection. This requires holistic, rights-based approaches that can access resources to address basic needs, advocate for security and protection, and recognize and address the needs of the more vulnerable children. This is the approach recommended by the Inter Agency Standing Committee Guidelines for Mental health and Psychosocial Support in Emergency Settings.
本文探讨了在冲突地区、冲突后地区和灾区设立儿童及家庭心理健康项目的服务提供者所面临的问题。借鉴人道主义环境中的临床经验和研究，本文呼吁更加关注儿童的视角、他们的个性以及他们生活的文化、社会和政治背景。文章认为，关注危机中儿童精神病理学的人士应拓宽其参考框架，从狭义定义的创伤反应扩大到包括其他心理健康和社会心理问题，包括日常生活中的当前问题以及患有既往精神疾病儿童的需求。文章建议采用具有文化效度的评估方法，创建适合不同年龄段的服务，并对初级医疗保健工作者进行培训。危机中儿童的心理健康需求多种多样、复杂且与他们对安全、食物、住所、教育和家庭联系的需求密切相关。这需要基于权利的整体方法，这种方法能够获取资源以满足基本需求、倡导安全与保护，并认识和满足更脆弱儿童的需求。这就是机构间常设委员会《紧急情况下心理健康和社会心理支持指南》所推荐的方法。
