Patel Vikram, Rahman Atif
London School of Hygiene & Tropical Medicine, London, UK.
Public Health Foundation of India, New Delhi, India.
Child Adolesc Ment Health. 2015 Feb;20(1):3-4. doi: 10.1111/camh.12083.
Even as mental health has become increasingly recognized as a key issue in global health, child mental health has largely remained in its shadows. This is possibly because many interventions for child mental health lie outside the realm of narrowly defined biomedical interventions and platforms, with the majority of interventions targeting psychological and social mechanisms and a strong emphasis on prevention. This situation must change, however, as child mental health interventions have potentially the greatest impact on the burden of mental disorders, and other health and social outcomes, than at any other time in the life course. There is now a growing body of evidence that indicates which interventions are ready for scale-up or show sufficient promise for further research and refinement. These are primarily delivered in community or school platforms through nonspecialist workers in partnership with parents and teachers. They include interventions to promote early child development, parenting interventions through childhood into adolescence, school interventions aimed at reengineering school environments and strengthening life skills, and interventions for the early detection and management of neurodevelopmental disorders and mental health problems through trans-diagnostic interventions based on impairments. Above all, what is needed is a population-based approach, which emphasizes the goal of coverage of evidence-based interventions for all children; with a particular focus on disadvantaged children; with seamless coordination of preventive and treatment interventions across platforms of care; and utilizing collaborative, stepped-care delivery paradigms.
尽管心理健康已日益被视为全球健康的关键问题，但儿童心理健康在很大程度上仍处于阴影之中。这可能是因为许多儿童心理健康干预措施并不在狭义定义的生物医学干预和平台范围内，大多数干预措施针对心理和社会机制，并高度重视预防。然而，这种情况必须改变，因为儿童心理健康干预措施对精神障碍负担以及其他健康和社会结果的潜在影响，比生命历程中的任何其他时期都要大。现在有越来越多的证据表明哪些干预措施已准备好扩大规模，或者显示出有足够的前景进行进一步研究和完善。这些干预措施主要通过非专业工作人员在社区或学校平台上与家长和教师合作实施。它们包括促进幼儿发展的干预措施、贯穿童年至青春期的育儿干预措施、旨在重新设计学校环境和加强生活技能的学校干预措施，以及通过基于损伤的跨诊断干预措施对神经发育障碍和心理健康问题进行早期检测和管理的干预措施。最重要的是，需要一种以人群为基础的方法，该方法强调为所有儿童提供基于证据的干预措施的覆盖目标；特别关注弱势儿童；在各个护理平台上对预防和治疗干预措施进行无缝协调；并采用协作式、分级护理的提供模式。
