Banati Prerna, Idele Priscilla
UNICEF West and Central Africa Regional Office, Dakar, Senegal.
UNICEF Office of Research at Innocenti, Florence, Italy.
Front Psychiatry. 2021 Jun 22;12:589827. doi: 10.3389/fpsyt.2021.589827. eCollection 2021.
The COVID-19 pandemic has led to lasting mental health and psychosocial consequences just as were experienced with the HIV epidemic. A rapid review of published systematic reviews on HIV/AIDS and mental health outcomes and responses among children and adolescents was used to identify lessons for the COVID-19 pandemic response. The review found that HIV/AIDS responses to promote mental health, prevent ill-health and treat mental health conditions included diverse interventions at the structural or national, community, household and individual levels. Some of these responses can be easily replicated, others require substantial adaptation, and some can inform development of new innovative offline and online responses to mitigate impact of COVID-19 on mental health of children and adolescents. Programs that mitigate economic impacts including child grants, income generating activities for caregivers, food distribution, health care vouchers, and other economic empowerment interventions can be replicated with minor adjustments. Helplines for vulnerable or abused children and shelters for victims of gender-based violence can be scaled up to respond to the COVID pandemic, with minimal adaptation to adhere to prevention of contagion. Mass media campaigns to combat stigma and discrimination were successfully employed in the HIV response, and similar interventions could be developed and applied in the COVID context. Some programs will need more substantial adjustments. In health facilities, mainstreaming child-sensitive mental health training of frontline workers and task sharing/shifting to community volunteers and social workers as was done for HIV with community health workers, could advance mental illness detection, particularly among abuse victims, but requires adaptation of protocols. At the community and household levels, expansion of parenting programs can help caregivers navigate negative mental health effects on children, however, these are not often operating at scale, nor well-linked to services. Programs requiring innovation include converting adolescent and youth safe physical spaces into virtual spaces particularly for at-risk girls and young women; organizing virtual community support groups, conversations, and developing online resources. Re-opening of schools and introduction of health and hygiene policies, provides another opportunity for innovation - to provide mental health and psychosocial support to all children as a standard package of care and practice.
新冠疫情已导致了持久的心理健康和社会心理后果，就如同艾滋疫情期间所经历的那样。一项对已发表的关于艾滋病毒/艾滋病以及儿童和青少年心理健康结果与应对措施的系统评价的快速回顾，被用于确定新冠疫情应对的经验教训。该回顾发现，艾滋病毒/艾滋病促进心理健康、预防健康问题和治疗精神健康状况的应对措施包括在结构或国家、社区、家庭和个人层面的多种干预措施。其中一些应对措施可以很容易地复制，另一些则需要大量调整，还有一些可以为制定新的创新型线下和线上应对措施提供参考，以减轻新冠疫情对儿童和青少年心理健康的影响。减轻经济影响的项目，包括儿童补助金、照顾者创收活动、食品分发、医疗保健代金券以及其他经济赋权干预措施，可以稍作调整后进行复制。为弱势或受虐待儿童设立的求助热线以及为基于性别的暴力受害者设立的庇护所，可以扩大规模以应对新冠疫情，只需进行最小程度的调整以坚持预防传染。在艾滋应对中成功采用了消除污名和歧视的大众媒体宣传活动，类似的干预措施可以在新冠疫情背景下制定和应用。一些项目需要更实质性的调整。在卫生设施中，将一线工作人员对儿童敏感的心理健康培训纳入主流，并像在艾滋病毒防治中与社区卫生工作者那样将任务分担/转移给社区志愿者和社会工作者，这可以推进精神疾病的检测，特别是在虐待受害者中，但需要调整方案。在社区和家庭层面，扩大育儿项目可以帮助照顾者应对对儿童的负面心理健康影响，然而，这些项目通常没有大规模开展，也与服务没有很好地联系起来。需要创新的项目包括将青少年和青年的安全实体空间转变为虚拟空间，特别是为高危女孩和年轻女性；组织虚拟社区支持小组、对话，并开发在线资源。学校重新开学以及引入健康和卫生政策，提供了另一个创新机会——将为所有儿童提供心理健康和社会心理支持作为标准的护理和实践套餐。
