An inter-sectoral framework for promoting and protecting mental health and psychosocial well-being in schools in low- and middle-income countries.

Schools are important agencies for preventive and promotive mental health interventions for children. However, In India, school mental health programmes are limited, first, in their coverage of sexuality and personal safety topics, and second, in responding to children's emergent health and social concerns. We worked in 162 government schools, reaching 21,234 children over 20 months. Sessions on gender, sexuality and personal safety were delivered to children in grades 6-10th. Discussions encouraged several children to share difficult experiences or health/social concerns. Forty-four children disclosed sexual abuse. To address health, care and protection and legal needs, we coordinated an inter-sectoral response involving school, child protection system, and police. We found that law and policy provisions were inadequately implemented in schools. Despite their crucial, complementary roles, schools, police, and child protection systems, faced systemic challenges that spanned inadequate skills, absent inter-sectoral mechanisms and coordination, lack of long-term approach in addressing health, and care and protection needs. Given the unique roles and challenges for each sector, an inter-sectoral framework is critical in organizing adequate, long-term assistance to children in distress. Schools need to play a central coordinating role, actively liaising with other sectors, especially familiarity with child protection systems among students and teachers.