By Giovanni Salum, MD, PhD
Vice-President, Global Programs, Child Mind Institute
&
Zeina Mneimneh, PhD, MS, MPH
Director, Global Landscape Mapping Program, Stavros Niarchos Foundation (SNF) Global Center for Child & Adolescent Mental Health at the Child Mind Institute
In recent years, mental health has emerged as a crucial component of global health discussions. However, much of the focus has traditionally been on high-income countries, leaving low- and middle-income countries (LMICs) with limited resources and tools tailored to their needs. This disparity especially impacts the child and adolescent population, as 90 percent of them live in LMICs (United Nations, 2011, Shinde, et al., 2023).
The Current Landscape: A Need for Cultural Sensitivity
Children and adolescents in LMICs face severe challenges that greatly affect their mental health, including high levels of poverty, exposure to child labor, violence, conflict, and limited access to education. Moreover, access to specialized mental health care and support services is limited or non-existent in many of these countries. Yet data on their mental health needs are severely lacking. Without such data, planning services, allocating resources, and assessing mental health programs are impossible.
Reliable data require reliable tools. While there are many existing tools tailored to children or adolescents, they are mostly focused on specific conditions and a particular age group. Most importantly, the majority are developed in the English language and do not necessarily address the need for cultural sensitivity. Currently, assembling an instrument that assesses a comprehensive list of mental health conditions and is tailored to both children and adolescents, would require multiple instruments to be stitched together. Furthermore, this endeavor would have to be repeated if respondents age out of a specific age group and follow-up data are needed. Many of these instruments use different terminologies and necessitate harmonization of content and language. Even if harmonized, many of them use words such as “distress”, “uneasy”, or “agitated” that are difficult to translate and convey the same level of emotional intensity in different languages. And what about the calibration of scores across instruments?
This is the current landscape. And there is another essential limiting factor that is part of the definition of LMIC. Income. Cost is a serious barrier. How much does it cost to design or use any of these “specialized” instruments? For an LMIC with limited to no data, the answer is much more than what is available.
A Solution: A Free Multicultural and Comprehensive Tool
So, what do we need to mitigate these significant barriers to having relevant data that is needed for better mental health care for children and youth in LMIC? A free multicultural and comprehensive tool that measures a wide range of mental health conditions for children and adolescents. The tool must be designed by a diverse set of experts with a cross-cultural lens using terminologies and
definitions that can be translated into multiple languages. Such a tool would embrace cultural diversity, promote equitable access, provide reliable and comparable assessments, and empower local researchers and professionals. The benefits of such a tool are enormous for the research and practitioners community facilitating their work and advancing policies and practices that will ultimately reduce stigma and health disparity, improve mental health outcomes, and increase productivity and resources within the community.
To develop such a tool, collaboration among mental health professionals, linguists, methodologists, technology developers, and youth is essential. Engaging youth, who have lived experiences, is paramount to accurately representing their cultural contexts and needs. And it will ensure the tool’s comprehension.
This is what the Stavros Niarchos Foundation (SNF) Global Center at the Child Mind Institute (CMI) in partnership with the International Association of Child and Adolescent Psychiatrists and Allied Professionals (IACAPAP) has already embarked on. More than 300 international mental health experts from 76 countries in all the 14 UN regions have been working together to design a tool that assesses 17 common mental health conditions, plus suicide and functioning for children and youth across their life span (3-24 years old). This tool has also been assessed by 12 linguists. This is only the beginning of its development, with the essential involvement of youth and psychometric assessments to follow.
We hope you follow our journey and keep advocating for mental health solutions that embrace cultural differences and are accessible to all, so that we can make strides toward equitable mental health care that spans the globe.
Tagged with: Mental Health
Giovanni Abrahão Salum, MD, PhD
Giovanni A. Salum MD, Ph.D., is the Vice President of Global Programs at the Child Mind Institute. His interests include … Read Bio
Zeina Mneimneh, PhD, MS, MPH
Zeina Mneimneh, PhD, is the managing director of the Global Landscape Mapping program at the SNF-Global Center at the Child … Read Bio
By Giovanni Salum, MD, PhD
Vice-President, Global Programs, Child Mind Institute
&
Zeina Mneimneh, PhD, MS, MPH
Director, Global Landscape Mapping Program, Stavros Niarchos Foundation (SNF) Global Center for Child & Adolescent Mental Health at the Child Mind Institute
In recent years, mental health has emerged as a crucial component of global health discussions. However, much of the focus has traditionally been on high-income countries, leaving low- and middle-income countries (LMICs) with limited resources and tools tailored to their needs. This disparity especially impacts the child and adolescent population, as 90 percent of them live in LMICs (United Nations, 2011, Shinde, et al., 2023).
The Current Landscape: A Need for Cultural Sensitivity
Children and adolescents in LMICs face severe challenges that greatly affect their mental health, including high levels of poverty, exposure to child labor, violence, conflict, and limited access to education. Moreover, access to specialized mental health care and support services is limited or non-existent in many of these countries. Yet data on their mental health needs are severely lacking. Without such data, planning services, allocating resources, and assessing mental health programs are impossible.
Reliable data require reliable tools. While there are many existing tools tailored to children or adolescents, they are mostly focused on specific conditions and a particular age group. Most importantly, the majority are developed in the English language and do not necessarily address the need for cultural sensitivity. Currently, assembling an instrument that assesses a comprehensive list of mental health conditions and is tailored to both children and adolescents, would require multiple instruments to be stitched together. Furthermore, this endeavor would have to be repeated if respondents age out of a specific age group and follow-up data are needed. Many of these instruments use different terminologies and necessitate harmonization of content and language. Even if harmonized, many of them use words such as “distress”, “uneasy”, or “agitated” that are difficult to translate and convey the same level of emotional intensity in different languages. And what about the calibration of scores across instruments?
This is the current landscape. And there is another essential limiting factor that is part of the definition of LMIC. Income. Cost is a serious barrier. How much does it cost to design or use any of these “specialized” instruments? For an LMIC with limited to no data, the answer is much more than what is available.
A Solution: A Free Multicultural and Comprehensive Tool
So, what do we need to mitigate these significant barriers to having relevant data that is needed for better mental health care for children and youth in LMIC? A free multicultural and comprehensive tool that measures a wide range of mental health conditions for children and adolescents. The tool must be designed by a diverse set of experts with a cross-cultural lens using terminologies and
definitions that can be translated into multiple languages. Such a tool would embrace cultural diversity, promote equitable access, provide reliable and comparable assessments, and empower local researchers and professionals. The benefits of such a tool are enormous for the research and practitioners community facilitating their work and advancing policies and practices that will ultimately reduce stigma and health disparity, improve mental health outcomes, and increase productivity and resources within the community.
To develop such a tool, collaboration among mental health professionals, linguists, methodologists, technology developers, and youth is essential. Engaging youth, who have lived experiences, is paramount to accurately representing their cultural contexts and needs. And it will ensure the tool’s comprehension.
This is what the Stavros Niarchos Foundation (SNF) Global Center at the Child Mind Institute (CMI) in partnership with the International Association of Child and Adolescent Psychiatrists and Allied Professionals (IACAPAP) has already embarked on. More than 300 international mental health experts from 76 countries in all the 14 UN regions have been working together to design a tool that assesses 17 common mental health conditions, plus suicide and functioning for children and youth across their life span (3-24 years old). This tool has also been assessed by 12 linguists. This is only the beginning of its development, with the essential involvement of youth and psychometric assessments to follow.
We hope you follow our journey and keep advocating for mental health solutions that embrace cultural differences and are accessible to all, so that we can make strides toward equitable mental health care that spans the globe.
Tagged with: Mental Health
Giovanni Abrahão Salum, MD, PhD
Giovanni A. Salum MD, Ph.D., is the Vice President of Global Programs at the Child Mind Institute. His interests include … Read Bio
Zeina Mneimneh, PhD, MS, MPH
Zeina Mneimneh, PhD, is the managing director of the Global Landscape Mapping program at the SNF-Global Center at the Child … Read Bio
By Giovanni Salum, MD, PhD
Vice-President, Global Programs, Child Mind Institute
&
Zeina Mneimneh, PhD, MS, MPH
Director, Global Landscape Mapping Program, Stavros Niarchos Foundation (SNF) Global Center for Child & Adolescent Mental Health at the Child Mind Institute
In recent years, mental health has emerged as a crucial component of global health discussions. However, much of the focus has traditionally been on high-income countries, leaving low- and middle-income countries (LMICs) with limited resources and tools tailored to their needs. This disparity especially impacts the child and adolescent population, as 90 percent of them live in LMICs (United Nations, 2011, Shinde, et al., 2023).
The Current Landscape: A Need for Cultural Sensitivity
Children and adolescents in LMICs face severe challenges that greatly affect their mental health, including high levels of poverty, exposure to child labor, violence, conflict, and limited access to education. Moreover, access to specialized mental health care and support services is limited or non-existent in many of these countries. Yet data on their mental health needs are severely lacking. Without such data, planning services, allocating resources, and assessing mental health programs are impossible.
Reliable data require reliable tools. While there are many existing tools tailored to children or adolescents, they are mostly focused on specific conditions and a particular age group. Most importantly, the majority are developed in the English language and do not necessarily address the need for cultural sensitivity. Currently, assembling an instrument that assesses a comprehensive list of mental health conditions and is tailored to both children and adolescents, would require multiple instruments to be stitched together. Furthermore, this endeavor would have to be repeated if respondents age out of a specific age group and follow-up data are needed. Many of these instruments use different terminologies and necessitate harmonization of content and language. Even if harmonized, many of them use words such as “distress”, “uneasy”, or “agitated” that are difficult to translate and convey the same level of emotional intensity in different languages. And what about the calibration of scores across instruments?
This is the current landscape. And there is another essential limiting factor that is part of the definition of LMIC. Income. Cost is a serious barrier. How much does it cost to design or use any of these “specialized” instruments? For an LMIC with limited to no data, the answer is much more than what is available.
A Solution: A Free Multicultural and Comprehensive Tool
So, what do we need to mitigate these significant barriers to having relevant data that is needed for better mental health care for children and youth in LMIC? A free multicultural and comprehensive tool that measures a wide range of mental health conditions for children and adolescents. The tool must be designed by a diverse set of experts with a cross-cultural lens using terminologies and
definitions that can be translated into multiple languages. Such a tool would embrace cultural diversity, promote equitable access, provide reliable and comparable assessments, and empower local researchers and professionals. The benefits of such a tool are enormous for the research and practitioners community facilitating their work and advancing policies and practices that will ultimately reduce stigma and health disparity, improve mental health outcomes, and increase productivity and resources within the community.
To develop such a tool, collaboration among mental health professionals, linguists, methodologists, technology developers, and youth is essential. Engaging youth, who have lived experiences, is paramount to accurately representing their cultural contexts and needs. And it will ensure the tool’s comprehension.
This is what the Stavros Niarchos Foundation (SNF) Global Center at the Child Mind Institute (CMI) in partnership with the International Association of Child and Adolescent Psychiatrists and Allied Professionals (IACAPAP) has already embarked on. More than 300 international mental health experts from 76 countries in all the 14 UN regions have been working together to design a tool that assesses 17 common mental health conditions, plus suicide and functioning for children and youth across their life span (3-24 years old). This tool has also been assessed by 12 linguists. This is only the beginning of its development, with the essential involvement of youth and psychometric assessments to follow.
We hope you follow our journey and keep advocating for mental health solutions that embrace cultural differences and are accessible to all, so that we can make strides toward equitable mental health care that spans the globe.
Tagged with: Mental Health
Giovanni Abrahão Salum, MD, PhD
Giovanni A. Salum MD, Ph.D., is the Vice President of Global Programs at the Child Mind Institute. His interests include … Read Bio
Zeina Mneimneh, PhD, MS, MPH
Zeina Mneimneh, PhD, is the managing director of the Global Landscape Mapping program at the SNF-Global Center at the Child … Read Bio
