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Identification and Management of COVID-19 Related Child and Adolescent Mental Health Problems: A Multi-Tier

Gunjan Dhonju1, Arun Raj Kunwar1, Utkarsh Karki1

  • 1Child and Adolescent Psychiatry Unit, Kanti Children's Hospital, Kathmandu, Nepal.

Frontiers in Public Health
|February 22, 2021
PubMed

Insights

The COVID-19 pandemic exacerbated child and adolescent mental health (CAMH) gaps in Nepal. A multi-tier online intervention trained professionals to support children, parents, and teachers, reaching over 28,000 individuals.

Area of Science:

  • Global Health
  • Mental Health
  • Public Health

Background:

  • Nepal, a low and medium-income country, faces significant gaps in child and adolescent mental health (CAMH) services.
  • The COVID-19 pandemic has worsened these challenges, impacting access to care for children and adolescents (C&A) due to school closures, lockdowns, and fear of infection.
  • Existing CAMH infrastructure in Nepal is limited, with only one full-time child and adolescent psychiatry clinic.

Purpose of the Study:

  • To address the escalating CAMH needs in Nepal exacerbated by the COVID-19 pandemic.
  • To develop and evaluate a feasible, multi-tier intervention model utilizing online platforms for resource-limited settings.
  • To enhance the capacity of local human resources and improve CAMH service delivery for children and adolescents.

Main Methods:

  • A multi-tier intervention model was designed, leveraging online platforms for training mental health professionals across Nepal.
  • Trained professionals facilitated sessions for C&A, teachers, parents, and caregivers, linking them to local and remote CAMH services via teleconsultation.
  • The pilot intervention was implemented from June 2020 to February 2021, aiming to reach 40,000 individuals.

Main Results:

  • As of November 2020, the intervention successfully conducted 1,415 sessions, reaching 28,597 individuals, including 16,571 C&A and 12,026 parents, teachers, and caregivers.
  • The program extended its reach across all 7 provinces of Nepal.
  • The model demonstrated successful engagement and delivery of CAMH support despite travel restrictions and limited resources.

Conclusions:

  • The multi-tier online intervention model is a feasible and effective framework for addressing COVID-19 related CAMH challenges in resource-limited settings like Nepal.
  • The intervention successfully built capacity, enhanced community support, and improved CAMH service delivery.
  • This approach offers a scalable solution for improving mental health support for children and adolescents in low and medium-income countries.

Keywords:
COVID-19capacity buildingchild and adolescent mental healthsystem level interventionteleconsultation

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