Optimizing Multicomponent Interventions to Improve Child Mental Health Following Reintegration From Institutions:...

Area of Science:

• Child and Adolescent Psychiatry
• Developmental Psychology
• Public Health Interventions

Background:

• High rates of child institutionalization persist in Eastern Europe, Caucasus, and Central Asia due to the Soviet childcare system's legacy.
• Deinstitutionalization and family reunification policies are adopted, yet often lack adequate support for children's mental health and family functioning during reintegration.

Purpose of the Study:

• To compare and optimize three prevention and early intervention approaches: family strengthening, trauma-focused child mental health services, and economic empowerment.
• To experimentally evaluate which interventions yield meaningful improvements in child mental health outcomes for children with a history of institutional care.

Main Methods:

• A randomized clinical trial with a 2³ factorial design involving 439 children (aged 7-12) and 305 caregivers in Azerbaijan.
• Participants were assigned to 8 conditions, receiving combinations of family strengthening, economic empowerment (including Matched Child Development Accounts and financial education), and usual care.
• Data on child mental health, cognitive/social processes, academic/social functioning, family functioning, and economic well-being were collected via multi-informant surveys and clinical assessments at baseline and 1- and 2-year follow-ups.

Main Results:

• Intervention effects analyses are ongoing, with data collection completed in 2025 and analyses expected in 2026.
• This section will report on the comparative effectiveness of the tested intervention combinations on child and family outcomes.

Conclusions:

• The study aims to identify the most effective and efficient intervention combination for supporting the mental health of children reintegrating from institutional care.
• Findings are expected to inform deinstitutionalization and family reunification initiatives, strengthening the global evidence base for community-based interventions in low- and middle-income countries.