Mental health conditions Mental and Behavioural Disorders
Conditions
Interventions
The Community Case Detection Tool (CCDT) is a tool for trusted and respected community members to proactively identify children in need of mental healthcare and to encourage help-seeking. The CCDT is
Sponsors
War Child
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Two groups of participants are identified. The CCDT employs a gatekeeper model and is developed for trusted and respected community members (‘community gatekeepers’). Community gatekeepers use the CCDT to proactively detect children in need of mental healthcare to encourage help-seeking. Community gatekeepers: Community gatekeepers will be selected from WCH’s and TPO’s existing networks and community-based structures. They include: Village Health Teams (VHTs), teachers, group activity facilitators, child protection committee members, local community leaders and refugee committee leaders. They will be selected, based on the below criteria, by WCH’s and TPO’s Project Coordinators, responsible for ongoing programming with children and adolescents in each cluster. Specific inclusion criteria are: 1. At least 18 years of age 2. Trusted and respected members from the community 3. Engaged in promoting child wellbeing 4. Access to children, adolescents and caregivers 5. Demonstrate a high level of empathy and interest in children’s wellbeing 6. Willing to provide informed consent and participate in supervision meetings to provide feedback on the feasibility of the approach 7. Willing to sign and follow WCH’s Child Safeguarding Policy, Code of Conduct and Code of Ethical conduct in using the CCDT Children, adolescents, and their caregivers: Children, adolescents aged 6-18 years old, and their caregivers will be proactively identified by the trained community gatekeepers based on a match with the CCDT (i.e., children and adolescents in need of mental healthcare services). Whenever a trained gatekeeper encounters a child or adolescent that matches with the tool, they will hand out a referral card for TPO and encourage help-seeking at TPO’s clinical team serving their zone.
Exclusion criteria
Exclusion criteria: Not providing consent/assent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome is the utilization of TPO’s mental healthcare services among children and adolescents detected by the CCDT. Utilization in this study will be defined as initial encounters with TPO’s mental healthcare among children and adolescents 6-18 years old or their caregivers, or re-entry into services for children and adolescents that have not been using TPO’s services for 6 months. This is measured in two ways: 1. Service utilization data: the number of children and or adolescents aged 6-18 years old that seek mental healthcare services from TPO, compared to utilization rates of practice-as-usual (i. e., during the pre-CCDT period). TPO’s routinely collected monthly mental health service utilization data will be used for this. Following routine practices, upon intake, TPO’s clinical team completes a ‘case registration form’. Service utilization data will be collected monthly from each zone (i.e. cluster) the day before the next step. Furthermore, every cluster provides before and after utilization data, one month before the first step and one month after the final step of the SWT. 2. The proportion of children and adolescents detected by the CCDT as in need of mental healthcare that seeks help at TPO. Two data sources will be used and compared for this: 2.1. Detection data: number of detected cases per gatekeeper. Gatekeepers will be trained in keeping a log of the number of detected children while using the CCDT. Gatekeeper logbooks will be collected bi-weekly by one of WCH’s facilitators attached to the zone and handed over to the project officers who will be trained in entering the data in a digital master sheet. 2.2. Service utilization data: number of cases contacting TPO as a result of a community gatekeeper trained in the CCDT handing out a referral card. The same ‘monthly mental health service utilization data’ (see outcome 1 above) will be used for this. TPO’s clinical team will be trained to ask all new clients (children, adolescents or ca | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary outcomes include the (1) acceptability and appropriateness of the CCDT according to trained community gatekeepers, (2) the feasibility of using the CCDT at scale, and (3) changes in attitudes towards individuals experiencing mental health problems among community gatekeepers: 1. Acceptability and appropriateness of the CCDT according to trained community gatekeepers. defined as the satisfaction of community gatekeepers with various aspects of the CCDT tool and perceived fit and relevance of the CCDT tool, adapted to the local context in which it will be employed in the refuge settings. This will be assessed prior to implementation and will be assessed as part of WCH’s ongoing program activities. Where four community adaptation workshops were conducted with 20 community gatekeepers about the different emotional and behavioral problems related to mental health amongst children, these were subsequently used for the creation of the vignettes (one for emotional problems and one for behavioral problems). Furthermore, based on the problems that have been identified in the communities, the researchers have worked with a local artist to create context-sensitive illustrations. A focus group discussion (FGD) was organized in the five settlements in selected zones with 25 community gatekeepers to assess: (a) the level of understanding of the illustrations and vignettes, (b) if they recall a child in their vicinity who experienced similar symptoms, (c) whether they were comfortable by the way the cases were presented in the vignettes and illustrations and (d) the extent to which the CCDT can be successfully used by gatekeepers during their daily routine tasks. The FGD was conducted in their local languages using the translated vignettes including Swahili, Kinyabwisha, Lugbara, Kakwa, Kuku, and Juba Arabic. Based on the FGD further adaptations to the tool were made. 2. Feasibility of using the CCDT at scale, defined as the extent to which the CCDT can be successfully | — |
Countries
Uganda
Contacts
Public ContactMyrthe van den Broek
Outcome results
None listed