Balancing the law with children's rights to participation and decision-making: Practice guidelines for mandatory reporting processes in child sexual abuse.

In India, legal response to a sexual offence, namely, punishment of the perpetrator,relies nearly entirely on mandatory reporting provisions in child sexual abuse law.Mandatory reporting forms an important first step in the medico-legal processes of CSAwork, because it leads onto other legal interventions in CSA cases. However, social, stigma, perceived harassment, rampant gender stereotypes, the unwillingness of, family, disbelief of the victim, and threats by the perpetrator are a few of the many, barriers to mandatory reporting in the Indian context. One particularly insufficiently, addressed critical barrier in the global and Indian literature on CSA and law stems from the reluctance of children to allow child protection and mental health professionals to report to relevant authorities. There are few guidelines or practical strategies available,on how to engage children in mandatory reporting processes. This article uses a childcentric lens to propose the need to balance children's rights to participation and decision-making with the mandatory reporting law. It proposes a conceptual frameworkthat acknowledges the imperatives and challenges of the mandatory reporting law and its implementation, whilst also recognizing children's barriers to abuse disclosures andtheir rights to make decisions and provide consent on reporting issues. It culminates in a guideline for child mental health and protection service providers, offering step-bystep support on navigating the challenges and dilemmas of mandatory reporting through suggested scripts that engage children to enable more effective reporting ofCSA to child protection systems and relevant legal authorities.

Shifting landscapes of global child mental health: Imperatives for transdisciplinary approaches.

There are a multitude of stakeholders involved in the protection, education, mental health and psychosocial care of children for children in LMIC countries. The article presents how the current medical and public health models for child mental healthcare, do not adequately address the complexities of child protection and mental health. It argues for mental health professionals to: (a) recognise the role of Adverse Childhood Experiences (ACEs) in mental health morbidity; (b) adopt an alternative approach, namely that of transdisciplinarity, to enable more effective solutions to children's psychosocial and mental health issues, through systemic reform and transformation.

A transdisciplinary public health model for child and adolescent mental healthcare in low- and middle-income countries.

Despite the high burden of child and adolescent mental health problems in LMICs, attributable to poverty and childhood adversity, access to quality mental healthcare services is poor. LMICs, due to paucity of resources, also contend with shortage of trained mental health workers and paucity of standardized intervention modules and materials. In the wake of these challenges, and given that child development and mental health concerns cut across a plethora of disciplines, sectors and services, public health models need to incorporate integrated approaches to responding to the mental health and psychosocial care needs of vulnerable children. This article presents a working model for convergence, and the practice of transdisciplinary Public Health, in order to address the gaps and challenges in child and adolescent mental healthcare in LMICs. Located in a state tertiary mental healthcare institution, this national level model reaches (child care) service providers and stakeholders, duty-bearers, and citizens (namely parents, teachers, protection functionaries, health workers and other interested parties) through capacity building initiatives and tele-mentoring services, public discourse series, developed for a South Asian context and delivered in diverse languages. Role of Funding Source: The Ministry of Women and Child Development, Government of India, provides financial support to the SAMVAD initiative.

Building a research agenda for mental health assessments in resolving legal dilemmas on adolescent sexual consent.

The dilemma of adolescent consent confounds dispensation of justice in child sexual abuse and juvenile justice contexts, with legal personnel struggling to discern between consent and coercion in cases of adolescents who are sexually abused and those who are accused of alleged sexual offences. Given that capacities for consent also determine personal safety and mental health, there is an imperative to build a child mental health research agenda for developing methodologies that incorporate psychological knowledge on abuse dynamics, adolescent mental health and development, vulnerability and risk, to assess adolescent sexual consent and sexual decision-making processes.

Swatantra Clinic: A descriptive study on the specialized child mental health service for children in difficult circumstances at a tertiary care center in India.

In India, children in difficult circumstances, like institutionalized children have higher mental health morbidity and complex psychosocial concerns than the non-institutionalized children. To cater to the complex needs of these children referred by the Juvenile Justice System, a specialized service called 'Swatantra Clinic' was initiated by the Department of Child and Adolescent Psychiatry at the National Institute of Mental Health and Neurosciences, India. This article thereby aims to describe the psychosocial characteristics of these children, along with the array of specialized interventions provided during the first year of its inception in June 2018. It was found that majority of these children were girls and were from lower socio-economic, urban background, primarily referred for externalizing or internalizing concerns. The majority of them reported experiences of physical and verbal abuse along with family stressors and almost half of them had a diagnosable psychiatric condition. The nature of the psychosocial services rendered at the clinic mostly comprised of brief, individual and family counseling along with liaison work with various governmental agencies for rehabilitation services. These form the key components of a comprehensive, collaborative, time-bound and holistic care model to cater to the distinct psychosocial issues of this vulnerable population of children in low - middle resource settings. Policy implications are discussed.

Integrating Child Protection and Mental Health Concerns in the Early Childhood Care and Development Program in India.

Adverse childhood experiences and protection risks such as neglect and abuse and family psychosocial and protection vulnerabilities, beginning in early childhood, are linked to negative development and mental health. Child protection is becoming an increasing concern in India, creating new imperatives to address it amongst all children, but particularly among children below the age of 6 years, who due to their age and developmental abilities, are rendered more vulnerable than older child populations. It is therefore imperative, particularly in developing contexts such as India, for early childhood development (ECCD) to integrate child protection and mental health services into their existing intervention package. Although early childhood programs work with multiple sectors, they have limited collaboration with child mental health and child protection systems. This article addresses the question of how to integrate child protection and mental health interventions into existing ECCD programs by describing the experience of a pilot project in the Indian context. It provides the rationale, methodology and content of service delivery for integrating child protection and mental health interventions into the existing ECCD program, the Integrated Child Development Scheme, highlighting emerging concerns and challenges and drawing from the interventions to show how some of these were addressed.

Children on the brink: Risks for child protection, sexual abuse, and related mental health problems in the COVID-19 pandemic.

In developing contexts such as India, children in adversity form a high-risk group, one that cannot be subsumed under the general category of children, who are generally considered as a vulnerable group in disaster and crisis situations. Child mental health issues in contexts of protection risks and childhood adversity tend to be over-looked in such crises. This article focuses on examining the impact of the COVID-19 pandemic and its socio-economic consequences on children in adversity, describing the increased child protection and psychosocial risks they are placed at, during and in the immediate aftermath of the COVID-19 crisis and its lockdown situation. It specifically links the lockdown and the ensuing economic issues to sexuality and abuse-related risks, as occur in contexts of child labour, child sex work and trafficking, child marriage and child sexual abuse, and that result in immediate and long-term mental health problems in children. It proposes a disaster risk reduction lens to offer recommendations to address the emerging child protection, psychosocial and mental health concerns.