A special training programme for medical professionals to help them understand child and adolescent mental health, to further train others, has concluded in Chitwan, on Friday.

Recognising the need to train doctors in the fields of Psychiatry, Paediatrics and General Practice, the Master Training of Trainers (MTOT) programme was organised at Hotel Earth Light in Sauraha to address the issue of awareness on mental health among adolescents which is abysmally low in the country.

The workshop was organised by Epidemiology and Disease Control Division (EDCD) under the Ministry of Health and Population and endorsed by National Health Training Centre (NHTC), Child Workers in Nepal (CWIN), Child and Adolescent Psychiatry Unit (Kanti Children's Hospital), and UNICEF.

EDCD Director Dr Krishna Prasad Paudel, NHTC Director Dr Yadu Chandra Ghimire, Section Chief of Non Communicable Diseases (NCD) and Mental Health at EDCD Dr Phanindra Prasad Baral, and Adolescent Health Officer at UNICEF Ghanashyam Kandel were among the speakers at the workshop.

Similarly, Dr Arun Raj Kunwar (Head of Unit), Dr Utkarsh Karki (Consultant), Isha Bista (Clinical Psychologist) from Child and Adolescent Psychiatry Unit, Kanti Children's Hospital, were among the trainers.

This is the first MTOT for Child and Adolescent Mental Health carried out nationally, informed Dr Karki. "The training programme is based on WHO mhGAP guide Version 2.0 – Adaptation for Children and Adolescents."

EDCD selected a total of twenty-four doctors based on provincial representation and mix of disciplines comprising psychiatrists, paediatricians, and general practitioners from all over the country for a five-day training session.

Dr Srizana Bhurtel, MD Psychiatry at Bharatpur Hospital, who is one of the participants at the MTOT session will now impart training to those in the next level. "Failure to recognise and address mental health problems in children and adolescents is a serious public health issue. The pandemic has left students – who already face an array of problems – to remote learning and has isolated them from friends and peers," she said.

"We are currently experiencing trends where parents are coming to the Out Patient Department (OPD) with complaints of their children spending all their time on mobile phones and tablets. In addition to this, to some extent, effects of joblessness and financial problems of parents owing to the lockdown have left a negative impact on the overall wellbeing of children."

Bhurtel added, "There are numerous things, we as an doctors, need to work on. Overall, the training has been an extremely enriching experience."

Following the training, MTOT recipients will be able to carry out the training on other medical doctors, paramedics, nurses, and female community health volunteers. Acknowledging the need for mental health intervention in children, it is important to navigate the lives of adolescents through early intervention and well-structured mental health training.

According to the World Health Organization (WHO), globally, 10-20 per cent children and adolescents experience mental health disorders.

A significant number of pediatricians lack training in child psychiatry during residency programmes resulting in inadequacy for diagnosing childhood psychiatric disorders. "Majority of the times children first go to paediatricians and general practitioners for health related issues and not very often children with mental health issues are directly brought to a psychiatrist, or specifically, child and adolescent psychiatrist," lamented Dr Karki.

The involvement of all three disciplines (psychiatry, paediatrics and general practice) is also because training of child and adolescent psychiatry in very limited in residency programmes. Hence, involving doctors from other disciplines from various provinces would bridge the gap between demand and supply. It will also ease the access of services for children with mental health problems at the community level itself.

Training of Master Trainers will further capacitate doctors in understanding children that can help prevent the onset of mental illnesses at an early stage, which will contribute to actually change things on the ground.

Moving a step closer towards the mental health awareness in children, the training has concluded today after distribution of MTOT training certificates to all participants.