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Background: Practitioners who support unaccompanied minors (UAMs) come from different professional backgrounds and often are not appropriately trained to address children's complex mental health needs. This gap informed a training programme across all accommodation centres in Greece. Methods: The aim of the Train-of-Trainer (ToT) national programme was to upskill trainers from 17 organisations to cascade knowledge. Training was interprofessional, trauma-informed and culturally sensitive. A pilot implementation involved 199 practitioners from all disciplines. A sub-sample of 33 practitioners, nine managers and six trainers shared their experiences in focus group discussions, which were analysed through a thematic framework. Results: Participants found that the programme was useful in generating knowledge relevant to children's needs and their roles, addressing the emotional impact of trauma on staff, sharing learning across professional disciplines and being interactive, but systemic support should be put in place for benefits to be sustained. Conclusions: Train-of-Trainer is a resource-effective approach to upskill mixed staff groups across many organisations. This should involve caregivers and staff with limited educational opportunities, while accommodating for different professional needs. Training should be integrated to service budgets, specifications and structures. Plain language summary: Staff who support refugee children without parents come from different backgrounds, and often have limited mental health knowledge and skills. To address this gap, a national programme was established for 17 organisations hosting accommodation centres across Greece. Selected professionals were upskilled as trainers to cascade knowledge to their staff group. Training was based on the understanding of the impact of trauma and children's cultural needs and was provided to interdisciplinary staff groups. In total, 199 staff attended pilot training. Experiences of the training were shared by a sub-group of 33 trained staff, nine managers and six trainers through focus group discussions. These were analysed through a qualitative thematic approach. Key findings included the relevance of new knowledge to children's needs and staff roles, training as a team, using learning methods based on real issues, and supports that should be put in place to ensure that benefits are maintained. Such a model of cascading knowledge and skills can be useful for large numbers of organisations and staff supporting refugee and other vulnerable children. Training should include staff such as caregivers, who may have had limited educational opportunities, while balancing between different staff roles. Training should be integral to all functions of accommodation centres. [ABSTRACT FROM AUTHOR]

Several risk factors for children's mental health and wellness have been established. These are compounded by inequalities, especially in Majority World Countries (MWC). As evidence is largely based on adult reports, we aimed to capture children's experiences of risk across five MWC resource-constrained settings (Brazil, Pakistan, Turkey, Kenya, and South Africa) during the height of COVID-19 pandemic. Participants included 36 children aged 8–10 years and 37 young people aged 14–16 years. We employed a thematic design using a participatory methodological approach in collecting data through diary entries, drawings, posters, focus groups discussions, and child-led interviews with elders. Two researchers integrated and analysed the data set through a thematic codebook framework. Three identified themes related to exacerbation of existing risks, disruption or loss of protective factors, and lack of access to structural supports. Children linked risk factors along their socioecology. The findings have implications in actively involving children as social actors in determining and addressing risk for mental health and wellness through child-centred and multi-sectoral policy and interventions. [ABSTRACT FROM AUTHOR]

There is little knowledge on how children perceive psychosocial supports and seek help in resource-constrained settings. The aim of this study was to establish these perspectives among 22 children aged 7–10 years living in a disadvantaged community in Kenya. Children discussed available resources in response to three scenarios of common life stressors. Focus group discussions were subjected to thematic analysis. Children regularly sought internal and relational (family and peers) rather than external structural resources when faced with adversities. Their unique knowledge of their needs, environment and required supports should inform the development of interventions and services through developmentally appropriate participatory methods. [ABSTRACT FROM AUTHOR]

• Child mental health interventions in Majority World Countries should be contextualized to local sociocultural needs. • Integration to existing psychosocial support can enhance uptake and maximize limited resources. • A Train-of-Trainer cascade approach has potential to widen reach and sustain impact. • Communities should be involved in the whole design and implementation process. This study evaluated the process of integrating child and youth mental health to existing psychosocial support in disadvantaged South African communities. Four child practitioners of the host organization attended a Train-of-Trainer programme. They subsequently co-produced an intervention informed by a service transformation framework along five service domains. Implementation involved 368 community participants. A sub-sample of 43 participants were engaged in focus groups on their experiences. Data were analysed through thematic analysis. Established themes were inter-linked and transcended the five intervention domains. Engagement and conceptualization of mental health through awareness were viewed as pre-requisites to application of new knowledge. This should be supported by systemic changes, predominantly community mobilization and integrated care. Knowledge transfer involving collaboration between services and communities would enable sustainability of impact. The findings led to the formulation of a Theory of Change. Integration of child and youth mental health through a cascade approach that actively involves communities in co-production and delivery can enhance service provision in resource-constrained Majority World contexts. [ABSTRACT FROM AUTHOR]

Social emotional literacy (SEL) interventions are widely implemented through schools, with growing evidence for a range of positive child outcomes. Increasingly, such interventions are delivered on online platforms. To date, there is limited evidence about digital SEL interventions in low- and middle-income countries (LMIC). The aim of this study was to explore the perceptions and experiences of children, parents and facilitator of the potential value of addressing SEL via tailored digital intervention. The intervention was designed to help children, in Brazil, to cope during the first COVID-19 pandemic lockdown. The intervention was delivered via a digital platform to groups of three children for 45 min per week for nine. Thirteen children, nine parents and nine facilitators were interviewed following the completion of the intervention. The data was analysed through a codebook thematic approach, which led to three themes: empowerment, participatory aspects of the intervention and digital adaptation. Overall, children's SEL development was reported to be supported during the COVID-19 pandemic, by the application of new skills outside the sessions. Children reported a number of empowering factors such as being heard and belonging. A range of useful participatory tools were identified including storytelling, games, drawings and videos. Blended SEL interventions involving both face-to-face and web-based facilitation could be developed within a tiered model of universal mental health promotion and targeted prevention. Access to online platforms would increase reach to large numbers of children in LMIC, especially in contexts of disadvantage. [ABSTRACT FROM AUTHOR]

\nContributions to the intergenerational field There is limited evidence on how intergenerational trauma and resilience are perceived by children, especially in Majority World Countries (MWC). We established such perspectives among 73 children and youth in Brazil, Kenya, South Africa, Pakistan and Turkey. Children interviewed older adults, kept diary fieldnotes, and shared learning in focus groups. Data were integrated through a thematic codebook. Four themes reflected deprivation of safety needs and family challenges, especially for girls, which shaped older adults’ resilience. Children related accounts to their experiences, to generate intergenerational learning. Implications of the findings are considered in the context of intercultural shared trauma and resilience. Children can draw strength from intergenerational narratives to build their resilience in the face of future adversity. The emotional impact of intergenerational narratives can have more impact on children than conveying information or advice. A multi-method approach can be adapted for different age groups to elicit intergenerational perspectives. Children can make an important contribution as co-researchers in intergenerational research. Children can draw strength from intergenerational narratives to build their resilience in the face of future adversity.The emotional impact of intergenerational narratives can have more impact on children than conveying information or advice.A multi-method approach can be adapted for different age groups to elicit intergenerational perspectives.Children can make an important contribution as co-researchers in intergenerational research. [ABSTRACT FROM AUTHOR]

Children in low- and middle-income countries (LMIC) have high levels of unmet mental health needs, especially in disadvantaged communities. To address this gap, we developed a child mental health service improvement programme. This was co-facilitated using interprofessional principles and values in four countries, South Africa, Kenya, Turkey and Brazil. Eighteen stakeholders from different professions were interviewed after six months on their perspectives on enabling factors and challenges they faced in implementing service plans. Participants valued the holistic case management approach and scaled service model that underpinned the service plans. Emerging themes on participants’ priorities related to service user participation, integrated care, and different levels of capacity-building. We propose that an integrated care model in LMIC contexts can maximize available resources, engage families and mobilize communities. Implementation requires concurrent actions at micro-, meso- and macro-level. [ABSTRACT FROM AUTHOR]