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Children living in resource-constrained environments have high levels of unmet psychosocial needs. Through participatory focus groups, we juxtaposed the views of 55 children aged 7–10 years from resource-constrained settings in South Africa and Pakistan, with those of 96 service providers, focusing on available sources of psychosocial support. Children largely relied on individual and relational resources, with limited awareness of structural supports. Service providers focused less on children's capacity, instead viewing schools and community-based resources as essential sources for psychosocial support. Children's agency and capacity should be recognized and bolstered to inform service planning, community-based interventions, and systemic change. [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]

• Youth mental health support in Global South Countries should be concurrently addressed at the inter-linked relational, systems and structural levels. • Forming meaningful connections are central to accessing such support. • Youth with mental health lived experience should be incorporated in the planning, implementation and evaluation of services. Youth mental health support and services vary across sociocultural contexts. It is important to capture the perspectives of youth with lived experiences for planning needs-led interventions and services, especially in Global South Countries (GSC), with limited specialist resources and representative literature. The aim was to establish how youth with lived experiences of anxiety and depression viewed external support in different countries, and how these views were juxtaposed with those of professionals. We involved 121 youth aged 14–24 years and 62 professionals from different disciplines in eight countries, predominantly from the Global South. Two youth and one professional focus group was facilitated in each country. The data were analysed through a codebook thematic approach. Youth across all countries largely valued informal support from family, peers and community, whilst those from GSC had limited access to structural support. They related lived experiences to therapeutic engagement and processes, in contrast with professionals who focused on outcomes and service delivery. Mental health awareness and integration of interventions with social support were considered essential by both youth and professionals, especially in disadvantaged communities. The mental health needs of youth in disadvantaged GSC communities can be best met through multi-modal interventions addressing these needs across their socioecology and positioned within a stepped care model. Youth with lived experiences should be involved in service planning, implementation and monitoring. [ABSTRACT FROM AUTHOR]

Abstract Refugee young people have high rates of unmet mental health needs. Established barriers to accessing mental health care may be contextual to the host country and its support systems. The aim of this study was to establish the perspectives of refugee young people, parents, and service providers on service responses across one middle-income and one high-income country, Turkey and the UK, respectively. In Turkey, eight professionals (social work, psychology, and education), ten parents and ten young people took part. In the UK, stakeholders included four professionals (health, educational psychology, and non-statutory), seven parents and seven young people. Data were analyzed using a codebook thematic approach. Despite structural differences between the two systems, several commonalities were identified in responses. Conceptualization of mental health, stigma, shame, and parents’ language acquisition acted as barriers to help-seeking in both countries, whilst schools were viewed as central to the initiation of interventions. Contextual barriers in Turkey included child marriage and labor, whilst reliance on non-governmental organizations (NGOs) facilitated joint care pathways. In the UK, providers aimed to adapt and extend care pathways through primary health care. Recommendations included designated policy, joint working, schools acting as service hubs, awareness, and training professionals on contextual knowledge. [ABSTRACT FROM AUTHOR]