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The dearth of child and adolescent mental health services (CAMHS) is a global problem. Integrating CAMHS in primary care has been offered as a solution. We sampled integrated care perspectives from colleagues around the world. Our findings include various models of integrated care namely: the stepped care model in Australia; shared care in the United Kingdom (UK) and Spain; school-based collaborative care in Qatar, Singapore and the state of Texas in the US; collaborative care in Canada, Brazil, US, and Uruguay; coordinated care in the US; and, developing collaborative care models in low-resource settings, like Kenya and Micronesia. These findings provide insights into training initiatives necessary to build CAMHS workforce capacity using integrated care models, each with the ultimate goal of improving access to care. Despite variations and progress in implementing integrated care models internationally, common challenges exist: funding within complex healthcare systems, limited training mechanisms, and geopolitical/policy issues. Supportive healthcare policy, robust training initiatives, ongoing quality improvement and measurement of outcomes across programs would provide data-driven support for the expansion of integrated care and ensure its sustainability. [ABSTRACT FROM AUTHOR]

A substantial body of evidence suggests that adverse childhood experiences (ACE) are associated with negative health outcomes. While this relationship has been widely established for developed countries, the present study is the first to our knowledge to look at ACE, as well as protective factors and life outcomes in a developing Caribbean nation. The present study compared early life experiences of 57 nutmeg workers in Grenada with a global lifetime measure of adult outcomes, including physical and mental health, level of education, substance use, and delinquency. Higher ACE scores were significantly associated with increased poorer global lifetime outcomes. In addition, there was a significant negative correlation between ACE and coping skills, as well as coping skills and global health outcome measures. ACE in a Caribbean nation appear to occur at similar rates to developed countries. The findings suggest interplay between ACE, coping skills, and global adverse life outcomes. Interventions aimed at preventing ACE and increasing coping skills in young children and youth at risk may represent an effective prospective treatment to reduce the negative impact of ACE. [ABSTRACT FROM AUTHOR]