Please select the eligibility criteria that correspond to the clinical trial below.
Title: Collaborative Child Mental Healthcare in Low-Resource Settings
Brief Summary: Background: Mental health problems cause a disproportionate burden of disability among children and youth compared to adults. Primary care plays an important role in efforts to prevent and intervene early in the course of child and adolescent mental health problems. While research with adults has shown the feasibility of integrating mental health care into primary care settings, there have been few studies among children and youth. Evidence remains lacking that integration is feasible in diverse settings, that it improves outcomes, and that methods can be developed to address the mixed symptoms of emerging child/youth problems and their overlap with developmental and parental disorders.

Goals: The purpose of this project is to test the effectiveness of adding a child/youth mental health component into an existing collaborative care program for adult mental health problems. The work will refine a framework for efficient cultural adaption and tailoring of an existing child/youth primary care mental health intervention and then test whether the tailored intervention results in improved child and parent outcomes. The work will also provide evidence about the mechanisms by which those outcomes are achieved and what factors influence uptake of the child/youth component by general practitioners (GPs). These results should be generalizable to low and middle income countries and to underserved areas of the US where there are minimal child mental health resources and family physicians provide the bulk of medical care for children and youth.

Methods: The planned work involves the adaptation/tailoring process followed by a trial with 45 GPs already engaged in collaborative care for adults; the trial will study adding collaborative care for children ages 5-15. GPs will be randomly assigned in groups to begin 6-month control periods involving child mental health screening and referral. They will then receive child/youth training and begin second 6-month periods of screening plus ongoing coaching and booster sessions and collaborative management. Primary outcomes will be measured by recruiting and following for 6 months two cohorts of children/youth and their parents (one control, one collaborative care). Data collected from GPs, parents, youth, and the collaborative care data system will allow measurement of key factors that determine the program's success in helping children and families.


Options:
A: Inclusion Criteria:

* .(1) HIV+ women enrolled at FACES-Kisumu; (2) Diagnosis with depression (MDD, dysthymia, minor depression) and PTSD secondary to GBV\* on the CIDI; (3) Ability to attend weekly therapy sessions and repeated measures; (4) Age greater than 18 years; (5) Ability to give informed consent.

Exclusion Criteria:

* (1) Cognitive dysfunction requiring a higher level of care or compromising ability to participate in IPT\*\*; (2) severe thought or mood disorder symptoms requiring a higher level of care or interfering with ability to participate in IPT; (3) current drug and alcohol dependence requiring substance use treatment. Although PTSD is associated with substance abuse in EuroAmerican populations, a recent study of 5175 FACES patients found that over 80% of this LMIC population use no alcohol.
B: Inclusion Criteria:

* Age ≥ 16
* GHQ-12 ≥ 6
* Willing to participate in the intervention and research program
* Able to communicate fluently in Nepali and to participate the required visits
* Resident in Dang for the subsequent 10 months

Exclusion Criteria:

* Age \< 16
* GHQ-12 \< 6
* Signs of severe mental health problems (i.e., psychotic features)
* Severe illnesses or conditions requiring immediate attentions( i.e., suicidal)
* Not willing to participate in the intervention and research program
C: Inclusion Criteria:

* minimum age 18
* HIV infected outpatient enrolled in 1 of 5 AMPATH clinics
* drank alcohol in past month
* hazardous or binge drinker (AUDIT-C)
* lives within an hour of Eldoret HIV clinic
* verbal working knowledge of Kiswahili

Exclusion Criteria:

* active psychosis, suicidality or severe cognitive impairment
* physically unable to attend session
* previous participation in CBT study
D: Inclusion Criteria:

* Brought by parent to see general practitioner

Exclusion Criteria:

* Child is acutely physically ill, in acute pain, or general practitioner feels family should not be approached about the study.

Answer: D