A simple and cross-cultural screening scale for psychological distress in young children
Although young children make up more than half of the population in low- and middle-income countries, their mental health needs often go unmet. Young children are in a vulnerable psychological period, which influences their emotional, cognitive, and physical development. This is especially true in crises when children’s risks of exposure to violence, abject poverty and displacement is increased.
Along with direct effects on the child's mental health, other potential consequences can occur, such as anxiety, depression, and somatic disorders. These are often not addressed, even when screening and treatment programs exist. Furthermore, psychological distress in young children is particularly difficult to assess, as many behaviors are normal at certain ages but not at others.
The limited number of local and international mental health professionals combined with the absence of simple, rapid, and cross-culturally validated screening tools often leads to children going without care. While training and infrastructure development would be ideal to address children's mental health, tools that help identify children in need of further assessment can help streamline resources and refer children if needed.
As the psychological response of children depends on their individual, family, and social environments among many other factors, recognizing the diversity of potential psychological responses is essential to provide appropriate interventions. This means the tool needs to be both generalizable and cross-cultural, but also simple.
PSYCa6-36 & PSYCa3-6: a simple cross cultural screening tool
PSYCa6 3-6 is a scale developed and cross-culturally validated by MSF and Epicentre for assessing potential psychological difficulties (depression, phobia, anxiety, regression, psychosomatic complaints, and psycho-traumatic disorder) in young children aged 3 to 6 years old to determine whether they need to be referred for additional evaluation or care.
The questionnaire, filled in by the parent or caregiver through the intermediary of a non-specialist (not a psychologist or psychiatrist) interviewer, is designed to uncover empirical observable information through hetero-assessment (hetero-assessment tools are based on the principle of observation by a third person (caregiver, family) of behavioral manifestations that are indicators). It is a tool for screening and orientation, and not a diagnostic tool.
Building on the methods used for the PSYCa 3 -6; MSF and Epicentre developed and cross-culturally validated a generalist tool to screen for psychological difficulties in younger children aged 6 to 36 months, the PSYCa 6-36.
Both the scale and the user guide are available here for public use.