Valsamma Eapen, Philip Graham, Shoba Srinath. Published by Royal College of Psychiatrists, 2012. ISBN: 9781908020482. Contains 214 pages. Price: £10.00+P&P
This slim paperback with its bright friendly cover belies the comprehensive guide to investigation and management of community childhood and adolescent psychological problems that lie within. It is aimed at health workers in low and middle income countries where there is no child psychiatrist.
Despite the authors being three eminent academic child psychiatrists from around the globe, they clearly draw on a wealth of clinical experience and with their jargon free language their style is highly accessible. Each topic starts with information about the condition followed by ‘how to find out about it’ and then ‘how to help’. In particular, the management options are simply described, practical and based on current best practice. Special attention is paid to ensuring that the local cultural beliefs and values are taken into account, especially those of child rearing practices, beliefs about cause of illness and beliefs about treatment.
As well as the range of typical child psychiatry presentations, emphasis is given to the frequently seen physical presentations of psychological distress seen in the community such as stomach aches and fatigue.
There is also a very helpful section on how to ask the right questions about whether family stress such as bereavement or parental relationship strain may be impacting on the child. There is an appropriate emphasis on the psychological aspects of children with chronic physical illness and disability. There are lovely sections on developmental and habit disorders which I will be giving to psychiatric registrars in training.
Mental health promotion is seen as an integral part of the health professional’s role and there is information on how to tackle bullying in schools (even cyber bullying) and how to work with teachers. Information on public heath prevention strategies such as the importance of maternal health and nutrition in pregnancy and immunisation in childhood is emphasised.
I was initially surprised to see the section on medication, but on the role of medication is firmly grounded in a stepped care approach and there is clear information on how and when to use medication and on the child and adolescent dose ranges used in real world practice.
I particularly liked the section on emotional abuse. Hints on when and how to consider this guide the reader through what to do- and this is the manual’s strength in that it shows the reader not only how to think about problems, but practical and effective ways to dealt with them.
This manual covers the wide range of presentations of child developmental and psychological problems so well that it also has a place in primary care settings in developed countries.
Senior Lecturer in Child Psychiatry
University of Otago, Christchurch, NZ