Development of a multi-layered psychosocial care system for children in areas of political violence

There is ample literature available to demonstrate the impact of perpetual political violence on child mental health [1,2]. A broad spectrum of consequences have been reported, including disruption of normal developmental pathways [3], breakdown of social structures such as family and school systems [4,5], increased psychopathology such as depression, post traumatic stress disorder and anxiety [6,7], as well as literature stressing the non-pathological nature of children's reactions, such as increased aggression, withdrawal, pre-occupation with negative thoughts [8]. At the same time, there are authors that warn for pathologizing entire populations and advocating children's and community's resilience [9,10]. Patel and colleagues [11] report a vast gap between child and adolescent mental health needs and mental health resources in low- and middle-income countries, advocating for increased promotion and prevention activities. Moreover, there is very little evidence for the effectiveness of interventions in complex emergencies [12]. Concerned about the impact of violence and lack of attention for needed care, the international humanitarian community has developed a framework of protection, that is increasingly incorporating psychosocial and mental health care for children in complex emergencies like war [13-16].Based on guidelines and research-informed recommendations, the following thematic areas on the provision of mental health and psychosocial support for children in low- and middle income countries (LAMIC) seem to emerge. First, the need for a complementary approach that addresses both individual clinical needs (curative approach) and broader needs of community revitalization (preventative approach) is often advocated [17]. Moreover, interventionists recommend moving from single intervention approaches to multi-sectoral, multi-level, ecological or systems-oriented intervention programs [6,10,18-20], i.e. intervention packages that address multiple types of needs r