The multi-tiered care package consists of a variety of interventions within each tier.
The first tier comprises mental health promotion activities, aiming to increase adaptive adjustment and community resilience. This tier’s activities include running peer groups, which are recreational activities combined with theme-centered group discussions for children without indication for care. It also includes community sensitization and psycho-education to increase awareness of the mental health needs of children, as well as of existing coping strategies and resources.
The second tier consists of interventions that target subgroups of children with elevated psychosocial distress. Detection of children in need of psychosocial support is done by a brief context-sensitive screening tool that was developed and validated in each context. This tool, the Child Psychosocial Distress Screener, is employed within the school setting. The second tier includes a structured group intervention (CBI) aimed at decreasing symptoms of distress and strengthening protective factors.
The third tier comprises treatment for children with severe mental health problems. This tier’s actions include providing individual counseling to reduce symptoms and improve functioning. Children requiring specialized treatment are referred to a psychiatrist by the counselors, whenever necessary and possible.