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Background: In psychiatric emergencies, there is a high premium on rapid assessment and acuity categorization. The Crisis Triage Rating Scale (CTRS), a 3-item clinician-rated instrument, has been validated for assessing the severity or urgency of emotional crises in psychiatric emergency units. The CTRS also expedites the screening of patients who require hospital admission from those who are suitable for outpatient treatment. However, its utility has not been evaluated in Nigeria. Aim: This study aimed to assess the validity of the CTRS as a triage tool among patients attending a psychiatric emergency service in Nigeria.

Introduction:Sexual abuse of children and adolescents is a public health problem with potentially dire mental health consequences. Studies suggest that the first sexual experience of one out of three girls in sub-Saharan Africa is forced. However the relationship between sexual abuse and mental health problems among children and adolescents is grossly under-researched in Nigeria.Objectives/Aim:This study determined the association between sexual abuse and mental health problems in a sample of adolescents attending secondary school in Lagos, Nigeria.Method:A cross-sectional study of 230 secondary school students in Lagos, Nigeria. Participants completed a socio-demographic questionnaire, Global School-based Health Survey Questionnaire, Strength and Difficulties Questionnaire, Suicidality module of the Mini International Neuro-Psychiatric Interview and the Hospital Anxiety and Depression Scale.Results:The mean age of the participants was 15.9 (± 1.3) years, and 58.7% were males. A fifth (21.9%) of the respondents had experienced sexual abuse in the past year. Less than a tenth of the victims reported the abuse, and none had accessed mental health service. On regression analysis, being a victim of sexual abuse was independently predictive of depression (p=0.041), anxiety (p=0.007), peer problems (p=0.014), emotional problems (p=0.005) and suicidal ideation (p=0.014).Conclusion:Exposure to sexual abuse is under-reported and un-detected among Nigerian school children, despite its association with several mental health problems. There is need for interventions targeted at facilitating the access of victimised children to timely supportive care and appropriate mental health intervention. Furthermore, efforts to protect children from sexual abuse must be intensified.

We investigate the possibility of improving access to interventions among mothers screened positive for post-partum depression (PPD) at National Programme on Immunization (NPI) clinics randomly selected from Lagos and Enugu States in south-western and south-eastern Nigeria respectively. The principle of human centred design was employed by engaging the mothers screened positive for PPD to be part of the decision making regarding their further assessment and intervention services. The study brought intervention services to primary healthcare centre at the NPI clinics. Improvement in willingness to seek interventions was observed among the mothers screened positive for PPD in this study when compared to our observation in a previous report, where mothers diagnosed with PPD were referred and requested to visit a mental health facility closer to their NPI clinics for further assessment and interventions (95.2% versus 33.7%). Interventional services for the mothers diagnosed with PPD also impact positively on the growth parameters of their infants on follow-up. Principle of human centred design improved access to intervention services among the mothers and infants studied. NPI clinics at primary healthcare level would provide appropriate forum for early screening of mothers for PPD and interventions in low-resource setting like Nigeria. There would be improvement in maternal and child health coverage if the Nigerian Government can adapt human centred design principles employed in this study nationwide.

Introduction:Globally, children and adolescents are victims of various forms of violence, including physical, psychological and sexual violence perpetrated by peers or adults within the community, school or domestic setting. Suicidal behavior is public health problem with escalating trends among young people. There is dearth of research on the relationship between violence and suicidal behavior in sub-Saharan Africa.Objectives/Aim:This study determined the association between violence victimization and suicidal behavior (suicidal idea and attempts) in a sample of secondary school students in Lagos, Nigeria.Method:A cross-sectional study of 230 secondary school students in Lagos, Nigeria. Participants completed a socio-demographic questionnaire, the Global School-based Health Survey Questionnaire (violence module) and the ‘Suicidality’ module of the Mini International Neuro-Psychiatric Interview (MINI).Results:In the past year, a fifth of the respondents were victims of weapon-related violence (23.8%) and sexual violence (21.9%). More than half (56.4%) reported peer-related violence/bullying, while 60.7% were exposed to domestic violence. Less than a third (31.3%) reported lifetime history of suicidal idea, while 13% had attempted suicide. Suicidal behavior was significantly associated with history of bullying (p=0.020), sexual violence (p=0.014), weapon-related violence (p=0.005), and exposure to domestic violence (p=0.020).Conclusion:Exposure to violence is associated with suicidal behavior among secondary school children in Nigeria. This highlights the need for urgent interventions to protect Nigerian children and adolescents from violence. There is also need for improved access of victimized children to mental health care and other support services.