North East England South Asia Mental health Alliance (NEESAMA): an exemplar of global north and global south collaboration to improve research, training and service delivery in mental healthcare.

Despite the worldwide burden of mental illness and recent interest in global approaches to address this, progress on increasing awareness, lessening stigma, reducing the treatment gap, and improving research and training in mental health has been slow. In 2018, the North East England South Asia Mental health Alliance (NEESAMA) was developed as a collaboration between high-income (global north) and low- to middle-income (global south) countries to address this slow progress. This paper outlines how the joint priority areas for research, training and service delivery were identified across the life course (child and adolescent, adults and older people) between partner organisations spanning Afghanistan, Bangladesh, India, Nepal, Pakistan, Sri Lanka and the UK. It describes the progress to date and proposes a way forward for similar alliances to be forged.

Balancing the law with children's rights to participation and decision-making: Practice guidelines for mandatory reporting processes in child sexual abuse.

In India, legal response to a sexual offence, namely, punishment of the perpetrator,relies nearly entirely on mandatory reporting provisions in child sexual abuse law.Mandatory reporting forms an important first step in the medico-legal processes of CSAwork, because it leads onto other legal interventions in CSA cases. However, social, stigma, perceived harassment, rampant gender stereotypes, the unwillingness of, family, disbelief of the victim, and threats by the perpetrator are a few of the many, barriers to mandatory reporting in the Indian context. One particularly insufficiently, addressed critical barrier in the global and Indian literature on CSA and law stems from the reluctance of children to allow child protection and mental health professionals to report to relevant authorities. There are few guidelines or practical strategies available,on how to engage children in mandatory reporting processes. This article uses a childcentric lens to propose the need to balance children's rights to participation and decision-making with the mandatory reporting law. It proposes a conceptual frameworkthat acknowledges the imperatives and challenges of the mandatory reporting law and its implementation, whilst also recognizing children's barriers to abuse disclosures andtheir rights to make decisions and provide consent on reporting issues. It culminates in a guideline for child mental health and protection service providers, offering step-bystep support on navigating the challenges and dilemmas of mandatory reporting through suggested scripts that engage children to enable more effective reporting ofCSA to child protection systems and relevant legal authorities.

Breaking the silence: Development of a qualitative measure for inquiry of child sexual abuse (CSA) awareness and perceived barriers to CSA disclosure.

The present study aimed to develop a qualitative measure for assessment of child sexual abuse (CSA) awareness and perceived barriers to CSA disclosure based on adolescents' perspectives and expert consensus. Focus group discussions (FGD) were conducted with the adolescents (n = 10) and the Delphi method was used to gain expert consensus (n = 5). The FGDs were audio recorded and Delphi method was conducted via email. Salient domains and themes were identified through manual thematic analysis of the qualitative data obtained from both the methods. Data validity and authentication was obtained through data and researcher triangulation. The qualitative measure for assessment of CSA awareness and perceived barriers to CSA disclosure consisting of 13 qualitative questions was developed based on these domains and expert opinion. The test-version was administered to a pilot sample of 20 adolescents meeting the inclusion criteria for this study. Based on their feedback on ease of understanding and clarity, questions were modified and rearranged. Participation rate was found to be high amongst adolescents as they readily agreed to engage in the study. Findings further indicated that the ambit of CSA awareness includes knowledge of multiple aspects like forms of sexual abuse, characteristics associated with people at risk for perpetration and at risk for victimisation, prevalent beliefs about CSA, prevention strategies and CSA legislation in India. Perceived barriers to CSA disclosure were identified in the context of self, others and the society. Implications for research, and the need for preventive frameworks for CSA in Indian context are discussed.