New Delhi: On the eve of World Mental Health Day (10th October) child rights experts have stressed the need to provide adequate mental health services for children in institutional child care in order to ensure their smooth and meaningful social inclusion.
Most children residing in institutions (children’s homes, care homes, orphanages, reform schools, institutes for physically and mentally disabled, juvenile detention facilities, etc) have been through exceptional and undeniable traumatic experiences of being orphaned/abandoned/lost due to conflicts or natural disasters. All these factors make providing adequate mental healthcare to the children extremely important. Some of the common mental health problems seen in these children include Depression, Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), Substance Abuse, Attachment Disorder, Intellectual and Learning Disability, etc.
“There is a need to understand what Mental Health means in relation to children in institutions. We need to stop thinking about Mental Health as Mental Illness, and instead internalize the concept that Positive/Good Mental Health is an essential component of the child’s social, emotional, psychological development. We need to demystify and simplify the whole concept of mental health among practitioners, policy makers and the general public,” says Dr. Kiran Modi, Founder Managing Trustee, Udayan Care.
“The risk of developmental and psychological damage is particularly acute among young children under the age of four, which is a critical period for children to bond with their parents or care givers. Even in a well equipped institution with focused staff, it is unlikely that the attention they receive by the personnel could replace good parental care. Also, at an older age, the lack of individualized care, which the children would get in a healthy family environment, can cause harm to their neurobiological systems, and greatly contribute to stress and lowering of psychological well being, cognitive skills, coping capacity and emotional resilience,” says Dr. Deepak Gupta, Child and Adolescent Psychiatrist at Sir Ganga Ram Hospital & Founder, Centre for Child & Adolescent Wellbeing (CCAW) & Consultant Udayan Care.
Highlighting the importance of proper training of professionals and caregivers working in the field of institutional child care Aneesha Wadhwa of Udayan Care says- “The training of caregivers is fundamental. They have to know how to empathetically handle everyday problems amongst the children and have to be trained to manage the stressful conditions under which they work. We also need to build a bank of trained mental health professionals through specialized academic courses that cater to the treatment of children in institutionalized settings. Linkages with professionals willing to give pro bono consultation is also vital, given the budgetary constraints of most child care institutions and government funding. Mental Health has to be seen as a fundamental component of the protection system at the legislative and policy level, as well as within a single institution.”
According to UNICEF, there are approximately 43 million children in South Asia who have lost one or both parents of which nearly 31 million orphan children live in India. Besides orphans, a substantial number of children are out of the family protective net and get institutionalized as abandoned, abused, runaway children or children in conflict with the law.
While standards of care within institutions have been outlined in different ways through legislation and policy in all South Asian countries, mental health is not a prominent feature yet. In this context Udayan Care organized a two day seminar earlier this year (March, 2014) to question the actual standards of care in children’s institutions and the current legislative and policy frameworks for the protection of children across South Asia. (A complete report on the seminar along with recommendations is attached as annexure)
Udayan Care also implements an inbuilt Mental Health Programme (MHP) which is a holistic preventive and intervention programme that ensures that children living in Udayan Ghars (Sunshine homes) learn to come to terms with their traumatized past and look towards shaping their own future. The MHP constitutes – Individual screening, interventions, counseling and medication, observation and interactions with children, group therapy, life skills workshops, dealing with sexuality and other teenage issues, capacity building for caregivers, social workers and mentors, research and development and advocacy.