Research in Child and Adolescent Psychiatry in India

Article excerpt

Byline: Priyavadan. Shastri, Jay. Shastri, Dimple. Shastri

The primary source for this annotation on child and adolescent psychiatry is Indian Journal of Psychiatry. Articles covering various dimensions of child and adolescent mental health were searched from its electronic data base to discuss relevant articles. Literature was mainly in the form of original research articles, review articles, case reports, editorials, orations and presidential address.

Introduction

In India, child mental health services have been neglected in the last 63 years. National Mental Health policy makers (2003) have practically nothing on their agenda as far as child mental health policy and planning are concerned. It is a sorry state of affairs. In last 67 years, from 1937 when first child guidance clinic was introduced till 2003, NIPCCD study located only 164 Child Guidance Cinics (CGC); roughly two CGC a year and that too only in metro cities and mega cities. All these child guidance movements and mental health activities, services have been initiated and sustained by efforts from non-governmental organizations (NGOs). [sup][1]

Ten per cent of the child population is in need of special care and treatment. Only one out of the 100 gets some care and treatment. It is high time we reach out to 99% of the child population that is being unattended by any agency. Children with borderline intellectual functioning and various learning, speech, visual and hearing difficulties are conservatively estimated to be 20% of the total child population. These 114 million children have no facilities even in the urban areas. [sup][1]

Child population is not homogeneous. Large numbers of children have no home, school and family. They can be in orphanages, destitute homes, beggars' homes, juvenile homes, rescue homes and remand homes. They can even be street children. All these groups some how have their own self-help group, one of the motto of such group is "each one teach one" to become self-sufficient. Some of them run their own child guidance clinic. [sup][1]

Child psychiatry in the West expanded rapidly in the 60s and 70s. Strikingly, Indian Child Psychiatry has been part of general psychiatrist and that trend has grown much more in last two decades. Mumbai, Bangalore and Lucknow had considerable child mental health activity. General psychiatrist offered their services to children in many diverse ways. They are to be found working in many fields child's home, remand home, rescue home, delinquency, cerebral palsy and other handicap. [sup][2]

Multidisciplinary child practice

Child mental health is not in the province of child psychiatry alone. Education, social welfare, primary health services, even community leaders and neighbors contribute more than child psychiatry on its own. The team work always does wonders in child psychiatry. Important key members of the team include psychiatrist, psychologist, social worker, neurologist, pediatrician, occupational therapist, speech therapist, physiotherapist, special educator, art, music, drama therapist and cytogenetic expert. [sup][2]

Cooperation with the educational services

School Mental Health has been a major mental health movement which covers up the large population of children and adolescent, but has been effectively implemented only in metros and not in smaller towns and urban areas in the last four decades. Research publications during the 60s, 70s and 80s reported that mental retardation formed bulk of population attending CGC during that period. While emotional and behavioral disturbances were less identified and referred. The trend has changed. All spectrums of diagnostic categories are now referred and treated at various teaching hospitals, psychiatry departments, pediatric departments, various colleges of social work and large number run by NGOs. [sup][3]

The last three decades has shown highly specialized clinics rendering specialized services to children with learning disability, autism, cerebral palsy and mental retardation mostly in metros and urban areas. …