Promotion and Prevention in Child Mental Health

By Shastri, P. | Indian Journal of Psychiatry, April-June 2009 | Go to article overview

Promotion and Prevention in Child Mental Health

Shastri, P., Indian Journal of Psychiatry

Byline: P. Shastri


The importance of psychological well-being in children and adolescent, for their healthy emotional, social, physical, cognitive and educational development, is well-recognized. There is now increasing evidence on the effectiveness of interventions to improve children's and adolescent's resilience, promote mental health and treat mental health problems and disorders.

Mental health problems will contribute significantly to the global burden of disease in the 21st century, and for adolescents, mental health hurdles are already as common as some physical health problems such as asthma.[sup] [1]

Clinical preoccupation of the available mental health professionals of the country and the delay of these professionals to spearhead work towards promotion, prevention, identification and early intervention in child mental health has been a major lacuna.

There are limited child and adolescent mental health services in India. Mostly such services are restricted to urban areas. Access to mental health services for children with a mental, emotional or behavioural disorder is substandard, not provided early enough, in sufficient supply and accessible only to a fraction of children and adolescents.

We currently have tertiary care centres which attend to mental illness in hospital setting. They are therapeutic in nature and aim to treat and rehabilitate back to society. However, large gap exists in the area of prevention, mental health promotion and early intervention programmes. Child Mental Health Policy and School Mental Health Programmes have provided excellent opportunity to enhance mental health programme for children and adolescents. Focus is rightly on preschool children and school based mental health programmes which will prevent and possibly promote positive mental health. It also ensures that it will reduce behaviour disorders in children and prevent adult psychopathology. Effectiveness of child mental health intervention programmes will surely help in addressing mental health disorders among adults.

Even WHO identifies the treatment gap in mental health care. World Health Organisation, asserts that many people suffering from psychiatric illnesses remain untreated, although effective treatment exists. WHO report examines the extent of this gap between the prevalence and treatment of psychiatric disorders globally. One in every 5 child has a mental health issue. If we invest in identifying the problems early and intervene at the right time, it will be more cost effective, as we will be preventing further breakdown and avoid an adult treatment and rehabilitation programme which is much more expensive. As it is rightly said that "Prevention is Better than Cure". It is possible to prevent the majority of behaviour disorders in preschool and school environment itself.

The dire need is to stimulate long-term and sustained improvement in children's health, by setting standards for high quality integrated health and social care for children from before birth, right through to adulthood. And while doing this one of the main focus area has to be the mental health and psychological wellbeing of children and young people.

In order to achieve desired outcomes one should embrace all those services that contribute to the mental health care of children and adolescents, whether provided by health, education, social services or other agencies. It is also crucial to partner with services whose primary function is not mental health care, such as GPs and schools. They can always contribute by offering general advice and treatment for less severe problems, contribute towards mental health promotion, identify problems early in their development, and refer to more specialist services. This is to explicitly acknowledge that supporting children and adolescents with mental health problems is not the responsibility of specialist services alone. …

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