'Mental Health Issues of children
in Institutions"
Dr.N. Janardhana
Assistant Professor
Department of Psychiatric Social Work,
NIMHANS
ESTIMATES
• According to UN estimates, 8 million
children across the world are living in
institutions.
• The actual number is expected to be higher
since there are gaps in these estimates and
with the ever rising rates of HIV, conflict,
disintegration of families due to various
reasons, etc.
• INDIA: An estimated 200,000 children in
the country are in about 5,000 Observation
and Children's Homes, and the numbers
are growing.
Children
Vulnerable
Children
Children with
Diagnosable
Mental Health
Conditions
Children
seeking
help
Institutional Care
Institutional care
Government institutions
- Shelter homes
- Children homes
- Observation homes
- Special homes
Institutions run by NGOs
Impact Of Institutionalization On
Children
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Care and Protection
Basic needs
Education
Health care
Recreation
Vocational Training
Impact Of Institutionalization On
Children
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Emotional deprivation
Separation anxiety
Anonymity and lack of personal attention
Interpersonal relationship problems
Difficulty in mainstreaming and adjusting in society
Segregation and isolation
Low self esteem
Failure to trust,
Excessive routinization and regimentation,
Physical abuse and trauma,
Deprivation of family care
Mental Health issues/ problems
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Emotional problems
Behavioural problems
Scholastic performance related problems
Psychiatric problems
Adjustment related issues
Relationship issues with peers, teachers and others
Experience of working with the institutions
providing care and protection for children
Continuum of Services
Tertiary child
care services
Secondary and
Specialist
services
Universal services
Source: Vulnerable babies, children and young people at risk of harm: Best
practice framework for acute health services, 2006
Developed curriculum for training on
capacity building and counselling
• Understanding of child and child protection
– Concept and theories of child development and
– Needs of children : physical/ social/ emotional / psychological
– Approaches to child protection – charity, welfare, need based
and rights based
– Juvenile Justice Act
• Children in difficult circumstances
– Specific psychosocial problems and issues of children
– Children in difficult circumstances/ children in need for care
and protection
Developed curriculum for training for
the capacity building and counselling
• Mental health needs of children
• Interventions with children
– Institutional and Non institutional care programmes
– Counselling Skills- Communication / problem solving/
motivation skills
– Family Interventions with children
– Group Intervention
– Individual care plan
– Preventive and promotive mental health activities with
children (life skills education)
– Behavioural Interventions
Child Sexual
Abuse
Adolescent
Girls
marrying
adults
Children
victims of
violence,
trafficking
and abuse
Destitute and
orphan
Children
Children with
special
Circumstances
requiring MH
interventions
Child
running
away from
home
Children
using drugs
Children
sent for
adoption
Clinical and non clinical interventions
for children referred from CWC
• All children do not require curative services but
requires mental health care.
• Children with mental health problems been
provided at In patient and Out Patient
Department- for children in distress.
• Psychosocial interventions been provided to most
children with non clinical symptoms.
• Group interventions for children in the
institutions- anger management/ emotional
regulation/ life skills and etc.
• Assessment
• Bio psychosocial
Interventions
• Training
Curative
Preventive
• Ensuring safety at
Institutions, school and
community
• Ensuring accessibility
of services
• Public awareness
• Positive mental health
• Overall development
Promotive
Levels of Interventions
Individual Level
Family Level
School/Institutional Level
Community Level
Networking & Collaboration
Research & Documentation
Training
Policy Formulation & Implementation
Interventions at the institutions
Assessment of child’s
psychosocial needs and
abilities
Preventing child abuse
and discrimination
Developing group
interventions for children
Children friendly
environment
Tracing parents and
Working with them
Empowering children
through creating
awareness about their
rights
Training
Counsellors/institution
staff to identify & mange
children’s problems
Managing children with
special needs
Ensuring Implementation
of programmes & policies
Mental Health:
A Development Issue?
Thank you
Email: janardhannimhan@gmail.com