MENTAL HEALTH SERVICES FOR CHILDREN
LIVING IN GROUP FOSTER CARE HOMES
NEW DELHI, INDIA
CONSTRAINTS & DILEMMAS
Dr. Deepak Gupta
Child and Adolescent Psychiatrist
Sir Ganga Ram Hospital
Founder, Centre for child & Adolescent Wellbeing (CCAW)
Mental Health Advisor & Consultant, Udayan Care
Dr Kiran Modi
Managing Trustee
Udayan Care, INDIA
OUTLINE
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Bio-psycho-social perspective
Mental Health Programme (MHP) at Udayan Care
Constraints & Dilemmas
Evolution
Dr Deepak Gupta, New Delhi, India
CHILDREN Who Reach
Institutions BRING ALONG …
 Experiences of being Orphaned/ Abandoned/Lost
 A Past full of Utter Deprivation and Penury
 Street History And Mixed Experiences
 Huge Trauma: Physical, sexual and emotional abuse
 Lack of Basic Life Skills
 Need for Communication & Behavioral Modification
 Need to develop Social Skills
 Need to get Educated
Dr Deepak Gupta, New Delhi, India
What is good or bad for Mental Health of
Children in Institutional Care
A proposed “bio-psycho-social perspective”
The array of mental health and behaviors associated with children in Foster
Care has been difficult to account for with a simple cause-and-effect
model.
This apparent diversity can be explained in part by the heterogeneity of
experiences of children in institutional care, the complexity of the confounds
among and a host of moderating and mediating constitutional and
environmental variables together with important individual differences in
coping strategies that may come into play at different points in
development in any given case.
Dr Deepak Gupta, New Delhi, India
Biopsychosocial Perspective
CHILD
Care Takers
Organization/Society/legal norms
Dr Deepak Gupta, New Delhi, India
A bio-psycho-social perspective
Why to understand?
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Holistic approach
To understand individuality
To enhance emotional & social wellbeing
To build Resilience
To nurture productive future and youth
Dr Deepak Gupta, New Delhi, India
Inbuilt mental health programme (MHP)
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Inbuilt mental health programme (MHP) is an
essential component to promote positive mental
health, early identification and treatment of mental
health problems and rehabilitation.
It is a comprehensive preventive and intervention
programme ensuring that our children learn to
come to terms with their traumatized past and look
towards shaping their own future as we work as a
cohesive team for holistic development of every
child.
Dr Deepak Gupta, New Delhi, India
Mental Health Programme (MHP)
Mental Health Programme
constitutes:
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Skill building workshops for
children
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Meetings at Homes
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Observation and Interaction with
children
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Individual interventions
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Capacity building workshops for
caretakers and mentors
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Meeting and Training programmes
with social workers
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Research & Development
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Advocacy
Dr Deepak Gupta, New Delhi, India
Mental Health
Team:
•Child & Adolescent
Psychiatrist (head)
•Psychotherapist
•Social workers
•Clinical psychologist
(assessment)
•Administrative Staff
•Volunteers
Common Mental Health Problems Seen:
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ODD & Conduct Disorder
ADHD
Depression
PTSD
DSH
Substance Abuse
Attachment disorder
Enuresis & Encopresis
Intellectual disability
Learning Disability
Dr Deepak Gupta, New Delhi, India
Constraints and Dilemmas
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Priority on physical health and education
Care takers and mentors reluctance to accept mental health
needs
Its often taken for granted that if children have mental health
problems/disorder then it is because of their past and nothing
can be done
Labelling of the child
Evolving mental health challenges
As children are growing the adolescent issues, relationship
issues and sexuality issues emerging
Career related issues, transition and settlement issues are
bothering them
Constraints and Dilemmas
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Bias against Medication
Children reluctant for medications
Children reluctance for mental health interventions
Change of professionals
Involvement of MH professionals in other admin work
Change of professionals
Lack of Human Resources
Dr Deepak Gupta, New Delhi, India
Evolution
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As homes and children are growing, MHP and MHP Team has
grown over the years
Work on “Prevention”
Creating awareness & life skills workshop
Early identification & interventions are being emphasized
Holistic approach
Training model and advocacy plans
Longitudinal Research work
Dr Deepak Gupta, New Delhi, India
Conclusions
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Mental Health of children in Foster Care deserves to
be addressed at every step.
Both ‘prevention’ and ‘intervention’ need to be
integrate at all levels of delivery of services for
children in Foster Care in order to overcome various
constraints and dilemmas that are associated with it.
Dr Deepak Gupta, New Delhi, India
THANK YOU
Dr Deepak Gupta, New Delhi, India