Global Child and Adolescent Mental Health Needs: Perspectives from a National Tertiary Referral Center in India
Tejas S. Golhar and Shoba Srinath
Affiliation: Child and Adolescent Mental Health Services, Goulburn Valley Area Mental Health Services, Goulburn Valley Health, Shepparton, Victoria-3630. Australia
Objective: To review and discuss the mental health needs of children and adolescents in India.
Methods: Recent community-based and clinic-based epidemiological data in child and adolescent psychiatry (CAP) from
a tertiary referral center for CAP in India [National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore,
India] are reviewed.
Results: The ICD-10 DCR criteria for CAP disorders and Rutter’s penta-axial diagnosis are used in these data. The community
prevalence rate for CAP disorders is found to be 12.5% (n = 2064). The most common diagnoses in community
are non-organic enuresis (6.2%), specific phobia (2.9%), ADHD (1.6%), stuttering (1.5%) and ODD (0.9%). Only 37.5
per cent of the families perceived that their children had any problem. The profile of CAP disorders among patients presenting
to the CAP clinic [n=374 over six months period; age-group 0-16 years; 240 (64%) boys and 134 (36%) girls] differs
from that in community: ADHD—16.6% (highest prevalence), autism spectrum disorders—15.5%, depression—12%,
dissociative disorders—8.8%, bipolar disorder—4.2% and psychoses—4%. 284 (75%) of children evaluated in the clinic
have at least one abnormal psychosocial situation. Physical abuse and the presence of parental psychopathology are significantly
associated with psychiatric morbidity.
Conclusions: Prevalence rates of CAP morbidity in India are lower than Western figures. With our total population figures,
the absolute numbers with psychiatric morbidity would be very large. We discuss the implications for manpower
training, practice, awareness building and policy initiatives.
Keywords: Child and adolescent mental health, mental health in India, prevalence
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