Empowering Families in the Management of Childhood and Adolescent Psychiatric Problems using a Public Mental Health Paradigm

• DOI: 10.4103/ijsp.ijsp_280_23
• Publication Date: 2023-11-24T10:01:08Z
• Authors: Rachna Bhargava; Prosenjit Ghosh; Aditya Somani; Hitesh Khurana
• Keywords: Paradigm shift

India is one of the largest populations children and adolescents in world. Hence, to achieve Sustainable Developmental Goals, focusing on health-care needs adolescents' becomes an essential mandate. Since mental health a prerequisite healthy growth development, be cognizant available options fill gaps. Mental significant concern as nearly 20% globally suffer from or other problems. In estimate 36 countries, approximately 250 million world are likely suffering issues at any given time.[1] India, recent meta-analysis reported that 6.5% community 23.3% schools have psychiatric disorders.[2] addition, most adulthood problems some precursors childhood, particularly up age 14 years.[3] Thus, there urgent imperative need consider childhood disorders public issue terms prevention, early identification, reducing treatment gap. akin having "elephant room." general, gap for has been high 90%.[4] Majority with difficulties unable seek help. The unlikely help independently decision-making process would involve family related factors. involvement parents each step certainly facilitate help-seeking adolescents. Simplistically defined, typically consists least living together. Although families Indian context disintegrated joint nuclear even single-parent type over years, remains primary caregiver young. knowledge impact interplay complex system give in-depth insight into processes involved initiation maintenance. It was late 1950s Dr. Vidya Sagar Rohtak successfully demonstrated good recovery, reduction stigma, acceptance mentally ill by involving planning delivering care. However, his concepts, reasons not understood, still awaiting appropriate implementation. role environment development psychopathology much interest; especially regarding interaction between nurture–nature context. A nurturing undisputedly ensures young mind. several factors such parents' knowledge, experiences, their own illness, deprivation may compromise only parenting but also child's (and needs) which can serve barriers help-seeking. scenarios where training trained workforce limited places inaccessible, it profitable strategize simple yet effective approaches enabling emotionally stable environment. This go long way toward promoting positive behavioral all economic levels. over-arching framework make child resilient intra- interconflicting situations peers, schools, society. Concepts quality time, shared meals, open communication, consistency disciplining, usage reinforcements guiding principles creating strengthen protective factors, thereby vulnerability illnesses bloom fully. giving "quality time" alien concept parent belonging lower strata educated bureaucratic family. rationale different; low socioeconomic status (SES) might understand sit converse apart making sure food another extreme (high SES) due preoccupation daily mundane activities. From perspective affected child, either end result, i.e., nonfulfillment his/her emotional needs. Application ecological model approach demands expertise levels professionals (including professionals) Efforts through different programs district program (DMHP) ongoing lack focus various emphasis (or both) required dealing important investing innovative preventive strategies besides empowering skills share burden clinicians diagnosis, initiating help-seeking, assisting intervention long-term follow-up. Families pivotal point undertaking action both prevention intervention. addressing parenting, well enhancing understanding common occurring childhood. two-pronged approach: general along specific enhance effectivity efforts. empowered, multiple ways, using multimodal systems. basic method psychoeducation. Awareness about relationship familial (parental conflict, neglect, abuse, perceived emotional, deprivation) reduce Reaching masses now easy use technology (TELEMANAS mobile applications). Indeed, services more accessible than before. fact, interactive applications (like Arogya Setu) probably convenient collecting information, providing skills, child. apps developing videos assessed mobiles identify disorders. systematic review[5] digital interventions parental outcomes, including low-quality evidence. More research this area before we upscale literacy campaign. For autism intellectual disability, seen indulge doctor shopping physicians pediatricians temples hope cure illness. care find support decreasing stress Parents face varying challenges externalizing internalizing conditions. Attention-deficit hyperactivity disorder, while overlapping extent these behaviors, manifests distinctly overactivity, inattention, impulsivity. Children special usually developmental disabilities. Based distinct needs, evidence-based individual group Triple P, Incredible years)[6,7] emerged conditions groups western countries. Such directly target improve communication relationships. largely used neurodevelopmental disorders, disability. Home-based documented West few studies[8] attempted develop examine feasibility. Group does provide opportunity learn serves social group. facilitates issues. viable option resources urban centers. Despite recognizing scaling involvement, continuous lacking reach out parents, those vulnerable population. foremost strategizing ways reaching families. Schools conceptualized link families, them conduit empower imparting psychoeducation skills. So far, predominantly educational centers children. change mindset vision new vista "public" "hospital" setup. By conceptualization, takes community-based promotion, screening deal potentially ultimate solution searching for! "Road less Travelled…."!