Children Mental Health Problems

                                                 Chapter One                      

1. Introduction

1.1. Background

Today’s children who are socialized in a safe and healthy environment are the adults of tomorrow and the bases for the future development of a country (Miles, 2009). Unless children are properly socialized, there will be a chance to become challenging for their personal and societal development (Gobena, 1998).

At the community level, the absence of adequate safety precautions and educational supports in spiritual, cultural, recreational, child care, educational, residential and therapeutic care settings may place children and youth in situations of risk (Kuehnle and Connel, 2009). Inter-generational patterns of abuse within the family, as well as family problems such as substance abuse and inadequate supervision are also taking considerations (Dargie, 2008).. At the individual level, the developmental age and gender of the child may also contribute to risk. While any child or young person is potentially at risk, the interactions between various risk factors can be complex. Some children and youth may be more vulnerable due to factors that isolate and marginalize them in their homes and communities, such as poverty, disability, racism and other forms of discrimination (Kuehnle and Connel, 2009). So, Children subjected to such type of abuse and exploitation, and discrimination become vulnerable to experience of depression and mental illness (Dargie, 2008).

Children mental health problems can threaten overall health and life quality and make it more difficult to thrive and succeed in school, at work, and in social situations. There is overwhelming evidence that mental health and behavior problems in childhood impair educational and social development, thereby impacting later competence and productivity (Miles, 2009).

Such untreated mental disorders contribute to suffer and economic loss and affect millions of people worldwide. While prevalence is immense, few people receive the basic services they need to treat mental disorders (Miles, 2009). Further. Children mental health disorders and other diseases influence each other; failure to get to be treated (Sanchez, Nurilegn Abebe, 2015).

About 500 million people are believed to suffer from neurotic and stress-related disorders worldwide (Alemayehu Gelemmesa, 2003). Another 200 million suffer from mood disorders, such as chronic and manic depression, eighty three million people are affected by mental retardation, epilepsy affects 30 million, dementia 22 million and schizophrenia 16 million (Alemayehu Gelemmesa, 2003).

Under developed and low income countries have a higher risk for prevalence of children mental health conditions. For example, in 2011 approximately 350-400 thousand Ethiopians were estimated to be living with epilepsy alone (WHO, 2000). The diagnosis and treatment of mental health conditions such as epilepsy is under represented in these parts of the world due to lack of priority, lack of resources, or clinical training and background to treat mental health disorders (WHO, 2000).

Community surveys in Ethiopia have shown consistently that severe children mental illness, for example resulting from schizophrenia or bipolar disorder is recognized as an illness that needs intervention.  However, severe mental illness is more often attributed to supernatural causes, for example spirit possession, bewitchment or evil eye, rather than as a result of biomedical or psychosocial causes.  As a consequence, affected individuals and/or their families often seek help from religious and traditional healers rather than health facilities (Alemayehu Gelemmesa, 2003). 

Hence, parents’ experiences in managing their children chronic mental ill are needed in order to minimize the problem because over the past century, a primary question in psychological and sociological research have been how parents influence the behavior and development of offspring, and patient’s satisfaction and experiences are increasingly used as indicators of quality in health care (Creswell and Brereton, 2000) . Parents are often an integral part of the treatment within the child and adolescent mental health services by reducing their mental ill problems (Creswell and Brereton, 2000).

1.2. Statement of the problems

Mental illnesses are common in Ethiopia; they are associated with a high burden due to disability and mortality. It is the leading non-communicable disorder in terms of burden, which comprised 11% of the total burden of disease, with schizophrenia and depression included in the top ten most burdensome conditions, out-ranking HIV/AIDS (MOH, 2012). These startling statistics show that mental illnesses have been overlooked as a major health priority in Ethiopia, and underscore the need for public health programs targeting mental illnesses. In this country, there is only 1 psychiatrist per 6 million people or about 36 in the country as of 2012.  Prevalence for mental health disorders is estimated to be 15% for adults and 11% for children, and/or the prevalence rate of the priority mental illness of Ethiopia in schizophrenia, depression, suicide (completed),suicide attempt, alcohol-problem, drinking, alcohol dependence Cannabis, abuse, childhood mental illnesses, epilepsy are 0.5, 5.07.7/100000/year, 3.22.2-3.7, 1.5, 1.5, 12-25, 1.0 respectively. This data shows the children mental illness is the chronic mental illness in here Ethiopia among the rest of the mental illness (MOH, 2012).

The proportion of young population under age 15 has 45.0% in 2007 in Ethiopia. There are 618,061 urban populations who are between 1-14 years old in Amhara region. Among this amount of population, 206,987 urban populations are living in Gondar town, which means 33.5% of the total urban population in Amhara region (CSA, 2007). And, there are 702 children who have chronic mental ill in this town, which means 0.4% of the entire urban population in this town. There are also 39 chronic mental ill children in Kebele 04 of Gondar town, which means 6% of the total mental ill children population in this town too. Among these populations (702), 365 chronic mental ill children have not protected, cured, and cared by parent. 234 chronic mental ill children are under the burden of parents’ punishment, neglect, and ignore (Mental Institution Annual Report, 2014).

While the problem of chronic mental ill children have been occurring in Gondar town, lack of well documented to show the existence rate of chronic mental ill children in this area is too much insufficient, which means the parents’ experience in managing their children chronic mental ill in Gondar town have remained largely on documented and there is a dearth of research and information on which to base counter- activities.  Due to the fact that some researchers explained mental ill like Alemayehu Gelemesa in 2003 on his work common mental ill and Mengesha Endalew on perceived causal attribution of psychological disorder and treatment seeking behaviors in Ethiopia, they couldn’t show the parents’ experiences on children mental health in Gondar town.

Therefore, this research will fill such gaps so as to investigate parents’ experiences in managing their chronic mental ill children in Gondar town, in the case of Kebele 04.

1.3 Research questions

The research questions of this study were:

1. What are the parents’ experiences in treating their children’s derangement?

2. What are the parents’ experiences in managing the behaviors of their mental ill children?

3. What are the parents’ experiences in making the interaction of their mental ill children with their community?  

4. What are the parents’ experiences for following their children medication?

                               1.4. Objective of the study

 1.4.1 General Objective

The main objective of this study has described about the parents’ experience in managing their children chronic mental ill in Gondar town; in the case of Kebele 04

1.4.2. Specific objectives

The specific objectives of this study are also:

1. To describe about parents’ experiences in treating their children’s derangement
2. To identify the parents’ experiences in managing the behaviors of their mental ill children
3. To illustrate parents’ experiences in making the interaction of their mental ill children with their community
4. To investigate the parents’ experiences for following their children medication

1.5. Significance of the study

Studying the parents’ experiences in managing their children chronic mental ill in Gondar town in the case of kebele 04 has hoped to have a paramount importance for advancing the researcher’s and his classmates’ academic performance from being taken to sociology of health care.

  This study has also helped parents, counselors, social practitioners, clinicians, and individuals to work with the legal system and other governmental and non- governmental organization for minimizing the problem.  

1.6. Delimitation of the study

 Although the problems of children chronic mental ill become the prevalent in different areas in the town, this study has been delimited to investigate the parents’ experiences in managing their children chronic mental ill in Gondar town, kebele 04 due to time, budget and human power constraints.