Glenda Anderson, Staff Reporter
THOUSANDS of school-aged children with severe mental disorders may be going unnoticed in Jamaica, as parents and guardians are unaware of the problem, cannot recognise sypmtoms or cannot access facilities available to help.
Dr. Ganesh Shetty, Child and Adolescent Psychiatrist employed to the South-East Regional Health Authority, (SERHA) said of nearly 100,000 youth estimated to be now affected by mental health issues, only five per cent were being cared for in 15 child guidance centres set up for this purpose islandwide.
"Any parent or child is free to go to the public health system for proper assessment services with help being available at different levels," he said.
One researcher directly named parents' non-intervention as contributing to the problem.
A cross-sectional survey of a cohort of over 1,700 Jamaican children ages 11 and 12 years old, conducted by Dr. Maureen Samms-Vaughan (2000, Cognition, Educational Attainment and Behavior in a Cohort of Jamaican Children. Planning Institute of Jamaica. Working Paper No. 5. Social Policy Analysis Research Project), found that "Children from lower socio-economic classes showed more behavioural problems, poor educational attainment and accessed mental health services less frequently.
"Significant number of parents, who are vital in initiating mental health referral, failed to identify many internalising and externalising problems in their children including drug use and suicidal ideation."
VARIETY OF REASONS
Dr. Shetty said reasons given for parents not coming forward with their children for psychiatric medical attention ranged from the economic to widespread ignorance.
"Number one, awareness of the problem. They do not recognise it as a mental health problem. Then awareness of the services available. Sometimes they know something isn't right but just where to go to get help they do not know. In other times it's getting to the areas. The problem for some parents could be as simple as finding the bus fare or the time off from work to get help."
His own research located a cross-national study of African-American and Jamaican children which showed that "more problems were reported for clinic-referred youth in the African American than the Jamaican sample, although the Jamaican youth presented with more severe problems."
Top diagnoses were abuse (all types), disruptive behaviour, conduct disorders, learning disorders, adjustment disorders, mental retardation and depression.
One very common disorder, Attention Deficit Hyperactivity Disorder (ADHD) identified as a major health issue was also under reported among inner-city youth, Dr. Shetty said.
He notes in one investigation, (a study of psychosocial factors affecting Jamaican children with ADHD) that "Children with ADHD in Jamaica exhibit significant externalising symptoms and suffer significant impairment in their social and academic functioning. They experience more psychological trauma and less financial and emotional support from their biological fathers when compared to their classmates of same age and gender. (Yet) significant number of schoolage children with ADHD may go unidentified in Jamaica.
"ADHD is a disruptive behavior disorder characterised by on-going inattention and/or hyperactivity-impulsivity occurring in several settings and more frequently and severely than is typical for individuals in the same stage of development. Symptoms begin before age seven and can cause serious difficulties in home, school or work life."
WAY FORWARD
Dr. Shetty says while there is now increasing awareness of the problem especially from Government, communities and parents must do more to stem the problem.
"The way forward will be to enhance parenting skills for parents and 'would-be' parents in systematic ways starting as early as the primary schools, as well as increasing the capacity of teachers and guidance counsellors to help. Sometimes they know what to do, but do not know how to, or how far to take it," he said.
