Child-friendly environment vital for positive mental health: Experts

By A Staff Reporter

KATHMANDU, Dec. 23: Many children in Nepal suffer from psychological problems due to direct exposure to violence, assault and loss of immediate family members or due to unrelated exposure to the media, such as TV footage and photographs. About 200,000- 300,000 people in Nepal suffer from severe mental illness and are in need of immediate care.

There is a need to create a child-friendly environment at school, at home and in the community for the promotion of positive mental health and prevention of mental illness through the participation of communities. "We must strive to fight against social discrimination, abuse and neglect of children and ensure proper parenting both at home and at school in order to prevent psychosocial disability," said psychiatrists today.

After a disaster, survivors' reactions will often take a more or less predictable course, with degrees of variations depending upon the individual.

There are three stages in a traumatic situation. First is the stage of shock and numbness leading to immobility; a feeling of denial that it 'can't be happening to me'. Secondly, the survivors begin to realise the full impact of the event when feelings start to come out.

"Feelings are mostly unpleasant, such as rage, terror, blaming and anguish. At this point, many people, unused to such strong emotions, may think they are going crazy," said Dr. Vidya Dev Sharma.

Thirdly, if all goes well, this is succeeded by a phase of acceptance. Healing can begin, and people can begin to rebuild their lives.

"It must be recognised that these stages are normal," said Dr. Saroj Ojha. "They are not signs of weakness or onset of mental illness. But, they must be counselled to tell the truth and treated well, otherwise the case may become dangerous."

All survivors will show some features of this sequence, not always exactly in the order as described. "Any disaster can damage personality, some more, others less. It is necessary to recognise and accept the stages as they occur," said Dr. Mita Rana.

There are millions of people in the country with some kind of mental disorder. However, there are less than 26 psychiatrists and 75 hospital beds for them.

At the programme on 'Psychological effects and impact on children who are brought up in a traumatic environment' jointly organised by the Mental Health Project and Tribhuvan University Teaching Hospital, Dr. Prof. Murari Prasad Regmi, Navaraj Koirala and others stressed advocating at both the local and national level the development of knowledge and understanding of children's psychological health issues. This, they believe, will decrease the social stigma and help identify such problems and support the children in need.

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