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.