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As told to Abhishek Jha:

D* (14) came to the Udaan Rose Shelter, a full-care residential centre in Delhi for children in street situations, with trust issues. She had been abandoned by her foster family because they couldn’t understand her recurring mood swings. She was still angry with the family. Didn’t it occur to them to take her into confidence before they shipped her to the shelter home, D wondered.

When she came to us, she would keep to herself and had tendencies of harming herself. We enrolled her again in a formal school, gave her space and opportunity to vent her feelings, and provided her with platforms where she could exhibit her strengths. While this doesn’t mean that all her issues are resolved, still she has learnt to take charge of her life.

D is one among the many children I work with at Salaam Baalak Trust. In over seven years of my experience as a counselling psychologist with the trust, I have dealt with many children like her. I have dealt with street children who face depression, or are battling with post traumatic stress disorder (PTSD), anxiety disorders and attention-deficit/hyperactivity disorder (ADHD). Recently, we have also diagnosed many cases of autism.

While training to become a mental health professional, you learn to work with people with all kinds of mental health needs. When it comes to the mental health of street children, we have very little research to go on, in India. Coming into this practice, therefore, we don’t have any idea about the kind of issues these children face or even an understanding about how their needs are different from others.

For instance, almost all street children face neglect and harsh conditions. Of the 51,000 street children found in a Delhi census conducted by the Institute for Human Development and Save the Children in July-August 2010, about 70% were estimated to be engaged in child labour. Over 50% of the children were also estimated to have faced some form of physical or verbal abuse, including sexual abuse.

This doesn’t alter the clinical work much – since the foundation for treatment of trauma requires building quality therapeutic relationships among the therapist, the child and the caretakers – something we are taught from day one. But it requires efforts in other directions.

For example, there is a lack of parental support for these children, for obvious reasons. So, we need to create a structure to support them. For instance, we build a team of people who are sensitised to and understand the mental health issues of children and are able to support their emotional needs.

For this, we train the staff regularly on different aspects of mental health, including an understanding of how various disorders manifest. Other children at the centre are also mentored to handle a crisis situation with the staff and provide emotional support to children with difficulties, because they are the immediate family. For one, we have a ‘buddy’ system, where a child from within the home is selected to spend some time with another child who is facing mental health issues.

However, even in such cases, some children find it difficult to understand the situation of a child with self-harming tendencies. We still have a long way to go before we can change the thinking of such children, particularly because there is still a lot of stigma attached to these issues.

There are other challenges too, which make dealing with the mental health needs of street children slightly complicated. The lack of education often leads to poor self-esteem and career-related anxieties. At times, there’s barely anything that can be done for the children who come to the shelter, because they are already 15 or 16 years old. This makes the process of counselling difficult, because not much can be done to address the main issue (education) from which these anxieties are stemming. Or sometimes, the child has inhibitions about talking about their traumatic experiences due to trust issues. It gets difficult to reach out to the child in such cases.

Therefore, building the environment to address the needs of street children is of utmost importance when helping them with their mental health needs. It is important that they feel loved. An approach where the focus is on a child’s strengths, instead of their weaknesses, gives them the confidence and self-esteem which the street robs them of.

There are quite a number of government policies that try to address these issues. Unfortunately, the process of getting the benefits from these policies is cumbersome – especially when street children don’t have any identification cards. More homes for children in street situations who have mental health needs – and more importantly, homes well-equipped to deal with their needs – could solve this problem. It’s important to remember that these homes are not permanent residences for the children. So, equipping children with life skills at these homes is important, too – to enable them to make rational decisions and also help them lead a fulfilling and independent life when they leave the home.

Country-wide, we need more people talking about mental health. If it’s talked about in textbooks, if there are workshops and seminars that spread awareness that mental health problems are also health problems – we would be a step closer to addressing the issue.

D’s troubles at her foster home, where she had been living since her parents died, started when she was turning adolescent – a time when it was important for her to have conversations about mental health. Her foster parents had brought her up like their own child, but it was her mood swings and her relationships with the boys of her class that led to arguments between them.

If everyone understood mental health a little better in this country, maybe D’s foster parents would have understood that she just needed the help of a mental health professional. Perhaps then she wouldn’t have had to lose another set of parents.

*Name changed

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Featured image used for representative purposes only.

Image Source: Salaam Baalak Trust/Facebook, Rajen Nair