We Must All Do Our Part to End Child Abuse

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Here’s what you can do.

First published at The Better India, The MINDS Foundation.

Abuse can take place in homes, schools, orphanages, residential care facilities, on the streets, at the workplace, in prisons or places of detention. Child abuse is one of the most insidious crimes increasing at an alarming rate globally. One of the lesser reported crimes, it is rampant across all socio-economic sectors and topographies. The problem with abuse is that it is repetitive and in most cases, it involves a perpetrator known to the victim.

UNICEF defines child abuse as an act of violence against children that may be physical or mental, may be in the form of injury, neglect or exploitative negligent treatment. In addition, the World Health Organisation (WHO) adds that the abuse may be of several kinds — physical, mental, emotional, psychological or in the form of neglect or exploitation.

Hence, there is a breach of trust and this affects the child much more intensely than it affects an adult.

According to one of the reports by the Women and Child Development Department, children aged 5–12 years are at the highest risk of abuse and exploitation. At a younger age, boys and girls both are at a risk of getting abused. However, the number of boys sometimes outnumbers that of girls.

Abuse of any nature affects the healthy development of a child. It has been well researched that several areas of the brain are profoundly impacted by abuse, leading to multiple impairments.

The emotional lobe, memory centre, decision-making centre and many other specific critical areas of working in the brain are impacted by abuse. This changes the way an individual engages in those (respective) processes.

These changes leave victims more vulnerable to mental health trauma and ill-being. The link between abuse in childhood and health maladjustment in adulthood is well established though less acknowledged.

Some psychiatric implications can be- mood disorders such as depression, anxiety disorders like panic attacks or phobia, eating disorders like anorexia nervosa, post-traumatic stress disorder (PTSD) and chronic pain syndromes.

Medical illnesses include — fibromyalgia, chronic fatigue syndrome, and irritable bowel. Studies have also reported that those who have experienced childhood abuse are more likely to engage in high-risk health behaviours including smoking, alcohol and drug use, and unsafe sex.

Research findings conclude that those who have suffered abuse have an overall poorer health and are more likely to use the health services. Also, it lowers the self-esteem of the child, dwindles the self-confidence and damages the self-image of the child.

The bio-psycho-socio implication of abuse demands not just attention but immediate intervention and humongous re-learning.

Parents, school teachers and management, medical professionals, mental health professionals and government policymakers, along with the entire society of citizens, are the stakeholders that bear the responsibility of managing the burden of child abuse.

It is crucial that we secure the future well being of our to-be ambassadors by making them feel secure and providing them safety. This learning begins at home.

Here are some quick pointers that we all can imbibe and spread to create security for our children:

                                                                                   Image Source: Pixabay

1. Know what child abuse it. Educate yourself and be aware. Support intervention programmes.
2. Create an environment of safety for children to share their experiences — good or bad.
3. Listen to them intently. Believe them. Talk about abuse in a manner that it helps the child understand and feel safe.
4. Know how children communicate. If they are speaking in broken parts, if they are keeping too silent, if their reactions are unusual or if they are completely shut down- don’t let it go otherwise. Intervene and discuss.
5. Every child has their way of expressing and behaving. Don’t reprimand the child for everything. Punish his or her behaviour but also teach them the right thing. Without teaching what is right, the child will never learn what actually went wrong.
6. Don’t stop yourself from rewarding the child about his or her achievement.
7. Learn to make them feel confident and good about themselves. It is important that they feel comfortable with their identity.
8. Unconditional positive regard and love are what not just children, but everyone, deserves. It costs nothing to love unconditionally.
9. Sex education is essential when children are young. If you feel uncomfortable, take them to a psychologist who can help communicate safety and important facts about growing up in an appropriate manner.
10. Learn the facts and understand the risks of abuse. Reduce one-child/one-adult situations.
11. Take time to spend with your child. A strong and nurturing parent-child relationship is quintessential to healing.
12. Be aware of the laws and keep the well being of the child paramount while taking action.
13. Teach children their rights. Make them learn what is right and wrong, what is acceptable behaviour and what is not. Instil the feeling of confidence in them by teaching them adequate assertiveness.
14. Discuss these issues at school at an appropriate age level so that children understand the essence of abuse as a group. This can help build support for each other.
15. Teachers must identify signs in class and be alert to intervene.
16. Education and awareness are key to reducing the rising levels of abuse.

Child abuse is a responsibility for all major stakeholders in the society. Collective effort and amplified education coupled with awareness have the potential to change the present debilitating scenario of child abuse — not just in India but on a global level.

The initiative does not merely come from the stakeholders but from each and every one of us.

 

Feature Image Credit: Annie Spratt on Unsplash

 

Pragya Lodha is the COO and the National Lead (Mental Health) at One Future Collective.

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Better Mental Health Services for Trans-Persons in India

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There is a need for understanding, training and infrastructure.

There is a population of an estimated 25 million people, globally a population of 0.5%, who are trans- an umbrella term for persons whose gender identity does not conform to their biological sex. India has one of the largest population of trans people in the world, with an estimated population of 5 lakhs.

Trans persons, not just in India but on a global level, are vulnerable to multiple aspects of discrimination, abuse and violence. From acceptance at home to accessing rights, the trans have had to face excessive struggles to what they really deserved as humans. The stigma and discrimination subjects them to multiple issues with respect to their well-being which includes rejection at home, struggle for societal identity and acceptance, access to health care and well-being and to ingress fundamental human rights. The history of trans struggles date back to the Puranic and Vedic literature, however, it was only on April 14, 2015 that the Supreme court of India legally recognised the trans community, and directed both the Centre and State governments to take needful action in order to uplift the community which is one of the most marginalised, misunderstood and underprivileged in the country.

Transgender, transsexual, and gender non-conforming individuals are a part of cultures around the world. Yet, the transgender population encounters several unique obstacles in accessing health care. There are diverse mental health problems affecting the trans community varying from early childhood care to geriatric mental health challenges. More than half of the 25 million trans people in the world suffer from depression. While mental health issues have their biological causes, systemic discrimination against trans members of society poses equal risks to their mental well-being. The transgender community in India is highly vulnerable to mental and physical illness, in large part due to limited economic opportunities, lack of understanding and stigmatised attitudes. Depression, sexual abuse, alcohol dependence and several mental disorders, forced prostitution and begging, HIV, AIDS are some of the plethoras of health problems faced by them. Despite increased health risks, these transgender individuals face an increased number of healthcare challenges. Understanding the barriers that prevent the Indian transgender community from receiving medical care is important so that health care professionals can more adequately address the unique needs of transgender patients in India and around the world.

Despite the sanctioned recognition of the trans community, apart from a few states, most of India continues to neglect the well-being of trans people. The Central Ministry of Social Justice and Empowerment works on ways of reaching out to the community. However, the physical and mental health services for trans communities remains to be restricted in growth and availability.

There are several challenges specific to the mental health of trans persons that the community faces in India:

  1. In a published study of The Lancet Psychiatry, researchers found that being transgender is not a mental illness. In India, however, little medical research has been conducted on the issues of trans persons and the notion that being transgender is a mental illness continues to pervade.
  2. Sex change therapies are a practice even today despite the known fact that it is incorrect and impossible to medicate someone in order to conform to their biological sex.
  3. The assessment before the sex reassignment surgeries and access to hormone treatment remain at the merciful approval of the practitioners, some of them who continue to give a diagnosis of Gender Identity Disorder (the revision of Gender Identity Disorder in DSM IV TR has evolved to that of Gender Dysphoria in DSM 5 which implies the treatment of distress, depression or anxiety due to the non-conformity to the gender and does not involve any techniques or therapies to dissuade the personal choice / preference of an individual to identifying with a gender).
  4. Post-surgery and post hormone treatment, care and counselling is missing, which is a crucial aspect in order to build and settle the transformations in the patient
  5. Unrequired ECT (electro convulsive therapy), tying the patients to beds and institutionalisation are resorted to for convincing patients about the ‘consequences of sex change’.
  6. Many mental health professionals and medical practitioners lack an understanding of the LGBTQ spectrum health issues. Thus, an expertise in treating their concerns is missing.
  7. Practitioners also have personal biases in taking up trans patients for therapy or treatment.
  8. Counselling and psychotherapies also need a branch of specialisation in order to understand and appropriately address the concerns and mental health issues of trans communities that are amplified due to multiple concerns.
  9. Schools and colleges lack a curriculum to understand the sensitivity of the health problems and other concerns of the trans community.
  10. Gender dysphoria clinics are a far-fetched dream.

Though transgender people can access information more easily today, many uneducated trans persons in India continue to risk their health due to lack of proper medical support.

The overall understanding, well-equipped training and accommodative infrastructure are a requirement in order to address the increasing mental health needs of the trans community. They deserve an equal stand to access mental health care in India, as also reinforced by the Mental Health Care Act 2017. Denial of health care access is the breach of their fundamental human rights. It is time that inclusion is practised as is spoken about. Inclusion of mental health care, too, is of optimum necessity.

Pragya Lodha is the COO at One Future Collective.

Featured image: David Pisnoy

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Uncuff India Episode 10: Dimensions of conflict and peace: visioning a utopian world

Uncuff India Episode 9: Civic space and dissent: A pathway to social justice