Child and adolescent mental health services in Pakistan: current situation, future directions and possible solutions

Khan, Fahad; Shehzad, R. K.; Chaudhry, H.R.

doi:10.1192/s1749367600002253

Cited by 13 publications

(9 citation statements)

References 6 publications

(7 reference statements)

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“…These issues were also reported in the Latino community (Portland, USA) where the diagnosis was delayed due to long 16 processes. The unidentified pathways to ASD care were the results of unclear diagnostic services, 21,22 untrained professionals to identify ASD red flags 7,23 and inability to make appropriate referrals. Moreover, the mothers reported their concern that a few good services that are available are concentrated in the urban areas and inaccessible to 11 the majority.…”

Section: Discussionmentioning

confidence: 99%

Sociocultural Barriers to Early Diagnosis of Autism Spectrum Disorder

Farooq

Ahmed²

2020

L&S

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Objective: To qualitatively explore community, family, and health care system barriers to early diagnosis of autism spectrum disorder (ASD) in children. Study Design: A phenomenological qualitative approach was used to explore mothers' experiences of receiving ASD diagnosis for their children. Place and Duration of Study: The study was conducted at Autism Resource Centre Islamabad, from March 2018 to August 2018. Materials and Methods: In-depth qualitative interviews of eight mothers of children diagnosed with ASD, who were above 36 months of age. Results: Using thematic analysis, three major themes were identified as barriers in reaching ASD diagnosis i.e. parent's lack of knowledge and misperceptions of ASD; health care system issues like undefined pathway to care, dissatisfaction with medical or associated professionals, delays due to structural and process barriers; and family factors such as stigma around mental health and disability, family denial and financial constraints. Conclusion: Additional educational outreach to families, de-stigmatization of ASD, streamlining the ASD diagnostic process, and providing additional support to parents of at-risk children may decrease delays in ASD diagnosis among children.

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Section: Discussionmentioning

confidence: 99%

Sociocultural Barriers to Early Diagnosis of Autism Spectrum Disorder

Farooq

Ahmed²

2020

L&S

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“…The diagnosis and treatment of Autism occurs in multiple settings and is provided by variety of health professionals including family physicians, pediatricians, neurologists, psychiatrists, psychologists and speech & language therapists. Most of these health professionals have little or no formal training in child and adolescent psychiatry [ 12 , 13 ]. Thus many questions regarding this puzzling disorder remain unanswered in Pakistan.…”

Section: Introductionmentioning

confidence: 99%

A survey of Autism knowledge and attitudes among the healthcare professionals in Lahore, Pakistan

et al. 2011

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BackgroundThe diagnosis and treatment of Autism in Pakistan occurs in multiple settings and is provided by variety of health professionals. Unfortunately, knowledge and awareness about Autism is low among Pakistani healthcare professionals & the presence of inaccurate and outdated beliefs regarding this disorder may compromise early detection and timely referral for interventions. The study assessed the baseline knowledge and misconceptions regarding autism among healthcare professionals in Pakistan which can impact future awareness campaigns.MethodsPhysicians (psychiatrists, pediatricians, neurologists and family physicians) and non-physicians (psychologists and speech therapists) participated in this study. Knowledge of DSM-IV TR criteria for Autistic Disorder, beliefs about social, emotional, cognitive, treatment and prognosis of the disorder were assessed. Demographic information regarding the participants of the survey was also gathered.ResultsTwo hundred and forty seven respondents (154 Physicians & 93 Non-physicians) participated in the study. Mean age of respondents was 33.2 years (S.D 11.63) with 53% being females. Reasonably accurate familiarity with the DSM IV-TR diagnostic criteria of Autistic Disorder was observed. However, within the professional groups, differences were found regarding the utilization of the DSM-IV-TR criteria when diagnosing Autistic Disorder. Non-Physicians were comparatively more likely to correctly identify diagnostic features of autism compared with Physicians (P-value <0.001). Significant misunderstandings of some of the salient features of autism were present in both professional groups.ConclusionResults suggests that current professionals in the field have an unbalanced understanding of autism due to presence of several misconceptions regarding many of the salient features of autism including developmental, cognitive and emotional features. The study has clinical implications and calls for continued education for healthcare professionals across disciplines with regards to Autism in Pakistan.

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“…The resources for child and adolescent mental health were already stretched thin even before the COVID-19 crisis. 10 Therefore, mental health of children is bound to suffer due to these factors. Analysis of individual items of our questionnaire showed that most of the children were feeling bored, which could be explained based on the lack of social interaction and physical activity at schools and parks, as is reported by Liu et al 11 in their study conducted in China.…”

Section: Discussionmentioning

confidence: 99%

“…As discussed above, there are chances to have a 'sleeper effect' of such behaviors as upon growing; therefore, these children are at increased risk of developing psychiatric disorders, including obsessive compulsive disorder, etc. 8,10 Item number 9, "My child/children talk about missing his/her peers at school and neighborhood," is related to physical activity and relationship of children with other children of their age group. During the lockdown period, this has been one of the major problems faced by the children, hampering their emotional and psychosocial adaptation to the new environment.…”

Section: Discussionmentioning

confidence: 99%

Perception of healthcare workers regarding the psychological impact of COVID-19 on their children

et al. 2022

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Background and Objective: Pandemics like COVID-19 adversely affect children’s behavior and psychological development by disrupting routine life activities. Children of healthcare workers are exposed additionally due to the fear of parental exposure to the virus. The objective of this study was to assess the perception of frontline healthcare workers (HCWs) regarding the psychological impact of the COVID-19 pandemic on their children. We also sought to identify the difference of the psychological impact on children of the male and female healthcare workers. Methods: A survey questionnaire was developed comprising 10 questions about the perception of HCWs regarding the psychological impact of COVID-19 on their children. It was distributed both online and face to face among 150 healthcare professionals, working in training and non-training posts in 4 public and 5 nongovernment hospitals of Pakistan. The mean and standard deviation were calculated for each survey item using Statistical Package for the Social Sciences 26.0. Results: The response rate was 71.3% and majority (64.2%) of the healthcare professionals were ≥30 years of age. Ninety-two HCWs (85.98%) either agreed or strongly agreed that the parental separation from their kids for long hours during the pandemic had a negative psychological impact on their children. There was a significant difference in perceived psychological impact of COVID-19 on the children of male and female HCWs, with a mean survey score of 2.29 ± 1.82 and 1.69 ± 0.79, respectively (t = 2.29, p-value = 0.024). Conclusion: Children of the healthcare workers experience more stress and anxiety because of long duty hours and working in high-risk settings. Continuous psychological support and counseling services may be adopted formally to prevent unforeseen adverse events or any long-term negative impact on their physical and mental health.

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Child and adolescent mental health services in Pakistan: current situation, future directions and possible solutions

Cited by 13 publications

References 6 publications

Sociocultural Barriers to Early Diagnosis of Autism Spectrum Disorder

Sociocultural Barriers to Early Diagnosis of Autism Spectrum Disorder

A survey of Autism knowledge and attitudes among the healthcare professionals in Lahore, Pakistan

Perception of healthcare workers regarding the psychological impact of COVID-19 on their children

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