History of abuse and neglect and their associations with mental health in rescued child labourers in Nepal

Abstract

Objectives: Little is known about rates of childhood maltreatment in low-income countries, particularly among marginalised sectors of society. Economic hardships mean that in such countries, many children and young people are exploited in the labour force and/or are trafficked, placing them at greater risk for being exposed to other forms of maltreatment. Cultural norms endorsing the use of physical and emotional acts to discipline children further exacerbate this risk. Here, we assessed the rates of childhood victimisation experiences and associated mental health problems in Nepalese youth rescued from illegal child labour including trafficking. Methods: One hundred and three young people aged 12–18 years living in out-of-home care institutions and rescued from child labour/trafficking completed translated versions of selected modules from the Juvenile Victimisation Questionnaire, the Youth Inventory and the Strength and Difficulties Questionnaire. Care-home employees responsible for looking after the young people completed the Adolescent Symptom Inventory and the Strength and Difficulties Questionnaire. Analysis described maltreatment frequencies and compared individuals who had and had not experienced any form of maltreatment on the presence/absence of psychiatric diagnoses. Results: Seventy-two percent of participants experienced some form of maltreatment in their lifetime. Rates for each maltreatment type were 46.6% for physical abuse, 40.77% for emotional abuse, 27.2% for sexual abuse and 33% for neglect. Symptoms indicative of anxiety disorders and trauma were commonly reported especially in victims of childhood maltreatment. Conclusions: Our estimates of physical abuse in this at-risk juvenile sample were commensurate to those reported in general-population youth samples in Nepal, but sexual and emotional abuse rates were somewhat lower. The potential presence of anxiety and trauma in this sample that may result from maltreatment requires replication, but underscores an urgent need for routine mental health screening in rescued child labourers during rehabilitation efforts.

Bricks in the wall: A review of the issues that affect children of in‐country seasonal migrant workers in the brick kilns of Nepal

“…Children's psychosocial distress includes traumas associated with separation from peers and wider kinship groups due to migration and difficulties in making social bonds, particularly for independent child labourers (ILO, 2018). This is supported in a study with young people in Nepal who had previously been child labourers and reported the impact of social stigma and disconnect with cultural norms, leading to anxiety disorders, panic attacks and social phobias (Dhakal et al, 2019).…”

“…Other factors that arose in the review include family dynamics, lack of choice, poor education system, peer pressure and aspirations provided by returning labourers. Several studies report that poverty is the major push factor for children's migration (Dhakal et al, 2019; Kamei, 2018; Rijal et al, 2016; Save the Children, 2019). Changes in family dynamics through events such as illness, disability, death or departure of one or both parents can drastically change a child's life and intensify risk of poverty (Guragain, Paudel, Lim, & Choonpradub, 2015).…”

“…Children of migrant workers have limited opportunity to engage in social activities or school and have anxieties about participating in new environments (Dhakal et al, 2019; Save the Children, 2019). Children's psychosocial distress includes traumas associated with separation from peers and wider kinship groups due to migration and difficulties in making social bonds, particularly for independent child labourers (ILO, 2018).…”

Children’s migration to brick kilns in Nepal: a review of educational interventions and stakeholder responses to child labour

“…In Nepal, child clubs encourage participation and support self-actualisation and agency of children to bring about change, for example, persuading their families to send them to school (Save the Children, 2016). More research on the role of life skills education for adolescents and specific mental health and counselling services for youths previously involved in child labour is needed (Dhakal et al, 2019;International Labour Organisation, 2018). There is limited research from the perspectives of children and youth on their experiences and longer term effects of education and support services, made difficult in part, by migration to various locations (Dobson, 2009; Save the Children, 2019).…”

Neuropharmacology of Anxiety Disorders at Young Age: A Perspective from Preclinical Research

“…Anxiety is a disorder that can be developed in offspring as a result of aversive life conditions. Some factors in the childhood and adolescence that predispose the development of anxiety disorders include sexual abuse [1], social isolation [2], maternal separation [3], physical abuse, emotional abuse, negligence, and exposure to partner violence [4]. In addition, children who experience multiple types of abuse can suffer exacerbate symptoms of anxiety and comorbidity with depression compared to those who are only exposed to one type of abuse [1, 5,6].…”