HEALTH CARE PROVIDERS KNOWLEDGE, ATTITUDE AND PRACTICES IN RELATION TO CHILD AND ADOLESCENT MENTAL HEALTH IN GOVERNMENT HOSPITALS, MONROVIA, LIBERIA

Abstract

Mental health problems in children and adolescents account for 10-20% of the worldwide global burden of disease and come from low and middle-income countries where 90% of young people lived (Kieling et al, 2010). Recognizing the mental health problem in children and adolescents by Health Care Providers in Liberia is a major step towards effective mental health service delivery at the Primary Health Care level which is part of the phase I of the Essential Packages for Health Services. The lack of knowledge of mental disorders in child from low and middle income countries is a challenge. Health Care Providers play a center role towards the integration of general mental health and especially child and adolescent mental health services into the realization of the physical, mental and social wellbeing of every citizens of Liberia. Thus, the focus of this KAP research in CAMH was to examine the knowledge as well as the attitude and practices of Health Workers to CAMH. We conducted a questionnaire survey of 404 randomly selected Healthcare workers in two government health facilities in Monrovia, Liberia. Modified Bogardus Social Distance Scale was used to assess the health care workers’ attitude towards children and adolescents with mental illness. Information on their knowledge and beliefs about CAMH difficulties was sought. Their practice was explored with clinical scenarios of serious CAMH difficulties that could be encountered in the hospitals. The health workers indicated how they would have responded to each scenario. 379 respondents completed questionnaires giving 94% response rate. 37% of respondents were males and 63% females. 68% of respondents were classified as having high social distance. 50% stated that Child and Adolescent Mental Health is very important. However, 28% stated they would be ashamed if a child in their family had a mental illness. 51% believed that children and adolescents with mental illness are dangerous. 28% believed that CAMH difficulties can be transmitted through handshake with an affected child. 28% would oppose their child going on a date with a peer with mental illness, while 48% would object to their child even having a conversation with an affected peer. 38% of the health workers stated they knew what to do about a child presenting with suicidal thoughts. Regression analysis showed that the two predictors of high stigma/social distance were limited knowledge of the causes of mental illness and perceived negative family attitude towards mental illness. This study elicited significant negative attitudes and misinformation among health workers regarding CAMH problems. The findings could inform interventions to improve the attitude and practice of healthcare workers towards Children and Adolescents with mental illness in Liberia.