PREVALENCE, CORRELATES AND PATTERN OF COMMON MENTAL HEALTH PROBLEMS AMONG ADOLESCENTS IN INSTITUTIONAL CARE IN AKWA IBOM STATE, NIGERIA

Abstract

Background: Globally, the prevalence of child and adolescent mental health is alarming, affecting 10-20% of children worldwide. This value is even higher among children living in institutions and orphanages. According to Merikangas et al (2009), three of the ten leading causes of disability in people between the ages of 15 and 44 are mental disorders, and the other causes are often associated with mental disorders (Ries Merikangas et al., 2009). The populations of children living in residential homes have constantly increased over the last 20 years. These children are very vulnerable in terms of psychological disturbances due to histories of child abuse and neglect, separation from their parents or placement instability. But there is currently no existing data on the prevalence, correlates or patterns of mental disorders among children and adolescents living in orphanages in Nigeria. We therefore sought to determine the prevalence and correlates of mental health problems of children living in this exceptional circumstance in this region. Methodology: A cross-sectional study was carried out to assess the mental health of 160 adolescents aged 10-19 years residing in orphanage homes by convenient sampling method. The study was conducted in 9 selected orphanage homes in Akwa Ibom State, Nigeria. Tools used in data collection were the self-report version of the Strength and Difficulties Questionnaires (SDQ) and Short Mood and Feelings Questionnaire (SMF). Data were analyzed using the IBM SPSS software for Windows Version 23. Descriptive statistics such as frequency and proportions and inferential statistics including the Chi-square test to test the association between categorical variables were used. A significance level was set at 5%. Results: A total of 160 children and adolescents, aged 10-19 years, with a mean age of 14.4 years participated in the study. The majority 105 (65.6%) were aged 14-19 years and there were more females 88 (55.0%) than males. Three quarters were secondary level education, and 71.3% were Pentecostals. One hundred and five participants (65.6%) were orphans and majorities were originally from monogamous families. The prevalence of depressive symptoms was 69.5%, as measured by the Short Mood and Feelings Questionnaire. None of the socio-demographic factors were associated with having depressive symptoms. Fifty-seven adolescents (35.6%) had mental health problems as measured by SDQ. Conduct problems were the commonest (45.0%) followed by emotional problems (41.3%). Of the individual subscales, age was associated with having conduct problems (p=0.002), gender was associated with having emotional problems (p=0.013). Furthermore, verbal abuse was reported by 60.9%, sexual abuse by 20.9%, and neglect by 52.7%. In addition, corporal punishment was reported by 56.4%. More than half of the participants (52.5%) had stayed in their current homes for 5 years and more. Conclusion: This study provided evidence that mental health problems are high, especially depressive, conduct and emotional problems. These observed behavioral anomalies might have led the community to label most of these children as witches. Children and adolescents in residential care are therefore a neglected high-risk population. However, there is a need for further research and subsequently, more intervention studies to reduce the high prevalence of mental health problems for adolescents in this situation. This study had some strengths and limitations. This is the first-ever study to determine the prevalence, correlates and patterns of mental health problems among institutionalized adolescents in the Akwa Ibom community.