Screening for abuse and mental health problems among illiterate runaway adolescents in an Indian metropolis
ObjectiveTo evaluate the prevalence of physical and sexual abuse, and their relation to mental health problems among the illiterate/semiliterate runaway adolescents in New Delhi, India.DesignCross sectional.SettingNew Delhi, India.PatientsRunaway adolescent boys (n=119) aged 11 to 18 years at an observation home.MethodsStudy subjects were screened for physical and sexual abuse using the Child Maltreatment History Self Report and Finkelhor's sexual abuse scale. Mental health problems were identified using the Achenbach's Youth Self-Report scale. As the participants were illiterate or semiliterate with Hindi being their primary language, the screening tools were appropriately translated, read out to them and their responses recorded.ResultsA total of 72 (62%) boys experienced domestic violence, 70 (59%) had engaged in substance abuse and 103 (87%) boys had been employed as child labourers. Physical abuse was reported by 86 (72%) and sexual abuse by 42 (35%). Mental health problems were recognised in 83 (70%) boys, which included internalising syndromes (59%) and externalising syndromes (34%). Multivariate analysis demonstrated that physical abuse was an independent predictor of internalising syndromes (OR: 3.3; 95% CI 1.2 to 9.1; p<0.01), while substance abuse and sexual abuse were independent predictors of externalising syndromes.ConclusionsOur study demonstrates that childhood abuse and mental health disorders are widely prevalent among the runaway adolescents evaluated at an observation home in New Delhi. Appropriate modification of the standardised self-report screening tools may allow the identification of mental health disorders in this vulnerable illiterate/semiliterate population.