MENTAL HEALTH PROBLEMS AMONG CHILDREN AND YOUTH LIVING WITH HEARING AND VISUAL IMPAIRMENTS IN THE GAMBIA

Abstract

Background: Children and young people with hearing and visual impairments are at higher risk of mental health problems both within special and mainstream schools. There is limited information on the mental health problems among children and young people living with hearing and visual impairments in sub-Saharan Africa including The Gambia. The aim of this study was to determine the prevalence of mental health problems among hearing and visually impaired children and young people and the relationship with socio-demographic characteristics. Materials and Methods: This was a mixed-methods study. Teachers of 151 hearing impaired and 25 visually impaired children and young people completed both the Socio-Demographic and Strengths and Difficulties Questionnaire (SDQ). A multivariate analysis was done on Socio Demographic and Strengths and Difficulties Questionnaire (SDQ) to identify correlates associated with mental health problems. In the qualitative aspect, focus group discussions were held with the teaching and non-teaching staff on their perceptions of mental health, resources available, resources needed and barriers to managing mental health problems in schools. Data were analyzed using thematic analysis. Results: The mean age of the participants was 15.5 with a standard deviation of 4.0. The prevalence of emotional and behavioral problems in the study population was found to be 30%. Among the respondents 11.4% had abnormal scores on the emotional problem domain while 18.2% had abnormal scores on the conduct problems domain, 13.1% had abnormal scores on the hyperactivity domain and 6.3% had abnormal scores on the peer problems domain. The results showed that among the children with mental health problems 47(36.4%) were 18years and below while only 6(11.3%) were 19 years and above. The difference in age range was significantly associated with mental health problems (p=0.002). It was found that those who are 19 years old and above were 74% less likely to have abnormal mental health disorder than the younger group (p=0.004), while those living with their fathers alone were 6 times more likely to have mental health problems than those living with two parents (p=0.012). The majority of the teachers indicated their understanding of mental health and believed that children with visual and hearing problems have mental health issues characterized by emotional problems; sadness and crying and behavioral problems; withdrawal and isolation, anxiousness, defiance, aggressiveness and arrogance among others. Resources available to help the children were parental involvement, engaging child in the class, making the school environment friendly through co-curricular activities and peer groupings, counseling and showing love and compassion to them. The participants also expressed their inadequate mental health knowledge and skills to help the children. Conclusion: The findings in this study showed that one-third of children with hearing and visual impairments experience mental health problems. Presently, there are limited resources available within special schools to manage their mental health problems. Hence, in order to meet their comprehensive mental health needs, effective intervention strategies and services must be put in place particularly mental health training for school staff.