Psychosocial Care Review for Child Welfare Cases
Psychosocial Care Review for
Child Welfare Committees
June 2018
Community Child & Adolescent Mental Health Service Project
Dept. of Child & Adolescent Psychiatry, NIMHANS
In Collaboration with
Dept. of Women & Child Development
What we will do…
•
Read each case.
•
Spend 2 minutes thinking what our
actions/response would be.
•
Share your thoughts in plenary…so we can
obtain multiple perspectives on our work.
•
Think of what you would do at that moment
as well as at a later point in time.
Case 1
X is a 5 year old girl who was adopted a few months ago.
Suddenly, her adoptive parents bring her back, wanting
to return her to the institution she was adopted from.
They say that they found some health problem in the
child; but the institution says child had no health issues
and all standard tests were done before giving child in
adoption. Parents say they adopted child so ‘we have
someone to take care of us in our old age…not for us to
take care of her health problems’. Child is very
distressed and wants to stay with mother…refuses to
leave her and go into institution.
Case 2
A well-dressed woman (aged between 20 and 30
yrs) comes to CWC with her 4 year old child, a boy.
She says that she wants to relinquish the child and
put him in the institution because she cannot take
care of him. She reports that she is divorced from
her husband, with whom she claims she now has no
contact. She feels that the child is a burden to her
and wants her own life/ does not want the
responsibility of the child. The child looks afraid but
at the same time, when others/ strangers try to
engage him, he does not cry or ask for mother.
(Note: This is an upper middle class family).
Case 3
A 13 year old boy is HIV+ is frequently in and out of
the boys’ home. The previous CWC had made
efforts to place him in institutions for HIV children
but he kept running away from them; they had also
had him treated at NIMHANS but the improvements
were always temporary.
Each time he would come back to boys’ home, he
would instigate other children to smoke cannabis
and join him in breaking windows and vandalizing
property. Some home staff also argued that he
should be sent to the observation home.
Case 4
N is a boy who appears to be about 15 years of
age was apprehended at the railway station for
travelling without a ticket. Both at the station,
and in the children’s home, he is often observed
to be getting involved in violent fights with
others. When inquiry is conducted, his narratives
are very fragmented and inconsistent/ difficult
to understand. He also says others call him
‘hijrah’ and that is when he gets angry. The
Home staff have observed some abnormalities in
his physique—such as development of breasts.
Case 5
P is a 16 year old girl brought to CWC by her
parents who say that she has been sexually
engaging with a 20 year old boy in the
neighbourhood. The girl says she is in love with
him; she also becomes increasingly distressed
when suggestions are made to her about POCSO
case/ police FIRs and medical tests.
Case 6
S is an adolescent, from another state, and
rescued from sex trafficking. She is insistent that
she is over 18 years and for the CWC to release
her. When asked to provide details of her home/
family, she refuses to do so—she is very guarded
in her manner and does not reveal much upon
inquiry.
Reflections…What to Consider…
•
Child’s psychosocial context and issues
•
Child’s right (to decide)
•
The best interests of the child (safety versus risks)
•
Other systems’ responses to the child/ how child
is affected/ how you will respond to systems
•
…based on the above, plan for placement/
reintegration of child into family/referral to
psychiatric facilities…
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Special Clinic for CWC/Child Care Institutions
Referrals
When:
Wednesdays, 11 to 1 pm
Where:
Child Psychiatry Out-Patient Dept. (OPD)
•
Send a letter of referral briefly explaining the
problem of child + CWC’s or institution staff’s
concerns
This review explores complex scenarios involving children in challenging situations within the welfare system. Each case presents unique dilemmas requiring thoughtful consideration and multidisciplinary perspectives to ensure the best outcomes for the children involved. From adoption struggles to health issues, abandonment, and behavioral challenges, these cases highlight the importance of comprehensive psychosocial care in child welfare services.
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Presentation Transcript
Psychosocial Care Review for Child Welfare Committees June 2018 Community Child & Adolescent Mental Health Service Project Dept. of Child & Adolescent Psychiatry, NIMHANS In Collaboration with Dept. of Women & Child Development
What we will do Read each case. Spend actions/response would be. Share your thoughts in plenary so we can obtain multiple perspectives on our work. Think of what you would do at that moment as well as at a later point in time. 2 minutes thinking what our
Case 1 X is a 5 year old girl who was adopted a few months ago. Suddenly, her adoptive parents bring her back, wanting to return her to the institution she was adopted from. They say that they found some health problem in the child; but the institution says child had no health issues and all standard tests were done before giving child in adoption. Parents say they adopted child so we have someone to take care of us in our old age not for us to take care of her health problems . Child is very distressed and wants to stay with mother refuses to leave her and go into institution.
Case 2 A well-dressed woman (aged between 20 and 30 yrs) comes to CWC with her 4 year old child, a boy. She says that she wants to relinquish the child and put him in the institution because she cannot take care of him. She reports that she is divorced from her husband, with whom she claims she now has no contact. She feels that the child is a burden to her and wants her own life/ does not want the responsibility of the child. The child looks afraid but at the same time, when others/ strangers try to engage him, he does not cry or ask for mother. (Note: This is an upper middle class family).
Case 3 A 13 year old boy is HIV+ is frequently in and out of the boys home. The previous CWC had made efforts to place him in institutions for HIV children but he kept running away from them; they had also had him treated at NIMHANS but the improvements were always temporary. Each time he would come back to boys home, he would instigate other children to smoke cannabis and join him in breaking windows and vandalizing property. Some home staff also argued that he should be sent to the observation home.
Case 4 N is a boy who appears to be about 15 years of age was apprehended at the railway station for travelling without a ticket. Both at the station, and in the children s home, he is often observed to be getting involved in violent fights with others. When inquiry is conducted, his narratives are very fragmented and inconsistent/ difficult to understand. He also says others call him hijrah and that is when he gets angry. The Home staff have observed some abnormalities in his physique such as development of breasts.
Case 5 P is a 16 year old girl brought to CWC by her parents who say that she has been sexually engaging with a 20 year old boy in the neighbourhood. The girl says she is in love with him; she also becomes increasingly distressed when suggestions are made to her about POCSO case/ police FIRs and medical tests.
Case 6 S is an adolescent, from another state, and rescued from sex trafficking. She is insistent that she is over 18 years and for the CWC to release her. When asked to provide details of her home/ family, she refuses to do so she is very guarded in her manner and does not reveal much upon inquiry.
ReflectionsWhat to Consider Child s psychosocial context and issues Child s right (to decide) The best interests of the child (safety versus risks) Other systems responses to the child/ how child is affected/ how you will respond to systems based on the above, plan for placement/ reintegration of child into family/referral to psychiatric facilities
Swatantra Clinic Dept. of Child & Adolescent Psychiatry, NIMHANS - Special Clinic for CWC/Child Care Institutions Referrals When: Wednesdays, 11 to 1 pm Where: Child Psychiatry Out-Patient Dept. (OPD) Send a letter of referral briefly explaining the problem of child + CWC s or institution staff s concerns
