Street Children and Mental Health By Dr. Gloria Karuri.

INTRODUCTION
According to the United Nations Children’s Fund (UNICEF), estimated tens of millions of children are living and working on the streets (UNICEF, 2006). A “street child” by a definition adopted by UNICEF, is any child (girl or boy) below the age of 18 years (United Nations Convention on the Rights of the Child, 1992) for whom the streets (in the widest sense of the word, including unoccupied dwellings, wastelands etc.) have become his/her habitual abode and or source of livelihood; and who is not properly guided supervise or protected by significant adults.

Along the lengths of most streets in West Africa are several millions of children hawking and begging passersby for means of survival. According to studies, over seven and a half million children are roaming aimlessly on the streets of Nigeria. A recent report by the Universal Basic Education Commission (UBEC) put the figure at 9,961,699 (approximately 10 million) street children. Some of these children are accompanied by older siblings or parents as begging or hawking, while majority are unaccompanied and may sleep on the streets. Street children are reported to often be found in busy places such as railway stations, bus stations, in front of film or night clubs, with no adult supervision, sleeping in half-destroyed houses, and abandoned basements, under bridges and in the open air. These children’s early experiences on the street, which are largely unsupervised, could result in mental and other health-related problems which are likely to remain with them even in adulthood. According to UNICEF, the street children phenomenon presents one of the most complex challenges in low- and middle-income countries for policy makers today.
According to the world health organization, mental health is an integral and essential component of health. The WHO constitution states that: mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, and is able to be productive and contribute meaningfully to his/her community. Mental health is fundamental to our collective and individual ability as humans to think, emote, interact with each other, earn a living and enjoy life. On this basis, the promotion, protection and restoration of mental health can be regarded as a vital concern of individuals, communities and societies throughout the world.

MENTAL HEALTH PROBLEMS
According to recent studies on mental health in West Africa, street children were found to be prone to traumatic experiences. There is a general feeling of hopelessness amongst street children and a greater prevalence of suicide among female street children. Schizophrenia, depression, hopelessness and suicide ideations, among others are the commonly observed psychiatric disorders among African street children.
Recent studies have reported a prevalence range of about 35 to 100% psychoactive substance use and abuse among street children. The age of initiation was between 10 and 13 years for street children who commonly use and abuse substances such as alcohol, cigarettes, inhalants, cocaine, marijuana, amphetamines, heroin, shoemakers glue, correction fluid, paint thinner and coca paste, with a higher prevalence reported among of the-street children than on-the-street children. Countries like South Africa, Kenya and have been rated high in substance use abuse among street children. Access to psychoactive substances in these countries are relatively easy due to non implementation of laws regulating purchase, use/abuse. The reasons given by street children for using psychoactive substances included coping and fitting into street life circumstances, boldness to withstand violence, survival sex, pleasure, to curb hunger, to induce sleep, to numb emotions and for entertainment, depression, lack of family contact.
Factors like Poverty, Divorce, separation of parents, death of one or both parents, economic decline, single-parent households, child abuse, neglect, alcohol abuse, school dropout, family size and traditional values have been associated with children’s vulnerability to street life. Parental deprivation, physical, emotional and other forms of abuse, hunger and disease all combine to place street children at risk. Substantial evidence have consistently linked early onset of substance use to mental and neurological disorders and difficult childhood experience as exemplified by the life of a child who has to fend for himself on the street is also a documented predisposition to future mental health problems. Nigeria

SPECIFIC WAYS TO PROMOTE MENTAL HEALTH INCLUDE (WHO)
• Early childhood interventions (e.g. providing a stable environment that is sensitive to children’s health and nutritional needs, with protection from threats, opportunities for early learning, and interactions that are responsive, emotionally supportive and developmentally stimulating);
• Support to children either through education or skills acquisition
• Socio-economic empowerment of women through improving access to education and microcredit schemes will translate into better conditions for the children
• Programmes targeted at vulnerable people, and people affected by conflicts and disasters (e.g.
psycho-social interventions after disasters);
• Mental health promotional activities in schools
• Housing policies to ensure more families have own homes
• Violence prevention programmes like reducing availability of alcohol and access to arms by children
• Community development programmes
• Poverty reduction and social protection for the poor
• Promotion of the rights, opportunities and care of individuals with mental disorders.
Isana Centre for Information and Substance Abuse Treatment (ICISAT) joins the rest of the world in remembering the International Day of the Street Child, believing that as a Country, we will take seriously the plight of our street children and look for ways of making this Country a better place for mankind especially our dear children on the streets, the leaders of tomorrow.

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