The Week Magazine...Society

It hasn't taken long for a notice like this to leapfrog from the corporate office to the classroom. Jostling with happy drawing s and invites for trekking camps it urges children to come for a special workshop. Ten-year-olds are being trained to deal with stress!

Pressure has invaded the carefree confines of childhood. If psychiatrists in cities like Mumbai are to be believed the age group of clients is falling. Children may not be flocking in hordes but there is a steady flow none the less. And as Jesuit priest Berkie D'souza says, "The child is the symptom, the client is the family."

Dr Harish Shetty, a psychiatrist in the city, is chatting up eight-year-old Ankita, a familiar face in television commercials, in his consulting room while her distraught mother looks on. The doctor tries to make her comfortable by talking about school and friends. He asks her to draw a story in pictures. The girl sketches two animals. "She explained it to me saying that a little bear approaches the mother bear and hen she does not get a bowl of milk from her, she claws mama bear and snatches the bowl. The story revealed the child's feelings," says Dr. Shetty.

A few days earlier Ankita had picked up a knife in the kitchen and told he mother that she would hit her. The horrified mother took her to a child specialist who, in turn, referred her to Dr Sherry. After a series of consultations he traced the root of the problem. "There was marital discord as a result of which the father was indifferent and criticised Ankita while the mother was over-indulgent," says Shetty. The child became inattentive in class and threw tantrums. "It was a cry for help," says the doctor who counselled the parents to sort out their differences of that Ankita had a more healthy environment at home.

Very often children requiring psychiatric help manifest a deeper problem in the family. Sunil, 9, found it difficult to keep awake in class. On the teacher's advice, the boy's mother met Dr P.C. Shastri, consulting psychiatrist, who discovered that Sunil's father was an alcoholic who quarreled with his wife at night. The couple would then make love and fall asleep. "But the boy would be traumatised and keep awake. He would sleep in the class because that was the only peaceful place," says Dr Shastri. He counselled the parents first - the father for his alcohol abuse and advised the mother to deal tactfully with her husband instead of nagging him.

PSYCHIATRIST and psychologists agree there is a rise in the number of children requiring treatment. These kids do not suffer from any mental illness and are normal in every respect. One of the main reasons for the growing number of young clients is the increase in awareness. "If there is any lag on the part of their child in comparison to others, parents do not hesitate to consult mental health professionals," says Dr Shetty.

According to Dr Hemangee Dhavale, head of psychiatry department at the BYL Nair Hospital, a municipal hospital, there is an increase in awareness even among the poorer sections which has led to more children coming for treatment. Often the patients are referred by the teachers of municipal schools but the better educated parents approach them directly.

She cites a case of a six-year-old boy, the only child from a rich family, who would beat his mother and grandmother and throw tantrums till they gave in to his wished. "In family therapy we teach behaviour modification. It is bad to be too strict or too lenient but the worst is inconsistent discipline," says Dr Dhavale. The boy's misbehaviour was a result of pampering and family members had to be reoriented.

Usually doctors succeed in resolving problems through psychotherapy, but there is the occasional failure. Ravi, 13, was disobedient, aggressive and disinterested in studies. When he was brought to Nair Hospital, the doctors found that the root cause was the disciplinarian father who quarreled with the mother and thrashed the boy. Despite their efforts, the doctors could not persuade the father to change. "So we helped Ravi and his mother become more understanding towards the father," says Dr Dhavale.

Often severe depression and conduct disorders need psychotherapy yet most kids are not taken to experts for these problems mainly because of the stigma attached to it. "Counselling deals with superficial issues and the goal is resolution of the issue. Psychotherapy, on the other hand, takes into consideration the broader picture including the child's coping mechanism," explains Dr Shetty.

The child may not verbalise his problem as depression but a doctor can diagnose it if help is sought early. When Shivankar, 12, refused to go to school one day, his father, a bus driver, was worried. A top-ranker in class, Shiv's poor appetite and fitful sleep added to his worry. Dr Shetty realised the boy suffered from depression and put him on medication, Two years later Shivanker is doing well in school but is still on medicines.

A little stress, as the doctor say,is essential for a challenging life but when it goes above the danger mark it can gradually disease both mind and body. "Parents face demands in their jobs and they in turn become demanding with their children. The stress is passed on," explains Brinda Jaising, counselling psychologist who is also a school counsellor.

Mental turmoil often manifests in physical ailments in children. "Anxiety is a defence mechanism to help us find solutions to problems. But too much anxiety leads to symptoms like giddiness and palpitations. Gastro-intestinal complaints too are common because of over-activity of the autonomic nervous system," explains consulting psychiatrist Dr Nand Katara, who has treated several children after they had been to child specialist.

THE EXTREME result of stress is an attempt for a quick end. People in Mumbai were taken by surprise by the suicide attempts by children in the last few months. Chandrakant Deshmukh, 16, a tenth standard student of the Marathi medium Chogale High School in Dahisar, set himself on fire in his Borivli home, in February. His parents left the city immediately after the tragedy but his classmates reveal that tough Chandrakant was not a high scorer in tests, he was a normal boy. "We feel that he had problems with the new syllabus," say his classmates.

A 14-year-old student of St. Anthony's School in Mumbai jumped from a building after her name was announced over the public address system for cheating in an exam. In Delhi, Payal Sharma, 13, torched herself after returning home despondent from the annual examination. Another 15-year-old hung herself as she felt she would flunk her maths test.

This year there have already been seven suicides among children in Delhi, two in Mumbai and one in Calcutta and Chennai. Many more cases go unreported. For most children, examinations have come to mean emotional stress and trauma. For parents as well. Listen to Dr Harmeet Bajaj of Mumbai whose daughter Sakshi appeared for her board exam this year: "Our house was like a jail for two months. Visitors were no welcome. We didn't go out and my husband took two weeks off from his job to teach her. But she doesn't seem to have fared too well. It's taken away all our happiness."

The academic pressure is only a part of the problem. "The cases of suicide cannot just be attributed to exam pressure," says Shyama Chona, principal of Delhi Public School. 'What works to the detriment of students is the pressure by parents and their immediate circle." Adds Dr Achal Bhagat, a psychiatrist at Delhi's Apollo Hospital, "Parents sometimes give a subtle message to their child that he or she has failed them. The kid is shattered a depression sets in."

According to Prof M.K. Raina of the department of educational planning, NCERT, "Many public schools have started the trend of producing super kids and in the process they are bypassing the natural grooming of a child." The situation is alarming. A study conducted by the ministry of human resources development said that 75.36 per cent of the students abandon school for the fear of examinations. This is their way of retaliating against the education system. "Unless we set in a revolutionary thinking in our education planning, things will go from bad to worse," warns Raina.

The burden of academics is not the only reason for suicides by children, though. Dr. Shahstri of Mumbai gives the example of a 14-year-old girl who consumed poison because she could not bear the guilt of an abortion and her parent's rejection. When Suraj, 14, failed in class with , his father , a mill worker, beat him and the family stopped talking to him for days. Unable to bear the humiliation, Suraj went to a well and was about to jump when he as spotted and brought home. "The parents were not willing to believe that Suraj attempted suicide because of his failure and their attitude," explains Dr Shetty.

OPENING UP of the economy, satellite television and multi-media exposures have give rise to a class of children smarter, brighter and more aware of the world and their rights. It is not easy to dismiss them with an I-tell-you-so-do-it attitude. They need rational reasoning but how many parents, spinning in their own pressure mills, have the time or energy to be logical with kids?

Eight-year-old Manish was so terrified of his father that the boy would hide under the bed when he returned from work. Realising that Manish's attitude towards him was unhealthy, the father consulted Dr Shastri. "I advised him not to lose his temper and to be less strict with the boy. But it was difficult for him to change," says Shastri. One evening the father, learning that Manish had not done his homework, yelled at him, "I'll kill you!" The terrified boy ran to the next room and jumped from the fourth floor!

"The father of a 10-year-old boy came to me because he was shocked when his son told him that he felt like jumping from a building," reveals Dr Shetty. The boy was a first-ranker. The doctor discovered this his mother suffered from depression and quarreled frequently with the father after she stopped medication. "The mother had to be put back on medicines, the father had to be treated for stress and the boy for depression," says Shetty.

The child may show symptoms before taking a drastic step such as suicide. "If a child is vulnerable and bottles up hurt and fear without recourse to coping mechanisms like crying and talking, the backlog builds up. The precipitating cause may be minor but it is the last straw," says Fr. Berkie D'souza, who is director of the Xavier Counselling Services in Mumbai.

The high-risk population is, however, adolescents and university students. "February-March is the season when even brilliant students break down. This is because they have been studying non-stop for one year," says Shastri. Forced to spend every free moment buried in books, the children either develop an aversion to studies or crumbling during crucial exams and if the results are bad, end their lives rather than face unforgiving parents.

But what do parents do when their children refuse to study? "I lose my temper fast. My son has to be forced to study, " says Asha Dhaval who has sons aged 10 and 12. "There is so much tension at home. We have all the luxuries but here is no peace of mind."

Asha has consulted her brother, a psychiatrist, and he advised her to spend more time playing with her son. "I have attended several seminars on how to deal with kids. I know all these things but it is so difficult to put them into practice," says the housewife who is a commerce graduate and a talented singer but decided to concentrate her energies on her sons. "My life has taken a backseat."

Many educated housewives don't get an outlet to express themselves. "They become irritable and tend to cry more easily and this depression is reflected in their kids," says Dr Shastri. Asha's son Dhaval Savla, 12, has had enough of all the coazing by his parents to make him study. "I like school because I can meet nay friends but I hate studies," says the sixth grader.

He has his own plans for the future. "I have decided to become a cricketer. I am confident I can get into the Indian team, so I won't study after class 10," he says firmly. Says Asha dejectedly: "I am so angry with the education system for robbing my son of his childhood. Sometimes I feel it is better to buy question papers!"

STUDENTS of municipal schools too, where education is largely free, complain of similar symptoms. The causes too are common: tension at home and inability to cope with heavy academics. What is different is the curse of poverty. Nilesh Takpire, 15, a class eight student of the Colaba Secondary School, a municpal school, failed in the previous year. His father stopped working two years ago because of a serious liver problem. But he is still a heavy drinker, stealing money from his wife, beating her after a day of hard drinking.

Nilesh shares a single room with a dozen family members. "I would like to study in an English medium school because the prospects for a good job are better, but I can't afford it," says Nilesh who works in the corporate office of ITC, earning Rs 350 a month. "We have new subjects this year; I have a lot of tension studying for exams." Another student of the Colaba school, Navanath Kondiram, 145, is slightly better off with both his parents employed in the docks as fish cleaners. "I know my parents fight but never in front of me. My father help me in my studies," says Navanath. "But I do wish we had more money so we could live in a better house and have some of the things other kids have ," says the boy who wants to become a teacher.

"Our teachers have to constantly motivate the children to study as 60 per cent of parents are illiterate," says Varsha Khanolkar, the principal of the Colaba municipal school. But she does not feel that a counsellor is an urgent need in the school. "Our teachers are counsellors." This was not the view of a former head of the department of psychiatry in Nair Hospital. In 1979, the international year of the child, the hospital commenced a unique programmed called the school mental health clinic. "If you help a child may be you can prevent psychiatric problems when he grows up," avers Hemangee Dhavale.

The programme involves two teams from the hospital, one of which visits the various municipal schools in Mumbai and helps teachers identify problem children. The cases that cannot be handled by the team re- referred to Nair Hospital. These include hyperactive children, irregular students and those who abuse other students. Realising the importance of training teachers on mental health in normal children, the hospital organises special course for them.

"We place a lot of importance on preventive psychology by emphasising early detection and treatment. Because of increasing stress in children, teachers have to be specially trained," says Dr Padmini Shetty who retired last month as the medical officer (schools) of the Brihanmumbai Municiapal Corporation.

Treatment mainly involves play therapy. "We give them games according to their interests and intelligence. It helps us strike a rapport with the child," says Dr Dhavale. Through the school mental health programme, the hospital treats over 1,000 cases per year.

"Behaviour cannot be separated from learning problems. Children sometimes don't study because they cannot concentrate. The could be hyperactive or have an attention deficit disorder," points out Anureet Sethi, a clinical child psychologist.

When a six-year-old student of a school in Chembur started hitting and biting his classmates, the teacher could not control him. When all methods of disciplining failed, the boy was taken to Anureet. 'We found that the boy had an eye problem; he could not see the blackboard,' says Anureet. After the problem was checked , there was a marked improvement in his behaviour.

It is not only parents worried bout a child's scholastic backwardness or misbehaviour who consult psychiatrist. "Highly talented children keen on improving their performances also come. They have the sills but want to learn how to achieve their best without breaking down," says Dr Shastri who advises Mira Parikh and her husband on how best to guide three-year-old Punishi, an exceptional child. "She loves studying and deeps asking questions," says Mira who is amazed at her daughter's insatiable interest in general knowledge.

Psychologists like Brinda Jaising believe in a wholistic approach. She conducts regular workshops on parenting sills and for children on time management, relaxation techniques and study skills. "Regular study habits should be taught from the beginning. Children should be helped to respond rather than react," says Brinda.

MUCH OF the stress today's children face may disappear soon if D. Edulberhram's words turn out to be true. "We are in the information age and we will have to equip children with the skills of information retrieval and logical thinking. This kind of stress will not be there in five years, " says Edulberhram, director of the Lilavatibai Podar High School.

"Learning will be a joyful experience because children will participate in their own education," she adds. "The child's individuality has to be respected." The need for counsellors in schools cannot be dismissed as a luxury. At a time when many parents spare little time for heir children, counsellors can act as the first line of defence against stress-related ailments. Understanding the urgency of counselling, Berkie D'souza has devised a unique post-graduate diploma in counselling psychology. He also has special programmes for parents. "It (parenting) is the only job one does not need a qualification for except a biological quality! But it is crucial to provide parents the sills," he says.

Indeed, it is the parents who will have to look out for behavioural changes in children. "We have to sensitise and empower parents and teacher for mental health," says Dr Harish Shetty. Maybe then the distress signals can be picked up more easily, helping kids traverse childhood's fast lane at a more comfortable pace.

Doing it for Sukanya

SANJIT SENGUPTA, a senior manager in private firm in Calcutta, could have allowed the tragedy to engulf his life. Instead he chose to reach out beyond his own pain and hear other cries of help. He started Crisis Intervention, a forum to fight frustration among children and adolescents last July.

It was the result of a seminar he coordinated on February 22 last year (his daughter's birthday) where eminent mental health professionals, sociologists and parents discussed frustrations among school children. "I took my cue from the tremendous response," Sengupta told THE WEEK. Though his only daughter Sukanya is no more, she is the force behind the forum. A class 10 student, she would tell everyone that her father was her best friend. She shared an enviable relationship with him, discussing everything with him.

No entirely. On December 1, 1995, Sukanya ended her life by jumping off a high rise. She was disappointed by the low marks she scored in English in a class exam. Keen on becoming a journalist she was a cub reporter for a couple of Calcutta newspapers. "She was very ambitious and could not accept her limitations," says Sengupta trying to find a reason for his daughter's tragic action.

"Today's children are very sensitive. Even if parents don't pressure them, they sense the expectation. If someone like Sukanya, with whom we had a such an open relation, could do it, there may be so many other children with worse problem," says Sengupta who got an overwhelming response after he wrote an article in the Anand Bazar Patrika. He gave his telephone number and urged students to call him to share their problems. He got over 400 letters and 200 calls!

Crisis Intervention meets on Sundays where the young teenage volunteers share their experiences. Sengupta and his wife Sanjukta have become kaku and kakima (uncle and aunty) to hundreds of students in Calcutta who come to then for advice. "We insist that children should come with their parents because very often parents are not even aware their children have a problem," says Sengupta.

MARIA ABRAHAM

	April 13, 1997
THE TENSION IS KILLING An increasing number of children are seeking help from psychiatrists in Mumbai.