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Year : 2022  |  Volume : 4  |  Issue : 2  |  Page : 69-77

A Review of Intersection of Social Determinants and Child and Adolescent Mental Health Services: A Case for Social Psychiatry in Pakistan

1 Founder & CEO, Synapse Pakistan Neuroscience Institute, Karachi, Pakistan
2 Consultant Child, Adolescent, and Adult Psychiatrist, Karachi, Pakistan

Correspondence Address:
Dr. Ayesha I Mian
4th Floor, 13 GPC, Rojhan Street, Block 5, Clifton, Karachi 75600
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/wsp.wsp_23_22

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Pakistan faces the accelerated growth of a young population each year. The country's many structural challenges include an unstable economy, poverty, gender inequality, health disparities, and vulnerable systems (especially sectors serving education and justice). The advent of the 21st century has witnessed rapid societal change globally. This societal evolution has inevitably shaped the sociocultural landscape for Pakistan's children, families, and childrearing practices as well, yet the social determinants remain stacked against them. Although children make up one-third of the Pakistan population, they remain the most physically, economically, and socially vulnerable group. For children growing up in low-income families, which are the majority, these challenges are magnified to a greater degree. These children are more likely to experience multiple family transitions, frequent moves, and change of schools. The schools they attend are poorly funded, and their neighborhoods more disadvantaged. The parents of these children have fewer resources to invest in them. Thus, the home environment becomes less cognitively stimulating, and parents invest less in education. Living in poverty and struggling to meet daily needs can also impair parenting. Socioeconomic deprivation during childhood and adolescence can have a lasting effect, making it difficult for children to escape the cycle of poverty as adults because the adverse effects of deprivation on human development accumulate. Health services for children are also underresourced. This state is evident by the extreme shortage of child and adolescent mental health (CAMH) services in a country with a significantly high disease burden among children and adolescents experiencing mental health disorders. The article examines the social determinants of CAMH in Pakistan and their implications for the orientation and effectiveness of child mental health services.

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