Mental health status of children (14-17 years) in conflict with law residing in the correction homes in Bagmati Province, Nepal: a mixed method study.

backgroundChildren in conflict with the law are predisposed to mental health difficulties as they are already a vulnerable, misunderstood, and frequently stigmatized group. This mixed method study assessed the prevalence and associated factors of Depression, Anxiety, and Stress (DAS) among children (14-17 years) in conflict with the law.

methodsA cross-sectional study was conducted from December 2022 to March 2023 using a mixed method approach among children (14-17 years) in two correction homes of Bagmati Province. The census was conducted due to the small population size. Nepali versions of the DASS-21 were administered to 182 children aged 14-17 years to collect quantitative data. The Depression Anxiety Stress Scales-21 (DASS-21) is a shortened version of the DASS-42, designed to measure emotional states of depression, anxiety, and stress comprising 21 items divided into three subsc ales. Key informant interviews were conducted with wardens and psychosocial counselors of correction homes. Data were analyzed using SPSS-21, and a thematic analysis handled qualitative data.

resultsMore than half of the respondents had depression (58.2%) and stress (52.2%), while anxiety was prevalent among 76.4% of children (14-17 years). The odds of having depression were more than double among females in comparison to males (AOR = 2.25, 95%CI = 1.68-7.47), which was 5.43 times (AOR = 5.43, 95% CI = 1.42-20.72) in the case of stress. Similarly, the odds of having depression among the respondents who live with persons other than parents were 4.11 times more likely as compared to those who used to live with parents before coming to the corrections home (AOR = 4.11, 95% CI = 1.37-12.27, which was 5.21 times (AOR = 5.21, 95% CI = 1.25-11.72) for anxiety. The respondents who were isolated from family were 12.57 times (AOR = 12.57, 95% CI = 3.58-44.17) more likely to have anxiety than those who were not isolated from the family, adjusting for other explanatory variables included in the model. Family history of conflict (AOR = 1.84, 95% CI = 0.82-4.13) and history of punishment (AOR = 2.10, CI = 1.13-4.41) were also found to be correlated with depression and stress, respectively. Mental health issues were linked to family conflict, broken homes, abuse history, and isolation, supported by key informant interviews as well.

conclusionMore than half of the children (14-17 years) in conflict with the law were having all three types of common mental health problems. These results highlight the urgent need for comprehensive and tailored intervention to address the mental health needs of the children in conflict with the law.