Child psychiatry takes to the streets: A developmental partnership between a university institute and children and adolescents from the streets of Sao Paulo, Brazil

Abstract

Objective High levels of domestic violence, mental illness, and alienation from authorities are associated with high incidence of children/adolescents living on the streets in low and middle income countries. The Equilibrium Project (Programa Equilíbrio) was created to facilitate social reintegration through a virtual partnership between an academic psychiatric institute and highly vulnerable children and adolescents living on the streets, in group shelter with supervision, and in other high risk situations. Methods Descriptive presentation of qualitative data and analysis of preliminary empirical data collected over a 24-month period. Results Dialogue between academic professionals, street children, and city officials shaped The Equilibrium Project over the last 2 years. The program has progressively moved from a professional clinic setting to a community-based but protected activity center with recreational and professional services and an emphasis on linkage with social service agencies, city government and law enforcement officials in an academic research context. A total of 351 patients have been served of whom virtually all were neglected by their parents, 58.4% report physical or sexual abuse, 88.89% have been diagnosed with a psychiatric disorder, 40.4% drug use. After 2 years of operation, 63.5% ( n = 223) successfully completed or continue in treatment and 34.8% ( n = 122) were reunited with their families. Conclusions and Practice implications Program development guided by consumer input led to a successful program offering professional services in a protected community setting that facilitates social reintegration by providing “go between” services integrating relationships between alienated consumers and formal psychiatric, pediatric, social service, and criminal justice systems.