Social and educational risk factors for child mental health problems in Karachi, Pakistan

Abstract

There are limited studies examining risk factors associated with child mental health problems in developing countries. To explore the association between social and educational factors and child mental health problems among primary school age children in Karachi, children aged 5–11 years were randomly selected from 27 mainstream schools in Karachi. The Strengths and Difficulties Questionnaire and a socio-demographic checklist were completed by 968 parents and 793 teachers. Poor physical health, male gender, urban neighbourhood, head of family other than father figure, school type (government and community), lower teacher's qualifications, less teaching experience, poor child school attendance and academic performance were significantly associated with the likelihood of child mental health problems. The multiple factors associated with child mental health in Pakistan are broadly consistent with previous findings from other countries. Public health and education programmes to foster child mental health require multiple targets. As Pakistan does not currently have any organized child mental health services, it is important not only to develop specialist services but also to disseminate basic assessment and treatment skills more widely to other professionals, including teachers and paediatricians, and also to establish strong links between frontline and specialist services.