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Children and youth in the institutional setting - mental health characteristics of children from the center for protection of infants, children and youth in Belgrade

Background/Aim. Unfavourable life experiences of children and youth, unmet 
 emotional needs in early age may lead to difficulties in emotional life and 
 mental health or externalizing problems. The objective of the paper was to 
 determine the number of children in the Center for Protection of Infants, 
 Children and Youth (hereinafter Center) in Belgrade who have mental health 
 issues, their life circumstances as well as the way their issues are 
 manifesting. Methods. The research covered all children in residence (486) at 
 Center during 2015. The research was implemented in the period from February 
 to April 2016. For the needs of the research a questionnaire examining the 
 children's mental health issues was developed. Both health workers and social 
 workers participated in the research. The children's health status 
 questionnaire was filled in from their health records while social an 
 amnestic data came from the social worker's records. The research included 
 four group homes for children without parental care ages between 7 and 18 
 years, 3 children's shelters for children since birth to 18 years, and the 
 organizational unit Infirmary (children with developmental dificulties), aged 
 between 4 and 18 years. Results. Out of the total number of children placed 
 in institutions during 2015 (486), 19.7 % or 96 children have got diagnosed 
 mental health issues. The International Classification of Diseases of the WHO 
 organization ICD 10 was used in this paper. (1) The most frequent diagnoses 
 are F90-F93(behavioral and emotional disorders usually occuring in childhood 
 and adolescence); F70-F72 (mental retardation); F30-F32.3 (mood 
 disorder-affective disorder).The percentage of children with mental health 
 issues diagnosed prior to their admission was 41.7% with one diagnosis while 
 21.8% had two, three and more diagnoses. 36.5% of children and youth got 
 their diagnosis after being received to the institution. 74%of children had 
 more than one life change prior to the arrival to Center. Average age of 
 children was 11 years although there were deviations in two group homes (15 
 years). 21% of children were hospitalized after the paramedic emergency 
 intervention. Inadequate parental care was the most prominent reason for 
 institutionalization into the organizational units of children's homes, as 
 well as the inability of parents to exercise their parental right (76%). 
 Inadequate parental care was neglect in 2/3of cases while in 1/3 of cases it 
 was abuse. 4 Conclusion. Living in an institutional setting can lead to a 
 number of problems in a child development. The results of the research 
 unequivocally show that children and adolescents placed in the social 
 protection system are a vulnerable population and at a significantly higher 
 risk of developing mental disorders, considering the negative influences and 
 the absence of positive emotional stimuli from the earliest childhood. What 
 the consequences will be due to the stay in the institution depends on the 
 age of the child, the length of the stay, his previous family experience and 
 the life changes that the child had.