Deca i mladi u institucionalnom okruženju – karakteristike mentalnog zdravlja dece u Centru za zaštitu odojčadi, dece i omladine u Beogradu
Sažetak
Uvod/Cilj. Nepovoljna životna iskustva dece i mladih, nezadovoljene emocionalne potrebe u ranom uzrastu mogu dovesti do teškoća u emotivnom životu i mentalnom zdravlju ili do eksternalizacije problema. Cilj rada bio je da se utvrdi broj dece u Centru za zaštitu odojčadi, dece i omladine (u daljem tekstu Centar) u Beogradu sa problemom mentalnog zdravlja, njihove životne okolnosti, kao i način na koji se problemi manifestuju. Metode. Ispitivanjem su obuhvaćena sva deca na smeštaju u Centru (n = 486), u toku 2015. godine. Istraživanje je sprovedeno u periodu od februara do aprila 2016. godine. Za potrebe istraživanja sačinjen je upitnik za ispitivanje problema mentalnog zdravlja dece. U istraživanju su učestvovali zdravstveni i socijalni radnici. Upitnik o zdravstvenom
statusu dece popunjavan je podacima iz zdravstvene dokumentacije, a socioanamnestički podaci su preuzeti iz dokumentacije socijalnog radnika. Istraživanjem su obuhvaćena četiri doma za decu bez roditeljskog staranja uzrasta od 7 do 18 godina, 3 prihvatilišta za decu uzrasta od rođenja do 18 godina i Radna jedinica (RJ) Stacionar (deca sa teškoćama u razvoju), uzrasta od 4 do 18 godina. Rezultati. Od ukupnog broja dece na smeštaju u toku 2015. godine (n = 486), 96 (19,8%) dece je imalo dijagnostikovane probleme mentalnog zdravlja. Najčešće dijagnoze bile su F90-F93 (poremećaji ponašanja i emocija koji se obično ispoljavaju u detinjstvu i adolescenciji); F70-F72 (mentalna retardacija) i F30-F32.3 (poremećaj raspoloženja – afektivni poremećaj). Sa već dijagnostikovanim problemima mentalnog zdravlja u ustanovu je primljeno 41,7% dece sa jednom dijagnozom, dok je 21,8% dece imalo dve, tri ili više dijagnoza; 36,5% dece i mladih dobilo je dijagnoze nakon smeštaja u ustanovu; 74% dece imalo je više od jedne životne promene do dolaska u Centar. Prosečno životno doba dece na prijemu bilo je 11 godina, iako je bilo odstupanja u dva doma za decu (15 godina). Ukupnio 21% dece bilo je hospitalizovano posle intervencije Hitne medicinske službe. Neadekvatno roditeljsko staranje bilo je najčešći razlog za smeštaj dece u RJ domske zaštite, kao i sprečenost roditelja da vrše roditeljsko pravo (76%). Neadekvatno roditeljsko staranje se kod 2/3 dece ispoljavalo kao zanemarivanje, a kod 1/3 dece kao zlostavljanje. Zaključak. Život u instituciji može dovesti do mnogobrojnih problema u dečjem razvoju. Rezultati istraživanja nedvosmisleno pokazuju da su deca i adolescenti smešteni u sistem socijalne zaštite vulnerabilna populacija i pod značajno većim rizikom od razvoja mentalnog poremećaja, s obzirom na činjenicu da od najranijeg detinjstva trpe negativne uticaje i nedostatak pozitivnih emotivnih stimulusa. Kako će se boravak u sistemu socijalne zaštite odraziti na dete zavisi od uzrasta deteta, dužine boravka u instituciji, prethodnog porodičnog iskustva deteta i životnih promena koje je imalo.
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