Are Child Ombudsmen Possible way for Preventive Psychiatry?
- 1. Department of Child Psychiatry, Comenius University, Slovakia
ABSTRACT
Background and Objectives: Legislation regulates rights also of individuals with mental disorders. Observance of these regulations is monitored by Ombudsman, or the Public Defender of the Rights which was created in Slovakia with the adoption of the Constitutional Act No. 90/2001.
Methods: The Public Defender of Rights paid special attention toward the young generation and also to mentally handicapped children. And this is the ground for collaboration since 2002 with child ombudsmen. They can advocate in prevention of the Child Abuse and Neglect syndrome.
Results: The problematic children receive little attention not only in Slovakia but similar is in many other countries. This is where the child ombudsman could act. Since December 2008 children from Slovak schools selected from their ranks a “child ombudsman” who is willing to defend the rights of every child also with mental problems. The child ombudsmen become assistants of pedopsychiatry.
Conclusion: It has been developed an international cooperation of child ombudspersons for preventing of mental and physical damage. The European Network of Ombudspersons for Children which takes place in 22 European countries, was implemented in a greater scale in April 2010. The children ombudspersons should be arranged in the public healthcare system also for positive mental health in minors.
KEYWORDS
Public Defender of Rights, Mentally handicapped children, Child ombudsman, International cooperation of ombudsmen for children
CITATION
ŠKODÁ?EK I. Are Child Ombudsmen Possible way for Preventive Psychiatry? Ann Pediatr Child Health 2022; 10(7): 1291.
INTRODUCTION
Legislation is a basic framework for ensuring dignity for individuals with mental disorders and for protection of their human rights [1]. It regulates also rights of individuals with mental disorders. In observance of the rights of children, parents have an important role to play, helping their offspring in personality development. Attitudes of teachers are also important and well known is the importance of harmonious family. This applies even more to children with mental disorders.
Observance of these regulations is monitored by so-called Ombudsman, or the Public Defender of the Rights in any given country. The Ombudsman offers faster, less expensive and less formal solutions.
The legal basis for creation of an independent constitutional authority of the Public Defender of Rights in Slovakia was the adoption of the Constitutional Act No. 90/2001 Coll. of February 23, 2001.
Besides general ombudsmen, there are also special ombudsmen with highly specified areas of activity (such as child ombudsman, ombudsman for prisoners, ombudsman for foreigners etc.). Since 2002, special attention has been paid for the developmental problems and issues of rights of ordinary and mentally handicapped children in Slovakia.
THE BIOPSYCHOLOGICAL ASPECTS OF DEFICIENCY AT CHILDREN IN THE FRAME OF CHILDREN RIGHTS.
Past President of American Psychiatric Association L. Hartmann [2], refused contradiction between so-called biological psychiatry and so-call psychological psychiatry. From the viewpoint of biopsychosocial integration, the development of a child is damaged by a defect of genome, high level of some neuromediators of his mother, trauma from the delivery or emotional, intellectual and sociocultural deprivation. The biological basis of the symptoms is temporary or permanent reconstruction of different neuronal maps.
Upbringing and education may mitigate mental and physical deficiencies and integrate the handicapped individual to human collective as a beneficial person. Pediatrics, employees and clients of schools, children’s homes and other educational institutions for children and youths may prove helpful in prophylactic way. They are chosen by children with minimal intervention of educators and other adults. Boys and girls are represented equally. Instructed child ombudsmen can catch up early symptoms of behaviour disorders, disorders of attention and mood in their peers and can better understand them without immediate labelling them by a psychic disorder. And this is the ground for collaborators of the Public Defender of Rights in Slovakia. They are helpful to parents of the minor, to teachers, healthcare professionals and to other adults working with minors. Thus the children ombudsmen become assistants of pedopsychiatry.
THE CHILD ABUSE AND NEGLECT SYNDROME IN THE FRAME OF CHILD PSYCHIATRY
From the viewpoint of a child psychiatrist, it was important to solve cases of bullying, physical punishments, inadequate restrictions, negligence of children in lives of ordinary families, as well as in stressful situations, that are connected to divorce or misunderstandings in school environment. According to psychiatrists, there are cases of active of passive Child Abuse and Neglect (CAN) syndrome of various scope [3].
In statistical overviews, the CAN syndrome may be overlooked under the label of various surgical and psychiatric diagnostic units. Aggressive and violent behavior, such as bullying, among the youths is widespread problem that is present around the globe, resulting in growing number of deaths of adolescents [4]. Also childhood punishments such as spanking, slapping and hitting -even in the absence of full-scale maltreatment- are associated with an increased risk of mental disorders in adulthood [5].
Bullying is widely present at schools and it is growing. Infringement of children’s rights, including those of children with mental disorder and behavioral disorders, may be detected also by their peers that can be called children ombudspersons .A basic responsibility of the children ombudsmen is to report any cases that call for pedopsychiatric or pediatric intervention. Then it depends on the decision-making of child psychiatrist, if child will be recommended to community treatment in the sense of bioethical and medical basis [6].
THE ROLE OF THE PUBLIC DEFENDER OF THE RIGHTS IN CHILD PSYCHIATRY AND COOPERATION WITH THE CHILD OMBUDSMEN.
Since December 2008 was applicated a project for creating the network of child advisors of the Public Defender of Rights is in operation in Slovakia and was supported by schools and other institutions for children. In the practice these ombudsmen were selected by children themselves.
The children ombudsmen protect the rights of their fellow students, by contributing to sympathetic view to possible disorders of a minor.
Appointment of children ombudsmen at schools means improved chances to detect negative phenomena related to children and their families. We expect the children ombudsmen act as mediators between their peers and the Public Defender of Rights in solving their everyday problems. Very important is the cooperation with managements of schools and other institutions for children, with psychologists, educational counselors and other educators, employees and parents.
In Slovakia, only some one of thirty actually existing cases of children with the CAN syndrome undergo professional pedopsychiatric examination that represents 5300 children in one year. Similar problems may be expected in many other countries.
Preventing occurrence and development of mental and physical damage is one of the most important tasks of every society. Especially now a days no one should make excuses that there are no monetary funds for that. A significant development of international cooperation of ombudsmen for children takes place in 22 European countries within the ENOC (The European Network of Ombudsmen for Children), which was commenced in a greater scale in 2010. In April 2010, a project called ENYA (ENOC Network of Youth Advisors) started – it is designed for the discussion of the young collaborators on such subjects as education, internet and privacy, violence and health.
DISCUSSION
The cooperation of the children ombudsmen with the Public Defender of Rights and with child psychiatrists contributes to locating children with problems and to healing of their sorroundings.
The aim of child ombudsmen is to sensitize the society to numerous demonstrations of intolerance or violence and to regulate activities of the minors so that they behave in socially adequate ways. This will contribute to reduction of the number of socially negative cases of conduct among youths, as reported in The Foundation for Child Development on conditions of children [7].
The child ombudsmen may act in various developing countries around the globe as effective defenders of the children´s rights. They can assist in helping children and youths in localities with less developed pedopsychiatry, lack of teachers and pediatricians in primary healthcare, weak social network. In this way, the child ombudsmen contribute to increased protection of rights of the child and mental health of their peers in coordination with the environment in which they live and grow.
The project of child ombudspersons should be one of the possible ways how World Psychiatric Association (WPA) contributes to creation and insemination of the principles of preventive psychiatry, where narrower international collaboration may be applied [8].The WPA supports the development of community, when it has happened too often that families of discharged patients also with severe mental illness have been left alone with their problems [9]. From dynamic point of view the project of child ombudspersons constitutes practical support Vaillant ´s seven models for conceptualizing positive mental health in minors [10].
DECLARATION OF INTEREST
The author declares that there are no financial or nonfinancial competing interests in this work.
REFERENCES
2. Hartmann L. Presidential Adress:Reflections on Human Values and Biopsychosocial Integration. Am J Psychiat. l992; 149: 1135-1141.
4. Preidt R. Youth Violence Knows No Borders. Health Day. 2005.
7. Land K. Children today doing better than parents were. 2005.
8. Lecic-Tosevski D, Christodoulou GN, Hosman C, Jenkins R, Newton J, Rajkumar S, et al. Consensus Statement on Psychiatric Prevention. WPA The Section´s Newsletter. 2003; 6: 6-8.
