Volume 3, Issue 1 –March 2013


Childhood adversities and subsequent mental health: Its relevance to South Asia

The role of the family in the causation and maintenance of mental illness and its recovery process is complex. The family plays a significant role in the development of a person’s personality. The nature of the relationships has an effect on the individual’s ability to cope in adversity and adapt to stressful situations.

Families are different from country to country as well as within a community. Traditionally families in Eastern countries are regarded as extended; whereas Western families are regarded as nuclear. Typical extended families however are rarely encountered in countries like Sri Lanka at present. Sri Lankan families are neither typical nuclear nor extended. In other words, families continue to evolve even in developing countries.

A positive aspect of our families is that the members within the family still have close ties with each other and also with other relatives and friends. In childhood, adverse family environment can give rise to problems in their developmental stages. It is known that the characteristics of the families, social relationships and the child’s development are intricately linked as the family acts as a powerful mediating factor in determining coping strategies of their members in various problematic situations including problems with health (Wilkinson, 1998). Erikson’s original work attempted to show a link between the personality development and socialization by describing various stages (eight stages) of life.


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by Kuruppuarachchi KALA


Disease versus Illness in Mental Health: The use of Narratives and Explanatory Models to bridge the gap

Summary: The core of any therapeutic activity is the clinical interaction between the patient and the clinician. Patients attend the session having followed a certain pathway into care and expecting a particular kind of help or intervention. Often this expectation is influenced by their age, gender, social status and explanatory models which determine what they see as the cause of their distress and what intervention will alleviate it. In addition education and economic status will also influence explanatory models. In this paper we describe the application of explanatory models in managing patients. There is no doubt that culture will affect this approach which will be particularly useful for south Asia.


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by Nooriya Uddin, Sean Cross, Dinesh


Job satisfaction and mental health of Sri Lankan doctors


Aim: To measure job satisfaction and mental wellbeing among medical practitioners working in Gampaha District, Sri Lanka.

Methodology: A cross sectional survey was conducted on randomly selected doctors working in three large hospitals in Gampaha District, Sri Lanka in 2008 and 2009. Warr, Cook, and Wall job satisfaction scale and the 12-item General Health Questionnaire were used respectively to measure job satisfaction and mental health wellbeing of doctors.

Results: A total of 172 doctors responded (response rate 28.6%). Average job satisfaction score was 47.8 (range- 10-70) and 43.6% of doctors reported high job satisfaction.  Better remuneration (97.1%) and better working hours (44.8%) were identified as ways to improve job satisfaction. Average GHQ-12 score was 1.9 and less than 10% scored greater than 3. No doctor reported drinking daily or using recreational drugs.

Conclusion: The response rate was low, thus preventing generalization of findings. The majority of doctors responding had good job satisfaction.


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by Rodrigo MDA, Dissanayake AUGIP,
Galhenage J, Wijesinghe S, Kuruppuarachchi


Promotion of School Mental Health Programme in Pakistan A Whole School Approach


Background: Whole -school approach is a mental health promotion program in schools, which will provide a framework for mental health promotion in Pakistani schools. Its objectives are to facilitate exemplary practice in the promotion of mental health; and develop mental health education resources which are appropriate to a wide range of schools, students and learning areas. It encourages the development of partnerships between schools, parents and community support agencies to promote the mental wellbeing of young people.

Objective: To find out the perception of Pakistani teachers on whole-school approach.

Place and Duration of the study: Trainings were held at department of Psychiatry, PIMS in collaboration with British council, THET, federal directorate of education and Kings College, London. Duration of training workshop was eight days from 20th Nov 2011- 27th Nov 2011.

Design & Method: This study involved 60 subject / class teachers, heads of school, officers from the ministry of education and school counselors of both government and private sector schools. Data was collected with the help of instruments i.e., pre designed pre and post – tests for the assessment of their knowledge regarding mental health and whole school approach before and after training. 

Results: Results of the study revealed an overall mismatch between teachers’ beliefs about a whole-school approach, childhood mental health problems and their perceived school reality and mental health issues. A whole-school approach was not seen as practiced in majority of these schools.

Conclusion: Whole school approaches encompass how to use school policies, systems and structures to create an environment that promotes mental wellbeing.


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by Asima Mehboob Khan, Rachel Jenkins,
Stuart Lancashire, Rizwan Taj, Zenab Ayub


Effects of hospitalization in children of parents working in foreign countries


Introduction: Increasing number of females in Sri Lanka leave their families to work in the Middle East. This leads to disruption in the family structure and the attachment process. Effects of this can be long lasting and is likely to be seen at events that can be considered stressful in a child’s life. Admission to hospital has been shown to be a stressful experience for children.

Methodology: Behavioural problems in hospitalized children who have one or more parent working in the Middle East were compared with hospitalized children who are not separated from their parents. The prevalence of deteriorating school performance and failure to gain weight were also compared in the two groups.

Results: Behaviours such as irritability, aggression, poor sleep and low mood were seen more in children who had one or more parent working in the Middle East.  Deteriorating school performance and weight loss were also seen more in this group.

Conclusion: Long term separation from a parent results in acute behavioural problems seen at times of stress as well as more long-term effects. 


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by Kuruppuarachchi KALA, Wijeratne LT, Gunasekera DPS, Karunasekera KAW