Parental perceptions of child mental health symptoms, causes and responses among cambodian and its correlation with their children mental health

VIETNAM NATIONAL UNIVERSITY HA NOI UNIVERSITY OF EDUCATION PHAN RATHA “PARENTAL PERCEPTIONS OF CHILD MENTAL HEALTH: SYMPTOMS, CAUSES AND RESPONSES AMONG CAMBODIAN AND ITS CORRELATION WITH THEIR CHILDREN MENTAL HEALTH” MASTER’S THESIS IN PSYCOLOGY HANOI, VIETNAM: April, 2016 VIETNAM NATIONAL UNIVERSITY HA NOI UNIVERSITY OF EDUCATION PHAN RATHA “PARENTAL PERCEPTIONS OF CHILD MENTAL HEALTH: SYMPTOMS, CAUSES AND RESPONSES AMONG CAMBODIAN AND ITS CORRELATION WITH THEIR CHILDREN MENTAL HEALTH” MASTER’S THESIS IN PSYCOLOGY Major: Clinical psychology of children and adolescents Code: Pilot Supervisor: Dr Amie Pollack Dr Dang Hoang Minh HANOI, VIETNAM: April, 2016 SUPERVISOR’S RESEARCH SUPERVISION STATEMENT TO WHOM IT MAY CONCERN Name of program: Master’s degree of Art in ClinicalPsychology, specializing in Child and Adolescent Clinical Psychology Name of candidate: Phan Ratha Title of research: ―PARENTAL PERCEPTIONS OF CHILD MENTAL HEALTH: SYMPTOMS, CAUSES AND RESPONSES AMONG CAMBODIANS AND ITS CORRELATION WITH THEIR CHILDREN MENTAL HEALTH‖ This is to certify that the research carried out for the above titled master‘s thesis was completed by the above named candidate under my direct supervision This thesis material has not been used for any other degree I played the following part in the preparation of this thesis: Supervisor (s)…………………………… Date……………………………………… CANDIDATE’S STATEMENT TO WHOM IT MAY CONCERN: This is to certify that the thesis that I (Phan Ratha) am submitting, hereby entitled Parental Perception of Child Mental Health (Symptoms, Cause and Treatment Options) among Cambodians and its correlation with their children‘s mental health, for the degree of Master of Arts in Clinical Psychology at the University of Education, Vietnam National University-Hanoi is entirely my own work and, furthermore, that it has not been used to fulfill the requirements of any other qualification in whole or in part, at this or any other University or equivalent institution No reference to, or quotes from this document, may be made without the written approval of the author Signed by: ……………………………… Date: …………………………………… Countersigned by the Chief Supervisor ……………………………………… Date: ………………………………… Second supervisor (if any) …………………………………………………… Date: ………………………………… ACKNOWLEDGEMENTS This thesis could not have been completed without the help of many people who gave their support, advice, encouragement, and understanding I would like to show my deepest gratitude to the following people whom I will never forget First of all, I would like to give many thanks to my respectful mother, Sous Lon, and grandparents, who have always financially and emotionally supported me Secondly, my appreciation is extended to Associate Professors Dr Bahr Weiss and Dr Dang Hoang Minh for initiating and approving to release the first Englishclasses for master‘s level psychology courses in Vietnam National University, Hanoi to Cambodian students Additionally, I would like to express my sincerest thanks to Dr Amie Pollack and Dr Cindy J Lahar, Dr Poch Bunnak and Dr Tran Thanh Namwho are my kind and intelligent supervisors for their advice, encouragement, and consultation so that I would be able to successfully complete the thesis writing process from beginning to end Without their technical support and professional guidance, constructing the thesis could not have been done properly Furthermore, I would like to convey my thanks to lecturer Mr Sareth Khann and Mr Bunna Peoun who assisted me by frequently providing feedback to enhance this report Moreover, my sincere thanks are delivered to all professors in the master‘s program, who tried their best to provide me with valuable knowledge and useful skills to conduct research and write the thesis Finally, I cannot forget to say thanks to my classmates who provided warm learning environment as well as Vietnamese and Cambodian friends who frequently pushed me to focus on thesis tasks and provided a lot of feedback TABLE OF CONTENTS PART I - BACKGROUND 1.1 Background of the Study 1.2 Problem Statement 1.3 Importance of the study and policy implications 1.4 Purposes of the study / The Aim of Research (Research Questions): 1.5 Objectives of the study: 1.6 Hypotheses for the study: 1.7 Scope and Limitation PART II - LITERATURE REVIEW 2.1 Introduction to mental health and mental disorders 2.1.1 Worldwide epidemiological research regarding prevalence of mental disorders 2.1.2 Impact of mental health problems 2.1.3 Common causes of mental health problems 10 2.2 Mental Health Literacy 11 2.2.1 What is mental health literacy? 11 2.2.2 Mental health literacy regarding help-seeking behaviors 12 2.2.3 Factors influencing mental health literacy and help-seeking behavior 13 2.3 Parental influences on child mental health development and treatment .15 2.3.1 How parental factors put children at risk or help them recover from mental health problems 15 2.3.2 How parental mental health literacy affects identification, help seeking, and recovery from childhood mental health problems 19 2.4 Cambodian Mental Health Perceptions 22 2.4.1 Rates of child and adult mental health in Cambodia 22 2.4.2 Cambodian mental health literacy and seeking-help behavior 23 PART III - RESEARCH METHODOLOGY 26 3.1 Participants 26 3.2 Sampling procedure 26 3.3 Data Collection and Procedures 27 3.4 Measurements (Scale) 27 3.5.Statistical Data Analysis 28 3.6 Ethical Considerations 29 PART IV – RESULTS AND DISCUSSION 30 4.1 Descriptive Results 30 4.2 Perceptions of the cause and consequences of specific child mental health problems 35 4.3 Health-seeking behavior for mental health issues in children 45 4.4 Analysis of parental perceptions 54 4.5 Exploratory Factor Analysis 57 4.6 Explore the factors may influence parental perceptions of child mental health 60 PART V - CONCLUSION AND FURTURE RECOMMENDATION 62 5.1 Conclusion 62 5.2 Recommendations 65 REFERENCES 67 LIST OF TABLES Tables Page Table Demographics by location (percentages reported for urban versus rural) .31 Table Responses to vignette of child with somatoform disorder 38 Table Responses to vignette of child with separation anxiety disorder 39 Table Responses to vignette of child with Attention Deficit Hyper-active Disorder (ADHD) 40 Table Responses to vignette of child with tic disorder 41 Table Responses to vignette of child with aggressive behavior 42 Table Responses to vignette of child with depressive disorder 43 Table Responses to vignette of child with Posttraumatic Stress Disorder (PTSD) 44 Table Parental perception of causes of child mental health by demographic info 56 Table 10 Factorial analysis of cause of children mental health 58 Table 11.Correlations between parent perception factors, and demographic characteristics 61 LIST OF FIGURES FIGURE Page Figure Level of education completed by mothers by residential area 33 Figure 2: Level of education for fathers 34 Figure Household‘s income by location 35 PART I- BACKGROUND 1.1 Background of the Study The healthy development of children is an important concern for families and societies around the world Given a nurturing environment, children have the opportunity to grow into successful and productive members of society Raising children to be physically and mentally healthy requires much effort and serious care from parents or caregivers Mental health problems in children are a crucial influence on child development Understanding the symptoms and causes of mental health problems will help parents effectively support their children and promote their cognitive, social and emotional development (MoH, 2005; TPO 2005) ―There is no health without mental health‖ said Ban Ki Moon on October 10 th World Mental Health Day, 2011 This message encouraged public and private sectors to take into account citizens‘ mental health care, children included Improving people‘s quality of life and mental health is a priority for the World Health Organization (WHO) Worldwide epidemiological data indicate that about 20% of children and adolescents suffer from mental disorders with types of disorders varying by cultural context This finding is alarming and suggests that early intervention for mental health care is needed (Saxena, Thornicroft, Knapp; Whiteford, 2007) Another global study focused solely on children, conducted both in developing and developed nations, and showed that 10% to 15% of children suffer from mental health disorders with 3% to 4% of children having significant developmental delays or mental retardation (Dom Nokteok, 2010) This finding was very similar to a study (WHO, 2007) conducted by Seven Nation Collaborative Study on children aged 0-12 in the Philippines which found that 16% of children in the Philippines had mental disorders Regionally, a recent study (Weiss, Dang, & Nguyen, 2013) revealed that 1213% of Vietnamese children (aged 6-16) suffer from mental health problems, indicating that 2.7 million of Vietnamese children need access to mental health services Studies have also looked at what factors place children at risk for mental health problems Weiss and colleagues (2013) found that parental income and education play an important role as risk factors for Vietnamese child behavioral and A trained professional works on-on-one with the parents of the child to help the parents learn ways to cope with, manages, or improves the child‘s problem The child would NOT be involved in this treatment I believe this treatment would be helpful effective I believe this treatment is likely to result in permanent improvement Overall, I like this kind of treatment 6.Counseling for Parent(s) and Child A trained professional works together with both the parents and the child at the same time to help everyone learn ways to cope with, manage, or improve the child‘s problem I believe this treatment would be helpful effective I believe this treatment is likely to result in permanent improvement Overall, I like this kind of treatment Help from the Child’s School People at the school work with the child to help him/her learn ways to cope with, manage, or improve his problem For example, the school may provide extra help through special classes or programs or provide strategies in the classroom to help his/her behavior or emotion I believe this treatment would be helpful effective I believe this treatment is likely to result in permanent improvement Overall, I like this kind of treatment PART IV: Strength and Difficulty Questionnaire (SDQ) For each item, please mark the box for Not True, Somewhat True or Certainly True It would help us if you answered all items as best you can even if you are not absolutely certain or the item seems daft! Please give your answers on the basis of the child's behavior over the last six months or this school year Considerate of other people's feelings Restless, overactive, cannot stay still for long Often complains of headaches, stomach-aches or sickness Shares readily with other children (treats, toys, pencils etc.) Often has temper tantrums or hot tempers Rather solitary, tends to play alone Generally obedient, request Many worries, often seems worried Helpful if someone is hurt, upset or feeling ill 10 Constantly fidgeting or squirming 11 Has at least one good friend 12 Often fights with other children or bullies them 13 Often unhappy, downhearted or tearful 14 Generally liked by other children 15 Easily distracted, concentration wanders 16 Nervous or clingy in new situations, easily loses confidence 17 18 Kind to younger children Often lies or cheats 19 Picked on or bullied by other children 20 Often teachers, other children) 21 Thinks things out before acting 22 Steals from home, school or elsewhere 23 24 25 volunteers Gets children Many fears, easily scared Sees span on better with Graphs of gender, marital status and religion by location 80% 70% 60% 50% 40% 30% 20% 10% 0% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 120% 95% 100% 100% 80% 60% 40% 20% 0% Buddhism Figure Occupation of participants by residential area 0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 Table.1 Demo-graphic characteristic of respondents Variables Sex Male (N = 68) Female (N = 132) Marital Status Married (N=177) Separated/Divorced (N=14) Widow/Widower (N=9) Religion Buddhist Islamic Christian Others Occupation Unemployed Housewives Market Sellers Farmers Professionals Other Level of Education of mother None Primary school Secondary school High School Bachelor degree Higher Level of Education of father None Primary school Secondary school High School Bachelor degree Higher Household Income Less than $100 $100 - $300 $300 - $500 $500 - $700 $700 - $900 Over $900 From Table.2 to Table 8, please find in the full format Table Parental perception of causes of child mental health by demographic info Variables (T-test=-3.33, P=0.0010.05) Marital Status (F-test=0.877, P=0.498>0.05) Monthly income F-test= 1728, P=0.130>0.05) Education of mother didn‘t attend school (F-test= 0.956, P=0.446>0.05) Education of father didn‘t attend school Primary school Secondary school High school Bachelor degree Higher (F-test=2.400, P=0.04