Introduction:
Adverse Childhood Experiences (ACEs) up until age 18 greatly raise an adult's risk of mental and physical health issues, according to research from throughout the world. A dose-response association between the quantity of ACEs experienced and the degree of impact on well-being has been verified by research connecting ACE with health and well-being. The family, community, and immediate surroundings are the origins of Adverse Childhood Experiences (ACEs), which pose a long-term danger to mental health and may persist into future generations. The evidence indicates the need for additional factors beyond the 10 ACE elements in the groundbreaking original study, and the findings hold for both developed and developing nations. With 0.4 billion children and teenagers and one in seven having mental health disorders, India needs immediate action on ACE prevention and management. First, the impact of ACE factors on mental health is reviewed in a global study review and the scant evidence available in India is summarized in this article. Furthermore, to avert a serious public health emergency, it suggests a multifaceted strategy for identifying, managing, and preventing the mental health effects of ACE in India.
What Is the Worldwide Data Demonstrating How Adverse Childhood Experiences Affect One's Health and Well-Being?
More negative experiences are examined in later iterations by including the following: peer victimization, peer rejection or isolation, and socioeconomic position (SEP). Additionally, the WHO (World Health Organization) has spread a new questionnaire that includes two more new components: violence in society and death or separation of parents.
-
Physical Abuse: The Ministry of Women and Child Development's 2007 nationwide research on child abuse in India revealed a significant prevalence among young children (5 to 12 years old). These kids could have been abused or used for profit. In particular, males made up 69 of the 55 percent of victims, and parents were typically the ones who inflicted the abuse. Similar evidence can also be found in juvenile justice facilities. For both men and women, physical violence is the most prevalent type of early trauma that might result in suicidal thoughts.
-
Childhood Sexual Abuse (CSA): A study conducted in India on Childhood sexual abuse (CSA) found a substantial correlation between CAS and mood, substance use, and anxiety issues in both genders. Victims of child sexual abuse are more likely to experience insecure relationships with their parents, poor social adjustment, temperamental issues, and lack of trust. According to the same study's literature, 4–41 percent of Indian girls and 10–55 percent of Indian boys enrolled in school and attending college had encountered some kind of CSA (forced, non-contact, or contact). It also implies that CSA may co-occur with other ACEs in the same child rather than always occurring alone.
-
Emotional Abuse: a study conducted on 936 college students from three different strata in India—medical, engineering, and arts and science colleges—across several states revealed that: (a) 42 percent of the participants said they had been called "idiots" as children; (b) about 48 percent of them had been made fun of for their looks; (c) about 35.8 percent had been called derogatory names; and (d) 32.6 percent had been held accountable for things that were not their fault. Notably, approximately 18.2 percent of the individuals reported experiencing humiliation without any valid reason.
-
Neglect: Approximately 27 percent of girls received less food than their boys, according to a 2007 Ministry of Women and Child Development survey. While 71 percent of the girls had experienced family neglect, half of them had suffered emotional abuse. All of these forms of maltreatment were linked to poor mental health.
-
Domestic Substance Abuse: 12.9 percent of the sample as a whole showed evidence of parental substance misuse, according to a study on maltreatment among teenagers with a history of child labor from various cities. Parental substance misuse has a substantial impact on generalized anxiety disorder, dysthymia, and severe depressive trends.
What Is the Research Conducted in Areas Not Covered by Core Ace Elements?
-
Bullying: 70 percent of reports of bullying occur mostly in schools. Many participants were studying. Of them, many were bully victims. Bullying occurred when the instructor was absent from the classroom (18.9 %), at recess (26.6 %), during the school prayer period (7 %), immediately following school (21 %), and during the commute home (12.6 %).
-
Post-Traumatic Stress Disorder (PTSD): Given the ACE components, PTSD is a possible consequence. According to a study on PTSD prevalence in India, abuse had the second-highest average prevalence, at about 28 percent. In addition, 15 additional papers were located and contrasted with the prevalence rates of various illnesses linked to trauma. After being exposed to traumatic experiences, the most frequently reported prevalence rates of disorders other than PTSD include depression, anxiety disorder, adjustment disorder, and panic disorder.
-
Community Violence: Despite the history of communal violence in India, not much research has been done on this subject.
-
Additional research reveals a connection between abuse throughout childhood and the likelihood of being diagnosed with a particular phobia (41.66 %), conduct disorder (33.33 %), social phobia (30.30 %), dysthymia, obsession, compulsion, and other conditions. Maltreatment in childhood has been connected to PTSD, panic attacks, and generalized anxiety.
What Are the Challenges for Ace and Mental Health in India?
-
In India, mental health receives less than 1 percent of the total national healthcare expenditure. Recently released data from six states indicates that only 40 to 50 percent of Indians with schizophrenia and only 12 percent of those with depression receive treatment.
-
India is more difficult and riskier because people who face social and economic adversity are more likely to experience mental health issues. As a result, India lacks the resources and expertise necessary to assist those who are currently experiencing mental health problems.
-
The largest assessment on mental morbidity in India, the National Mental Health Assessment (2016), estimates that over 150 million people in the nation suffer from one or more mental morbidities.
-
Approximately 10 million Indians between the ages of 13 and 17 suffer from severe mental disease; if the full range of childhood and maturity is taken into account, this figure may rise.
-
In conclusion, data from 2017 indicates that mental diseases rank among the top causes of YLDs (Years Lived with Disability) in India at 14.5 percent. Additionally, their contribution to DALYs (Disability-Adjusted Life-Years) has increased from 2.5 percent in 1990 to 4.7 percent in 2017.
What Are the Prevention Measures?
India needs an intensive preventive plan because of the high frequency of individual ACE elements and their correlation with a wide range of detrimental effects on mental health, families, the individual's social function, and ultimately, the DALYs. Furthermore, a number of factors specific to the Indian context—namely, the strong correlation between childhood adversities and mental health, the growing proportional burden of mental health, and the intricate relationships between the individual, the family, the community, and society—indicate the necessity of a multifaceted, multi-level (i.e., across social, healthcare, and political levels) prevention-focused intervention.
The prevention strategy must consist of the following: (a) primary prevention, which tries to stop all potential ACEs so that kids are less exposed to hardship and are less likely to experience ACEs themselves; (b) secondary prevention, which seeks to lessen the experiences' immediate and short-term effects; and, finally, (c) tertiary prevention, which addresses and lessens the ACEs' long-term effects.
Conclusion:
Reducing the impact of various kinds of bad childhood events on mental health in India requires identifying, mitigating, and preventing their cumulative effects. This is supported by extensive worldwide research as well as preliminary results from India regarding the dose-response relationship between ACE and mental health. The evaluation has determined the urgent need for ACE prevention and underlined the necessity to hasten the research in this field in light of the background and growing body of scientific information. India must give ACE management and prevention a priority and revisit lessons learned from research conducted in both developed and developing countries. The suggestion calls for a multifaceted strategy that combines public health, social health, and mental health experts to effectively collaborate on research, awareness, prevention, education, and management.
