Lady Ridgeway Child Psychiatry Unit: First-of-its-kind in Sri Lanka

• A project funded by SriLankan Cares Trust

By Fathima Riznaz Hafi
The first multi-disciplinary in-patient Child Psychiatry Unit in Sri Lanka, made possible by a CSR initiative of Sri Lankan Cares, the community development arm of SriLankan Airlines, has commenced operations. The completely refurbished state-of-the-art unit in Ward No. 23 consists of a therapeutic room, consultation rooms, observation rooms and resident patients’ ward.
Lady Ridgeway Hospital Director Dr. Linton Padmasiri commended SriLankan Cares’ initiative to convert an old building that was in a delapidated condition and was in fact used to store discarded items, into its present admirable state.
“When this proposal was given to SriLankan Cares, they took it as a challenge and they have changed the entire environment into a very modern, appealing building providing the services of a child psychiatric unit. This is the first of its kind in Sri Lanka,” he said during a familiarisation tour of the ward on Tuesday.
The new unit provides the following services: in-patient, day hospital, play therapy area, multi-disciplinary team care, family therapy, parent mediated therapy, training of health workers and research.
Early recognition key
Consultant Child and Adolescent Psychiatrist Dr. Swarna Wijethunga stressed the necessity of such a unit, owing to the various mental health cases being presented to them. “We have been treating children with illnesses among which are ADHD, developmental delays, ASD, speech and language disorders, emotional disorders and SLDSS,” she said.
“If we don’t recognise them early enough, numerous issues will arise in the future such as emotional and behavioural problems, academic failure, illiteracy, self esteem issues, drug and alcohol abuse, anti-social personality, adult psychiatric disorder, marital failure, legal problems, unemployment, criminality and poverty. That is why we must target this at an early age,” she stressed.
During the tour of the ward, we met a 12-year-old patient who was admitted recently. Outwardly she seemed like a perfectly healthy and happy girl; when she was given some stationary and asked to draw, she was very obliging and started on it straight away, displaying care and neatness in her work.
However, Dr. Wijethunga told the Daily FT that this girl has suicidal tendencies. She said she was a very neat and meticulous child and took great care in her work; but frequently talks about wanting to kill herself.
Ensuring mental health
At present, 20% of the children in Sri Lanka have been reported as having mental illnesses, said Dr. Wijethunga. “If left untreated, we can have serious problems,” she said and expressed her gratitude to Sri Lankan Cares for understanding this dilemma and helping to upgrade their facilities and services. “It was a tremendous effort and they did a marvellous job,” she said.
Consultant Psychiatrist Prof. Hemamali Perera said, “There is a monetory allocation for mental health in the country but out of that amount, only a miniscule amount is for child mental health.” Noting the significance of monetory resources, and the necessity of donors, she added, “Stakeholders need to be involved so that the services are utilised to the maximum.”
She also stressed the importance of awareness: “We need to improve the understanding and knowledge of the general public and parents; we need to spread awareness on these issues,” she said.
Treatment for children
In response to a question regarding what sort of treatment is given to children brought to them with mental issues and whether medication is required, Dr. Perera said that first they assess the child and thereby obtain information to see where the problem lies.
When they find the problem points, they then focus specifically on those points and provide the relevant treatment. The doctors coach the mother on what to do to help the child and the mother practices this at home.
“The treatment is mostly non-pharmacological but there’s a small minority that may need pharmocological treatment. Sometimes it goes hand-in-hand,” Faculty of Medicine Senior lecturer Dr. Sudharshi Seneviratne added to this.
Limited resources
“We can’t wait for the resources to arrive, Dr. Perera continued. “Our resources are limited; the mother has to be coached and guided and she will help the child at home,” she said. When the parents are educated on how to help the child and this child is receiving the necessary treatment, progress takes place. “It’s very rewarding for everybody to see that progress,” she added.
“The downside of this is when it seems that we can handle things without the needed resources, we may never be given those resources,” she said.