Psychological maladjustment in children living in alternative care settings in Western Province, Sri Lanka

Abstract

Background: For children deprived of suitable family care, the State has the responsibility for ensuring appropriate alternative care. In the National Alternative Care Policy for Children in Sri Lanka (DPCS, 2019), alternative care is classified as family-based or family-like, where all residential options are considered as family-like care. Method: In this study, we explored the psychological maladjustment of children aged 10-18 years living in alternative care. The Sinhala-validated version and the Tamil translation of the Personality Assessment Questionnaire (PAQ) were used. The PAQ is a globally used 42-item self-administered questionnaire assessing young people’s psychological functioning. Data collection was conducted by trained data collectors. Ethical approval was obtained by the SLCP ethics review committee. Results: Two hundred sixty-eight children responded to survey. The majority were females (60.4%, n=162) and in the 10-14 year age group (59.32%; n=159). Children were residing in different alternative care settings, including “Fit person care”, NGO-based foster families, child development centres, approved or certified schools and remand homes. Of the 268 children in the study, 192 (71.6%) had a score at or above the PAQs’ cut-off of 89 (M=97.1; SD=14). Children under “Fit-person care” had the lowest maladjusted percentage (50%; n=6), while children in remand homes showed the highest maladjustment rates (93.3%; n=14). Children who were abused by a family member, encountered domestic violence or were in conflict with the law demonstrate a higher percentage of maladjustment, although there was no statistically significant association. Conclusions: These results reveal a higher percentage of psychological maladjustment in children aged 10-18 living in alternative care settings in Sri Lanka. Further, psychological maladjustment was lowest in children living with fit persons, which is a setting closer to family structure. This study highlights the importance of trauma-informed care and supporting the psychological needs of children in alternative care, making these institutions more “family-like”.