Mental health of children is not paid significant attention in the primary health care or public health service provision in the Southern Province, including in school health inspections, although the capacity building of primary health care workers, teachers and children on mental health provided by the WHO is mentioned in the Annual Action Plans of the MoH. Overall, there appearsto be a deficiency in quality mental health services, at both community and regional levels island‐wide. For instance as noted earlier, there is a dearth of technical capacity in the area of mental health, with only a very few practitioners available with a specialty in child mental health for the entire country.
Due to the stigma attached to mental illnesses, people with mental health issues are reluctant in reaching out for treatment. Therefore, there is a need for a community level health worker or a social worker who can visit families with members (including children) suffering from mental disorders, and provide the required services and care. However, community mental health care is not yet a part of the public or family health service provision. However, efforts are being taken by the government to extend mental health care to the community through several community mental health services, including community‐based interventions for alcohol and suicide prevention, outreach clinics and the establishment of Community Support Centres.
Even child care workers such as CRPOs and NCPA officers do not seem to have the capacity to conduct a basic assessment to identify children with mental health issues. In the event a child with a mental health impairment is identified, the child is usually referred to the Mental Health Unit (MHU) of the closest general hospital. However, information is not available to determine whether all the general hospitals have an adequately staffed MHU.
With regards to counselling services, school counsellors are appointed in most of the schools, yet as pointed out in the Education chapter (Chapter 3), the quality of services is rather poor while the emotional issues faced by many children both at home and school often receive little attention. Most of the child care officers have received a basic training in counselling while the NCPA Psychosocial officers (who are at the district level) are specially trained to provide counselling assistance, as a part of their role. However, none of the MOH staff are trained in counselling. Further, counselling services are not readily available or accessible, especially at the DSD level or closer to communities except for the Counselling Officers/Assistants stationed at most Divisional Secretariats. For instance, there are no counsellors in Deniyaya.