The Implications of Residential Care on the Psychological Well-Being of Adolescents in Lusaka Urban

Abstract

Residential Care (RC) is frequently used despite it being the last resort in the continuum of care for children and adolescents and evidence of its detrimental effects on the psychological well-being of children. RC is a type of care arrangement involving a group of more than ten children that is routine, impersonal and care is provided by a paid caregiver. Extreme poverty, family disintegration, parental death, HIV and AIDS, armed conflict, abuse, neglect and natural disasters are some of the main reasons why children end up in RC. A cross sectional study using quantitative and qualitative methods was undertaken to investigate the implications of residential care on the psychological well-being of adolescents in Lusaka District. Eighty (80) adolescents were recruited comprising 40 (50%) males and 4IV0 (50%) females aged eleven (11) to sixteen (16) years from RC and Family Care (FC). Three (3) residential care managers were interviewed to collect information on the psychosocial services provided to adolescents. Focus Group Discussions (FDGs) were held with adolescents from RC to collect information on perceptions about their living environment. The Strengths and Difficulty Questionnaire Youth Version (SDQ-Y) self report was used to collect data on the adolescents’ psychological well-being. The t-test revealed significant mean differences in psychological well-being between FC and RC adolescents on the SDQ-Y on Emotional symptoms, Conduct and Peer problems, p<0.05. The Two-way ANOVA revealed that the independent variable gender did not have a significant effect on Total Difficulties with F (1, 79) = 0.71, p>0.05. Both males and females in RC experienced psychological well-being to the same degree. The psychosocial services provided included counseling, talks and games which were incorporated with spiritual instruction. RC care service providers bemoaned the high cost of education and hiring professional staff such as psychologists and social workers to work with adolescents. Adolescents in RC were satisfied with the meeting of their daily basic needs but expressed dissatisfaction with recreation facilities. RC adolescents also expressed mixed feelings about family contact. RC adolescents showed low psychological well-being compared to FC adolescents. The study suggests that residential care does not provide a nurturing environment for optimal social and emotional development of adolescents. This was attributed to inadequate skills and knowledge by caregivers, financial challenges and inadequate psychosocial programmes. The Government needs to allocate adequate resources to Social Protection to reduce poverty at all levels of development. RC service providers should provide sustainable and effective services for adolescents in care to promote positive psychological well-being.