For the past year or so, I have been working with a programme for children who display behavioural problems.

I now share with you some insights gained from this programme.

Who are these children?

These are children from various backgrounds - rich and poor and from families in all the socio-economic groups. The majority of these children are boys.

What problems do these children have?

These children present with various problems. The most common problems are those associated with the display of disruptive behaviours. These disruptive behaviours are manifested at home, school or in the wider community.

Common problems include running away from home, lying excessively, truancy, involvement in fights, arguing a lot with adults, doing things to annoy others and defiance. Cannabis use is also a major problem. In fact, the majority of boys admit to cannabis use. On observation, we note that most of these boys display very erratic behaviour.

Why do children display these behaviours?

The causes are many but in the majority of cases, the problem lies within the family. Family problems include:

1. Absent parent - in many cases either father or mother or both were not present. This leaves the children feeling very rejected and unloved.

2. Abuse was also a major factor. This involved physical, emotional and sexual abuse. Many of the problematic girls admit to sexual abuse in their families.

3. Conflict within the family was common. This involves parental discord, domestic violence, divorce and separation.

4. Poor parenting skills. Many of the parents of these children displayed inconsistent discipline styles.

Problems in the schools

A number of problems within the school system seem to be contributing to the process.

1. A failure to recognise the problem early. Despite the fact that the ministry of education has a special programme to deal with multiproblem children, teachers and guidance counsellors were not detecting and referring these problems early.

2. Teachers' attitude. A teacher's attitude is critical in the socialisation and development of children. Many students report that teachers do not know how to speak with them. In fact, in many instances, teachers are abusive. Many students report that teachers often humiliate or embarrass them.

3. The failure to identify learning problems. This was common among students in the non-traditional high schools. Far too many of them have learning problems which were undetected and appropriate measures were not put in place to address these problems.

What are the solutions

It takes a village to raise a child. What is needed is a more comprehensive range of responses to deal with these problems.

1. Parenting education. This needs to be expanded, especially in high-risk communities. In addition, many of parents, especially the mothers of children with disruptive behaviours, are often burnt out, frustrated or depressed. Research has shown that when parents receive psychological support, the outcome is better for the children.

2. Early detection and referral. The ministry of education must expand the system of early detection and referral of students with disruptive behaviours. In many instances, the problems are allowed to get out of control.

3. Training of teachers and guidance counsellors. Teachers and guidance counsellors need to be given additional training to detect problems in children and to appropriately intervene. This will facilitate earlier referral of children.

4. More training in 'I Message' techniques. Far too many of our teachers do not know how to communicate with students. There is excessive use of 'You Messages' which humiliate and embarrass children. We have found that the school climate improves when teachers are trained in this technique.

5. Deal with the cannabis problem. This is a problem among boys. Many of the boys who use cannabis report major problems at home. This supports the adage that 'addiction begins and end with pain'. Students who use cannabis need intensive counselling and referral to persons who are appropriately trained.

6. Residential programmes will not necessarily help. There has been a great cry to establish residential programmes to address the needs of children from multiproblem families. Taking these children out of their home environments will not necessarily solve the problem. In many instances, the entire family needs help and treating the child and his or her family is the most effective strategy.

7. Employ school psychologists. A cheaper and more effective option to residential treatment is to employ adequate numbers of school psychologists to work with these children. This investment is urgently needed. Unfortunately, there are far too many persons who are counselling children who either have no experience or clue as to what they are doing. These people can do more harm than good.

Dr Wendel Abel is a consultant psychiatrist and head, Section of Psychiatry, Dept of Community Health and Psychiatry, University of the West Indies; email: yourhealth@gleanerjm.com.