Medical and Psychosocial Care of The Mentally Retarded Persons in Bangladesh

Abstract

Intellectual disability or mental retardation is a worldwide problem. The people suffering from mental retardation, themselves, their families and the society face enormous problems for their condition. Care for mental retardation has extensive aspects and needs elaborate arrangement. Throughout the world as well as in Bangladesh the problem is not duly addressed. So the sufferings for this problem are too much in our families and societies. The objective of the study was to assess the state of medical and psychosocial care for these people in Bangladesh and how to improve it.

There is no national survey related to the prevalence of Intellectually Disabled people in Bangladesh.

The study was done by taking case studies of 90 mentally retarded persons of different age, sex, education, economic and other perspectives. Respondents were mainly the parents of the mentally retarded persons. 30 cases were studied in Dhaka City, 20 cases in Rajshahi City and 40 cases were studied in different villages around Rajshahi University. The study period was from April 2012 to June 2014. Purposive sampling was done. The data was collected by semi-structured questionnaire along with socio-demographic information. It was in Bangla for the convenience of the respondents. All collected data were checked, rechecked for omission, inconsistencies and improbabilities. Data analysis was performed by Statistical Package for Social Science (SPSS). Ethical issues were considered duly in collecting data.

The results showed that majority of the respondents (55.5 %) were not aware about the genetic causes of mental retardation. Possible genetic causes for mental retardation were found as, hereditary diseases in the family’s (38.89%), history of previous abortion and neonatal death (10%), maternal age 35 and above (4.44%) and consanguinity among the parents (11.11%). Measures taken to prevent hereditary causes of mental retardation was found in 20% cases. Care for pregnancy and labour was taken as vaccination in 84.4%, regular checkup in 77.8%; nutritious food, vitamins, folic acid was taken by 62.2% cases. Measures for safe development of fetus were taken in 36.4% cases.

During infancy and childhood vaccination was taken in 91.1% cases. Screening test for mental retardation was done only in 18.89% cases. Medical care for mentally retarded persons were taken by specialist doctors in 25.6% cases. In 62.2% cases it was found that they were treated by multiple system of treatment. In 58.9% cases there were multiple psychological / emotional problems with the related society. Integrated education was proposed by 48.9% respondents, sheltered especial job was suggested by 66.7% respondents. 37.8% respondents thought that community should arrange home for the mentally retarded persons. 74.4% respondents think that mentally retarded persons should live within the society, preferably in own families with special care. 65.6% respondents think for integrated arrangement of different types of recreation. Majority of the services for the mentally retarded persons came from families, relatives and neighbors (45.6%). The respondents evaluated the services as poor in majority of the cases (56.7%).

It was found that the awareness about genetic causes of mental retardation is yet inadequate, which is due to less dissemination of knowledge. Urban, rich and highly educated people know more about hereditary diseases and so they noticed it more. Neonatal death or abortion is less as people are more conscious now a day than previous time. Consanguinity is also less due to awareness. Most of the respondents took no measure for prevention of hereditary diseases, which may be due to negligence or less consciousness in this regard. Maternal care now has improved in Bangladesh due to Government and other initiatives. Vaccination during pregnancy and care during delivery are better and more scientific now a days. Immunization is a successful programme in Bangladesh and it is praised by all. It is hoped that 100% immunization will be possible in Bangladesh very soon. Screening tests for mental retardation is just beginning in Bangladesh. It is hoped to be extended in near future. Most of the respondents took multiple system of medical care for their mentally retarded children, which indicate their indecision mixed with emotion about the care as well as scientific attitude and specialized care for these people. Most of the services come from families, relatives and neighbours, which indicates that Government and social organizations are not duly performing their roles in this regard. Finally the care provided to the mentally retarded persons was evaluated as poor by most of the respondents. It indicates that though the services are gradually improving it is not to the scale as per need and expectation.

It can be concluded that in many respect the situation of care for the mentally retarded persons is improving, while in other areas it is neglected. The preventive measures, screening test should be developed and extended. It is recommended to set up a separate special discipline in medical system of the country for mental retardation, which will deal with the prevention, treatment, care and research in the related fields.