Exploring psychosocial factors in the functional recovery of children with severe mental disorders: A qualitative content analysis

Background Severe mental disorders during childhood and adolescence can be chronic and disturbing, and may result in serious impairments in functioning. Research on the influence of such factors in the functional recovery of children diagnosed with severe mental illnesses is scant. This study aims to enhance understanding of the patterns and descriptions of social factors in the optimal functioning of children with severe mental illnesses. Methods We performed content analysis on 69 medical files of children taking treatment from Child and Adolescent Psychiatry (from 2018 to 2020). We analyzed the medical files using the summative approach by identifying and quantifying certain words and phrases. The Children’s Global Assessment Scale (CGAS) and data abstraction form were used to record the functioning profile and quantitative data. Socio-demographic and clinical variables were analyzed using descriptive statistics. Results A total of three major and ten sub-categories were identified from the data. The most striking categories in psychosocial environments were intrapersonal challenges, adverse living and relationship spaces, and outer structures and systems. Moderate to severe functional impairments were retrospectively observed among children. Conclusion Children diagnosed with severe mental illnesses and with poor functioning are the most affected group of population and hence, require proper attention. Plain language summary In India, due to its diverse cultural, social environments and limited child mental health facilities, it becomes important to understand the factors which restrict the recovery and optimal functioning of children with severe mental illness and making use of that information clinical practice and developing interventions. Over the years, various research reports, papers and commissions have highlighted the relationship of social and cultural factors and mental disorders. However, very little has been done to study the interplay of psychosocial factors that affect the recovery and normal functioning of children with severe mental illness. To our best knowledge, this study is a first attempt to understand the psychosocial factors affecting the children with severe mental disorders based on qualitative content analysis of individual case files.