Abstract
Background
A substantial proportion of institutionalised children come from environments marked by exploitation, parental death or incapacity, and unstable housing. Prior research indicates that early life trauma and institutionalisation adversely affect emotional regulation and psychosocial adjustment.
Purpose
This study examines how trauma, institutional environments in Indian child care settings, and the absence of stable familial support influence children’s psychosocial development and their preparedness for life outside institutional care.
Methods
A qualitative design was adopted. Five caregivers from a boys’ child care institution in Jahangirpuri, Delhi—serving as Child Protection Officer, counsellor, housefather, and other roles—were interviewed. Data were analysed using thematic analysis as outlined by Clarke and Braun.
Results
Caregivers reported persistent challenges among children, including verbal and physical aggression, low academic motivation, and difficulties in emotional regulation and forming social relationships. These findings reflect the compounded effects of trauma and institutional living conditions.
Conclusion
The study underscores the significant impact of trauma and institutionalisation on psychosocial development. It highlights the need for trauma-informed care and strengthened support systems to improve developmental outcomes and facilitate successful reintegration into society.
Vulnerable Children in India
India is home to approximately 44 million destitute children, amongst which 12.44 million are orphans who lack basic care, a family environment, or financial stability. 1 Even when growing up with a family, children may become vulnerable to insufficient care due to multiple factors, such as domestic violence, mental health challenges faced by caregivers, or chronic financial constraints. Broader systemic issues, such as high unemployment rates, insufficient wages and economic constraints, also directly hamper the ability of caregivers to disseminate proper care to their children. 2
The United Nations Convention on the Rights of the Child (UNCRC) 3 outlines four major principles guiding child rights: survival, protection, development and participation. The right to survival (UNCRC, Article 6) outlines access to life, basic needs, and healthcare. The right to protection protects children from abuse, neglect and exploitation, and calls for frameworks and systems to prevent and respond to harm (Articles 19, 32–36). The right to development includes the child’s right to learn, rest and grow holistically, with support given to the child’s physical, emotional and cognitive development (Articles 28, 29 and 31). Finally, the right to participation ensures that each child has the right to express their views about matters affecting them, and such views must not be disregarded (Article 12).
Why Children are More Prone to Neglect
Children are prone to neglect and abuse due to a combination of factors. A limited understanding of potential risks, underdeveloped coping skills, and dependence on their caregivers, especially when the caregivers themselves are facing challenges such as poverty, poor mental health or substance abuse.4–6 Children facing family stress, social isolation and lack of community are at a higher risk of maltreatment. 7 United Nations Office on Drugs and Crime (UNODC) adds that children in marginalised populations and unstable homes face an even higher risk of neglect and abuse. 8
Children in Child Care Institutions in India
Despite the expansion of child care institutions (CCIs) under schemes like Mission Vatsalya, the number of children housed in these institutions has declined—from 76,118 in 2021–2022 to 57,940 in 2022–2023. 9 This trend indicates a gradual shift in public policy and service delivery toward deinstitutionalisation and support for family-based alternatives. 10
Neglected Children: The Effect of Trauma on the Development of the Child
Neglect and abuse result in trauma, which can stunt the development of young children in physical, psychological and behavioural ways.
Often neglected children show physiological alterations, especially in the endocrine and the autonomic nervous systems. Major hormones spike, and the stress response of the body becomes dysregulated, causing damage to metabolism and neurodevelopment. 11 Adults with a history of childhood trauma report increased risks for chronic diseases such as heart disease, cancer and liver issues. 12
Cognitive skills such as memory, attention and language also take a hit, and children exposed to traumatic experiences exhibit lower intelligence quotient (IQ) scores, are delayed in language acquisition and have difficulties in learning, all of which hamper their academic success and productivity.13, 14
Traumatic experiences compromise emotional regulation and social interactions, which may manifest in the form of hyperaggression, instability, moodiness and socialisation problems. 14 Personality may also be influenced by severe traumatic responses and is found to correlate with high levels of neuroticism and lower levels of agreeableness and conscientiousness,15, 16 which in turn may hinder the formation of secure attachments throughout life.
Bronfenbrenner’s Ecological System Inside a CCI
Bronfenbrenner introduced the ecological systems theory, which posits that the development of human beings occurs as a result of interaction between five major systems into which one can divide any environment. These include the microsystem (the immediate environment of the individual); the mesosystem (the interaction between the microsystem), the exosystem (other environments that are not directly related to the individual but affect her nevertheless), the macrosystem (societal values and norms), and finally the chronosystem (time). Similarly, the environment inside any CCI may also be visualised in the form of these five systems interacting with each other, each of which influences the development of the children living inside. 17
Microsystems
The child’s microsystems are comprised of other children with whom he shares the CCI, the staff members who are their primary caregivers, and the school environment of the child (provided they are enrolled in one). All these immediate environments play a crucial role in the child’s psychosocial development.
Mesosystems
The different microsystems interact with one another. For example, the child goes to school with the same kids with whom she shares a CCI, who then meet her other friends from school. The staff members with whom she interacts with every day are also interacting with her other friends in the CCI. Such interactions also add to the development of the child based on how they interact with each other and how they are perceived by the child.
Exosystems
Exosystems include any existing family members of the child with whom she may still be in touch, such as siblings or parents, and the home environment of the caregivers who have an indirect influence on their demeanour towards the children and their work.
Macrosystems
Macrosystems encompass the current government policies that are governing the CCIs, such as Mission Vatsalaya, the political party in power, and their budget allocation to CCIs, and the extent to which the executive body can carry out the policies made by the legislative body.
Chronosystems
Finally, chronosystems refer to the passage of time. The time spent inside the CCI may produce notable differences in the way the child behaves or develops. Staff members, caregivers and other children living in the CCI with the child may also change with time, significantly impacting the child’s interpersonal bonds.
This article explores the psychosocial development of children living in CCIs of India. Current literature suggests that early childhood trauma has pervasive effects on the child’s neurobiology and subsequently on their emotional and behavioural regulation. Considering the history of institutionalised children and a possible history of trauma, we seek to understand how trauma, the environment at Indian CCIs, and a lack of family environment may impact the children’s psychosocial development and whether they are psychologically equipped for a life outside the institution. To achieve this end, we interviewed the caregivers of a children’s home for boys in Jahangirpuri, Delhi. The article employs thematic analysis to understand the subjective experiences of the caregivers and their insights into the development of the children that they are responsible for. Caregivers have an in-depth understanding of the functioning of the institution and can paint a nuanced picture of how the functioning of the institution and their individual roles and responsibilities may contribute to the psychosocial development of the children living in these institutions.
Review of Literature
Government Schemes for Children in Need of Care and Protection
The Ministry of Women and Child Development, Government of India, implemented the Juvenile Justice (Care and Protection of Children) Act, 2015.18, 19 It provides a framework for the care, rehabilitation and protection of children falling into two major categories—children in need of care and protection (CNCP) and children in conflict with law (CCL). It provides guidelines for the functioning of Child Welfare Committees (CWCs) and Juvenile Justice Boards when it comes to making decisions about children in need.
The Juvenile Justice Act (JJ Act), 2015, defines CCIs as ‘… any children’s homes, open shelter, observation home, place of safety, specialised adoption agency and a fit facility recognised under this act for providing care and protection to children, in need of such services’;
The National Commission for Protection of Child Rights (NCPCR) report (2018) categorises CCIs into five major types
20
:
Children’s home: This refers to an institution established and maintained by state governments in every district or group of districts. They may be run by governmental or non-governmental organisations (NGOs) and be registered under Section 50 of the JJ Act, 2015. Observation home: This refers to an institution established and maintained by state governments in every district or group of districts. They may be run by governmental or NGOs and registered under sub-section (1) of Section 47 of the JJ Act. Special home: A special home refers to an institution established and maintained by state governments in every district or group of districts. They may be run by governmental or NGOs and are registered under Section 48 of the JJ Act. These institutions provide rehabilitative services to children who are found to be in conflict with Indian law as recognised by the Board or by the Children’s Court. Shelter home: This refers to an institution established and maintained by state governments in every district or group of districts for children in need of urgent support, including runaway or missing children. They may be run by governmental or NGOs and are registered under Section 43 of the JJ Act. Specialised adoption agency: This refers to an institution established and maintained by the state governments in every district or group of districts for orphaned, abandoned or surrendered children. They may be run by governmental or NGOs and registered under Section 65 of the JJ Act.
Other similar facilities outlined by the JJ Act, 2015, are open shelters, which refer to a facility that provides shelter to children, set up by the State Government, and may be run by the government or NGOs. It is registered under sub-section (1) of Section 43 of the JJ Act. Place of Safety refers to another type of institution or facility, registered under Section 41 of the JJ Act, that is not a lock-up, and is separately established or in conjunction with an observation home or special home. This institution may be managed by a person who is willing to take in or care for children who are (or alleged to be) in conflict with the law, as recognised by the Board or the Children’s Court.
This act mandates inspections and regular reports of CCIs at three major levels: district, state and central levels to ensure that necessary steps are being taken to ensure safety and development of the children in these CCIs.
An amendment made in 2021 assigns District Magistrates as nodal authorities that need to take the necessary decisions when it comes to child care and protection. The amendment was originally made to fasten the process of pending adoptions by transferring them to the district magistrates. This amendment also increases functionality and accountability in the CCIs.
Mission Vatsalya, launched in 2021, comes under the JJ Act and is a scheme sponsored by the Central Government, implemented by States and Union Territories (UTs) to support CNCP and those in CCL. It includes essential services such as education, vocational training, healthcare, recreation and counselling services. In the fiscal year 2023–2024, CCIs under this scheme had roughly 62,594 children in institutions and 121,861 children in non-institutional settings. Currently, there are 762 District Child Protection Units, 781 CWCs, and 774 Juvenile Justice Boards across States/UTs. 21 Despite the number of CCIs in the country, there are still roughly 19,000 children living on the streets, according to an NCPCR report released in the year 2023. 22
Current State of Child Care Institutions in India
Infrastructural Inconsistencies
Childcare institutions in India continue to face structural and functional problems that are systemic and pervasive, despite having legislations such as the JJ Act, 2015 or schemes such as Mission Vatsalya.
A report prepared by the Ministry of Women and Child Development in 2016, 23 prepared with the aim of evaluating the CCIs of India, highlighted widespread non-compliance with the JJ Act of 2015: under registrations, lack of adequate staffing, lack of infrastructure and monitoring systems. Most institutions did not meet the minimum requirements, such as basic education, health and rehabilitation services. Records were not sufficiently maintained, and financial oversight was lacking.
Scientific literature suggests similar findings. Wanglar reported widespread deficiencies in the quality of CCIs in terms of infrastructure, staffing and others. 24 Healthcare also remains a significant issue, with widespread non-compliance with health mandates, as outlined by the JJ Act. 25 This included non-regular health check-ups, a lack of trained medical staff, insufficient documentation and poor coordination between all the relevant agencies. Such conditions led to poor health in institutionalised children and were a direct compromise of their right to health.
Wangler 26 identified systematic obstacles in disseminating effective care to children at these institutions, which in turn restrict the successful reintegration of children once they become young adults. Outdated skill sets, poor family bonds, lack of education and alternative care models all contribute to this outcome. Wanglar 27 reported some common difficulties, such as unpreparedness for independent living, lack of emotional support, limited access to higher education, and relevant skill sets. Dutta 28 reported similar findings amongst girls leaving CCIs after they came of age. While they were equipped with practical skills related to managing the household, they reported low psychological well-being, lack of access to higher education, and low financial independence. Keshri 29 proposed that leaving CCIs should be an extended and gradual transition as opposed to a singular event. The study advocated for transition programmes that equip young adults to leave the institution and include mandatory aftercare services to ease social reintegration.
Development of Children in CCIs
Institutions for childcare thus pose significant risks to the healthy development of children, and scientific literature suggests that foster care and family environments may be better for the overall development of children.30–32
Such widespread lack of resources and systemic deficiencies hinder caregivers from delivering effective care, which in turn becomes a barrier to the fulfilment of the emotional and psychological needs of the children. Mishra and Khuntia find that the lack of stable caregivers in CCIs results in many of these children developing insecure and unstable patterns of attachment. 33 Institutionalised children have a harder time when it comes to accurately labelling and recognising negative emotions as opposed to their non-institutionalised counterparts, 33 and emotional intelligence exhibited by institutionalised children is also significantly low. 34
These symptoms of psychopathology can be directly traced to adverse childhood experiences, which, in turn, reduce well-being and increase stress. 35 The COVID-19 pandemic served to increase further symptoms of psychopathology, stress and social isolation, 36 and added to the adverse experiences experienced by these children, making the mental health of vulnerable children in CCIs even worse. 37
Method
Objectives
The study has three major objectives. The first is to explore the different perceptions that the caregivers of the childcare institutions have with respect to their roles, the dynamics of the children with other children and with caregivers and the different challenges the children face during their time at the institution. The second objective of this study is to understand the different factors that had a positive impact on institutionalised children and helped them in better adjustment and subsequent integration into society. Finally, this study explores that problems and shortcomings faced by the institution in caregiving and management.
Methodology
The study employed a qualitative research design. The participating institution was selected through purposive sampling, with the objective of engaging caregivers working within a residential children’s home. Participants were recruited from among staff members who were directly and regularly involved in the care of the children. Prior to data collection, informed consent was obtained from all participants, and ethical clearance was secured. Data were collected through semi-structured interviews designed to explore the daily experiences of institutionalised children, their behavioural patterns, and the roles and responsibilities of their caregivers. The researcher spent 1 month in residence at the institution to develop contextual familiarity and deepen observational insight, which in turn informed and enriched the analysis.
The collected data were subjected to thematic analysis to identify salient themes related to psychosocial development and the potential challenges impeding it. Data coding was conducted manually to ensure a nuanced and interpretive understanding of the emergent patterns.
Ethical Considerations
Steps have been taken to ensure the ethical nature of the study. The steps are as follows:
Informed Consent
All staff members were given a clear explanation of the study, its objectives, and its purpose of the study. Only participants who were comfortable with participating in an interview were included in the study. Consent was obtained before the interview.
Confidentiality
All the information about the identity of the participants was kept confidential, and the participants were kept anonymous. All personal information has been removed from the transcripts, and the data have been used exclusively for research purposes.
Research Reflexivity
Data collection was done after completing a month-long internship at the institution. The influence of the researcher’s subjective biases and opinions has been recorded. The potential for personal biases to maintain reflexivity.
Credibility and Rigour
Steps were taken to maintain the credibility:
Institutional Approval
The institution was notified about the research study and its objectives. Permission was obtained from the institution before the collection of data.
Results
A thematic codebook was developed to organise the data, including major themes and its descriptions (see Table 1).
Table of Major Themes and Their Descriptions.
Discussion
The first objective of the article is to explore the different perceptions that the caregivers of the childcare institutions have with respect to their roles, the dynamics of the children with other children and with caregivers, and the different challenges the children face during their time at the institution.
Roles, Routines and Administrative Processes
Every caregiver in the institution has a defined set of rules and routines, with each caregiver interacting with the children in different capacities and for different durations. For this study, five different caregivers with different roles were interviewed.
Documentation and Legal Processes
Documentation and record-keeping are the first priority when the institution receives a child. The child welfare officers (CWOs) are predominantly responsible for this. All key documents, such as CWC orders and medical records, are verified first. CWOs are primarily responsible for maintaining progress reports of each individual child encompassing their health, education and participation in daily activities, resource allocation amongst children, and record keeping.
Form 7 of the JJ Act acts as a comprehensive form for documentation of resource allocation plans, use of resources, restoration and follow-up, also filled by these officers.
P1: When the child comes, we fill in Part A of Form 7 of the JJ Act. In that, we record what expectations the child has from us and how the child is using the resources that we have provided to him.
CWOs are also responsible for tracing family contacts in an attempt at restoration of the child and regular follow-ups once the child has been restored. Some officers stay in touch with the district child protection officer (DCPO) to be able to trace back missing children, and to prepare quarterly progress reports for their record-keeping.
P1: If a child turned missing and reached us, we try our best to trace his family back. Just because the child came to the home does not mean that we will keep him here, we try to trace his family as well. We contact the DCPO and police of the district and state from which the child is coming from and work to trace the family and that too is the work of a welfare officer.
Daily Care and Household Routines
House fathers are responsible for the health, hygiene and discipline of children inside the institution. The daily routine of the children is also maintained by them. These caregivers work 8-h shifts, alternating between morning, afternoon and night. Their roles differ depending on the time of day, but majorly encompass maintaining the daily routine of the child, such as timely meals, morning exercise, attending classes, school attendance and others. Security is also a major priority.
P2: So to get them ready, be careful when they are bathing, to make sure that no one is watching them in the wrong way and to prevent bad touch.
Housefathers may often be caught ‘in between’ roles, completing miscellaneous tasks for the children as well, such as taking a child to the hospital or getting his official documents in order. Housefathers also find themselves to be confidants of the children due to proximity in routine and often give them advice, guidance and companionship. Findings suggest that despite strong emotional commitment, structural limitations undermine optimal care delivery. Trauma-informed training and organisational reforms could enhance adjustment outcomes.
Education and Skill Development
Two teachers are employed by the institution to provide private classes to the children in addition to attending school. These teachers are responsible for taking classes both in the morning and evening, depending on the different schedules of the older and younger children. These classes are mixed and divided between younger and older children. Different subjects are taught on different days. Recreational games and movie streaming are also commonplace when the children finish their classes. Teachers are not only responsible for following up on the school syllabus, but they also aim to develop holistic growth by helping children cultivate motivation, critical thinking and skill building.
Counselling and Mental Health Process
A counsellor is available inside the children’s home for children to address their emotional/social requirements and behaviour dysregulation. The counsellor predominantly takes individual sessions with the children, records their progress and mental well-being (or otherwise), and is responsible for preparing CWC reports to be submitted regularly. This, however, does not make her inaccessible for daily concerns such as missing copies or a fight with a friend.
Placement, Tracing and Restoration
Duties of placement, tracing and restoration do not fall to one person; instead, it is divided between multiple people both inside and outside the institution.
Children are moved to homes depending on proximity and the needs of the child. The CWO of that institution is responsible for receiving the child and handing them over to the housefather. Housefathers often take up miscellaneous responsibilities such as document work, school enrollment and others, for the smooth placement of the child.
Restoration of the child includes attempts at tracing the child’s family. This includes the joint efforts of the CWO and the DCPO of the concerned state.
Warmth and Guidance to Children
Although this does not fall in the list of formal duties and responsibilities for any caregiver, many explain their duties by referencing the guidance-giving aspect of caregiving. Guidance may seem like introducing a new perspective to children or motivating them to study for a brighter future.
P1: So then we have to explain to them that the work they are doing outside is of such nature that they will end up doing the same kind of work their whole life and be able to learn nothing. But if you study, and this is not the age where you should be working.
All caregivers mentioned that treating the children with warmth and care was a part of their responsibilities. Caregivers try to maintain a positive attitude around the children to provide a supportive environment with adequate love and care.
Child Experience and Adjustment
Trajectory of Adjustment
Caregivers report a very slow and individualistic adjustment pattern for each child. Some children find it easier to adjust to life inside a children’s home than others. For example, children who have been victims of child labour feel that the institution is a ‘jail’.
P2: The rest, the child labour kids that come here, they are always in a hurry to leave. Because they think that, ‘I have come to a jail. I have made some mistake, I have committed a crime’.
Overall, with most kids, adjustment to the institution is slow and requires extensive trust building.
Caregivers note that children may ‘feel stuck’ in the institution initially.
In contrast to that, other children are more adjusted.
P5: There is a difference as in there are some children have not seen their parents, who have not been with them. I felt that they are very grateful to get this home.
A caregiver observes that kids with independence prior to institutional life have more problems accepting and adjusting to their circumstances.
P1: A lot of kids here are kids that have run away multiple times from other places. So, the kids that are runaways, that have worked outside, that have lived a life outside, that kid would always ask ‘why do I have to stay here?’ so such kids would want to leave, but most of the other kids are happy to be living here.
Children express wanting independence and resist confinement, with some children even attempting to run away multiple times. ‘Runaways’ often display a pattern of repeated attempts at escaping from the institution.
P2: Other than them, the kids who have a tendency to run away they think about trying to find an opportunity for staff negligence or an opportunity to run away from here, so even we need to be cautious about them.
The caregivers often tend to view runaway children as difficult, and some may fail to view them as a response to emotional dysregulation and adjustment problems.
P5: Yes, for sure, yes, they do, yes, they run away as well. So when that happens, we take the order from CWC, Alipur, and wherever the kid wants to go, whichever home, we send him there. Attributing the choice to run away to preferring not to live in that particular institution, not maladjustment to institutional life in general.
However, most children adjust to institutional life, with ‘runaways’ remaining a minority. While occasional discontentment may persist, children often start looking at their caregivers for support and guidance. This transition is marked by building trust.
Another perspective introduced by one of the participants was that children are forced to adapt to their surroundings despite being unwilling. He states that when the child comes to terms with his circumstances, he has no choice but to accept it and try to settle into the institution.
P5: The kid sees for himself. What is the state of affairs outside? The benefits he is getting over here, of shelter and food and drinks, that’s not there outside. Well, let’s take the main need he has, which is water, food and a place. So where will he sleep? So, in the end, the kid cannot go anywhere, and if the kids do run away, then they get into trouble and have to suffer through it. A lot of kids come back as well.
Socialisation and Peer Dynamics
Children at this institution show high amounts of socialisation with other residents. Their daily routines are normally carried out in each other’s company. Children mingle amongst themselves and also with other children at school. Caregivers note that socialisation with other children aids adjustment and helps the child feel more stable in their environment.
A caregiver notes that these children are very used to being in the constant company of others and may even face problems socially in the absence of company. Having constant company has made them socially adept and ‘good to go’.
Staff–Child Relationship Dynamics
Familial Metaphor and Care
A common theme in all caregivers’ narratives is the reference to familial relationships. Caregivers often compare their interactions with the children to those with their family members, describing it as occasionally difficult and emotionally draining, but loving, caring and forgiving overall.
P1: So it’s like how we have to fulfill all our responsibilities towards our child at home, here too it’s similar like ‘why didn’t you go to school?’ ‘I didn’t have my uniform’, ‘I didn’t feel like it’, ‘I didn’t do my homework’. So whatever we have done for our own children, I feel similar sentiments when I come here to work and I feel like once again I’ve come to my house and here too I have the same roles which I had in my own house.
Caregivers actively try to provide a warm and supportive environment to facilitate the acceptance and adjustment of children. They report providing personal guidance and advice for the future and being available for daily concerns and complaints.
P5: As soon as I enter, children are there, uh, around my office. My office is a child-friendly room. So, children, they greet me in the morning. They start coming to my office, sharing their issues. Right from the morning, they start complaining. [tone is affectionate] So that’s how my day starts.
Mixed/Conditional Trust: Give and Take Mentality
Despite the caregivers’ best efforts, occasional discontentment and underlying tensions are quite common between children and caregivers. Most caregivers report that children have mixed feelings about their caregivers. While some children share positive relationships with their caregivers and turn to them for support, others may struggle to do so. Caregivers perceive an ambivalent relationship with the children, perceiving contentment when the needs of the child are met, and good behaviour with supportive staff.
P2: Because kids only share and behave well with people who properly understand what they are saying and agree with them and work for them.
One participant notes that discontentment may rise from a clash of perspectives due to differences in emotional maturity. However, caregivers try to focus on the root cause of the conflict to be able to resolve it.
P3: Mostly, the clashes that happen, happen from the side of the kids because the kids are not in that state yet where they can understand things properly. And they are teenagers so they are a little bit aggressive towards others.
Boundary and Role Tension
Caregivers note that their interactions with children are sometimes emotionally draining, especially when they are expected to always portray a positive and accepting persona. Self-regulation of emotions may prove difficult when the child is behaving in a hostile or aggressive way and proves to be a challenge for many caregivers.
P2: So we have endured a lot for the kids, we have to be very controlled while talking to the kids, we cannot express our anger, we can only speak with love. Once or twice, I have had arguments with kids. The kids say whatever they want but we ignore it and speak to them nicely.
Participants mention their struggles to bring about positive change, being ‘taken for granted’, and struggling to meet the constant needs of the children, which they report as ‘ever-changing’.
P5: Some children are not grateful at all. They are like, the government is working for us and this is our right. So, all of them are aware of the rights, but some are very grateful, and some are not.
Emotional draining may increase even more in the face of public expectations. In the event of a misfortune such as the death of a child due to medical reasons, caregivers reported experiencing a high backlash from the family and very low cooperation and consideration.
Emotional and Behavioural Challenges/Obstacles with Children
The major obstacle reported by most participants was establishing trust with the children. With frequent changes in the administration and new people, including external teachers, guests and interns coming in every day, these children struggle to trust their caregivers. Participants report it to be a long and challenging process, and say it may stem from unstable attachment due to constantly changing staff and a lack of individual attention for each child.
Acceptance issues are another major obstacle reported by the participants. Children struggle to accept their circumstances and struggle with emotional and behavioural challenges such as low motivation, procrastination, aggression, misbehaviour and conflict. This impacts the child’s relationship with other children and caregivers alike.
P3: They have issues with willingness as well. They are not willing to move forward in life and they are not able to.
Miscommunication persists extensively as well, ranging from limited communication to pretence and lying.
P3: They pretend a lot of times and can be pretentious. You won’t be able to understand what they want to say to you; often, they lie in order to hide things.
The second objective of this study was to explore the different factors that had a positive impact on institutionalised children and helped them in better adjustment and subsequent integration into society. Positive influences on children’s mental health and adjustment are discussed.
Requirements for Child Adjustment
Caregivers point out certain physical and psychological needs that are crucial for the development of children in the institution. Children need a stable source of material resources and a disciplined routine to feel settled in. Those who require special attention (medical requirements, special educators and others) need individual resources and attention.
Second, education is an important requirement. Caregivers mention that it is crucial to build a career and thus, the institution emphasises that their education to be structured and regular.
Third, emotional support helps children to shift from a survival mode to a more relaxed state. Once physical needs are met, caregivers turn to their needs for emotional support.
It is facilitated by open and dynamic conversations.
However, many kids live here; they are all in survival mode. So, to bring them out of that survival mode is the biggest task and the most important task, because only after that can we process things further.
Practices Instilling Positive Child Mental Health
Caregivers have certain practices that are meant to promote positive mental health, which help children adjust to their new environment while also enhancing their mental health and positive traits.
Aiding Adjustment in CCI
Caregivers share complementary ways of helping a new child adjust to their environment. Most caregivers prefer a slow start characterised by enough space to adapt, build rapport with the child, and avoid any intrusive questions.
P5: So, in the start, I never asked them about their past because, uh, in the start, if you ask them about the past, they are like used to it because every other welfare officer or every other person coming from outside for their counselling session, maybe. Earlier, the counsellor has already asked. So, the child gets very tired and sometimes they lie about the past. This is never the first question of mine.
Caregivers remain approachable and offer help and care when needed. Communication increases as the child becomes more comfortable, and this often needs to be addressed with acceptance and empathetic listening.
P5: They come to me for every issue, not only their trauma, they come to me if they don’t have something, if they don’t have the drawing book, if they don’t have something, they come to me for every complaint, so they know that she’ll listen to me, so they come for that. Every problem, not only the issues, yeah, because they think that she’s very selfish [laughs], she will only want to know what she wants.
However, it is a lengthy process that takes time and multiple attempts. Communication must be dynamic and authentic.
P2: We need to talk to them always. It’s not like we have a fixed time that yes we will only talk to them in the mornings. Whenever we meet the kid, we speak to them nicely, ‘how are you, what have you been doing, what plans do you have after this’. We need to always stay in touch with them.
Trust building is a crucial part of this process. It helps bring the child out of their ‘survival mode’.
As discussed before, the dynamic environment of the institution makes for an unstable environment and makes trust-building even more difficult and time-consuming. Children are helped through their adjustment trajectory in counselling sessions.
Enhancing Mental Health
Many support systems are in place to support and enhance children’s mental health. To tackle difficult issues such as trauma, loss or adjustment issues, counselling sessions are held with the children. The counsellor present has completed training for trauma and suicide awareness. These sessions are a place where each child can get individual attention. If the counsellor determines that the problem is beyond her scope of treatment, the child is sent to the clinical psychology department of a government hospital.
Apart from professional help, the child is also given guidance and support from every other caregiver. This includes helping the child develop emotional maturity, self-confidence and motivation. This process starts from trust-building and is continued till the child is restored or attains legal age and leaves the institution.
P3: There is a kid X, so that kid has a lot of difficulties in dealing with his emotions, where he can’t decide what is important in his life. What is important that he should do? Even if I’m studying something, why am I studying it? What if all this gets wasted? So, the demotivation that was constantly showing in that kid’s behaviour, I tried resolving it through my own examples. That ‘whatever we do, we get the results for it’.
Aiding Reintegration into Society as an Adult
Caregivers are aware that every child is only inside the institution for a limited time period, and hence, they start preparing the children for life outside. This could be multifaceted, from academic motivation building to learning new, employable skills. The children who move into aftercare are taught to be more independent and take care of their own needs.
Children are also given awareness sessions about societal issues, such as gender sensitivity, and caregivers are available to answer their questions about careers and future life.
A participant notes that there is a gap between the children’s reality and the outside world, one which will only be resolved by actual contact after turning 18. The institution tries to bridge the gap as much as possible by providing support for career building and emotional support.
P5: We try to tell them, but the thing I feel is that even if we try to tell them, like by our words, by our experiences, they will have to face the real world, they will have to have the real practical experiences.
The third objective of the article was to explore what problems and shortcomings were faced by the institution in caregiving and management. Both shortcomings at the management and personal levels have been explored in relation to the same.
Limitations in Caregiving
The institution provides a safe environment for the children and constantly attempts to promote their academic and psychological development. However, certain shortcomings in management, institutional resources and caregiver functioning may pose challenges to efficient functioning. Some caregivers share that they lack formal education in psychology, which may occasionally make dealing with trauma or loss difficult.
Participants also report an ineffective system of communication and feedback, which does not allow caregivers to effectively communicate problems or messages to one another. There is no shared time or scope for peer learning, and skills are not shared amongst the caregivers.
The institution also faces problems of understaffing and low salaries for the employees.
This adds an extra burden without fairly compensating the caregivers for their time and effort.
P5: Madam, see this is an NGO. Now in an NGO, the salary is not that high, I have been here from around 2004 and how much do I even get?
Occasionally, the late delivery of everyday groceries may also delay the day’s tasks. The institution’s documentation system remains manual and undigitalised, making the task of documentation and storage labourious and sometimes ineffective.
P1: Here, we don’t have a computerised system. Sometimes we do have problems because then our documentation remains weak. Say, for example, if our system is not working and a report has to go today, then how will they send it?
Another problem noted by a participant is the stigmatisation of mental health. Mental health is still considered to be a sensitive topic, and some caregivers rarely address it openly. Those who do admit to having little knowledge about it. This stands in stark contrast with their daily roles, which are meant to promote better mental health in the children. A participant believes that while many measures exist for enhancing mental health, they are only in place due to governmental mandates.
P5: They have placed mental health on a secondary basis. The institution places mental health on a secondary basis. It is here because of the government thing and because the counsellor is compulsory in the JJ Act.
Conclusion
This study explored caregivers’ perspectives on the psychosocial adjustment of boys living in a residential children’s home in Jahangirpuri, Delhi, using thematic analysis. Caregivers described a complex picture in which pre-institutional trauma and the structural realities of institutional care interact bidirectionally to shape children’s emotional, behavioural and social functioning. Recurrent challenges identified were difficulties with trust and emotional regulation, externalising behaviours (verbal/physical aggression), low academic motivation and ambivalent relationships with staff. At the same time, caregivers reported meaningful protective processes, which included warm, consistent caregiving, structured routines, education and skill-building efforts, counselling services and deliberate trust-building practices that supported the child’s gradual adjustment and laid the groundwork for later reintegration.
The findings highlight three interrelated implications for practice and policy. First, the psychosocial needs of institutionalised children require sustained, trauma-informed interventions rather than one-off or purely administrative responses.
Second, strengthening caregiver capacity (formal training in child development and trauma-informed care, regular peer supervision and adequate compensation) and institutional systems (digitalised documentation, reliable staffing, coordinated mental-health referral pathways) would reduce role strain and enhance the quality of day-to-day caregiving.
Third, preparation for adulthood must begin early and be multi-faceted, which includes combining formal education, vocational skills, life-skills training and structured aftercare to bridge the clear gap between institutional life and independent living.
Limitations of the present study encapsulate any generalisations: the sample was small, drawn from a single, male-only CCI, and it relied solely on caregiver narratives. Children’s own voices, perspectives of family members, and quantitative indicators of psychosocial functioning were not included and would enrich understanding.
Future research should (a) incorporate children’s lived accounts and longitudinal follow-up of young people leaving care, (b) evaluate the effectiveness of targeted, evidence-based interventions (trauma-informed training for staff, structured aftercare programmes, specialised educational support), and (c) examine system-level reforms that improve monitoring, resource allocation and cross-agency coordination. Policymakers and practitioners should prioritise investment in mental health capacity, systematic family tracing and restoration where feasible, and transition supports that enable positive adult outcomes.
Footnotes
Authors’ Contribution
All authors contributed substantially to the conception and design of the study. Grover, Rastogi, Chakroborty were involved in data collection and analysis. Grover, Chakroborty drafted the manuscript, and Grover, Rastogi critically revised it for important intellectual content. All authors reviewed and approved the final version of the manuscript and agree to be accountable for all aspects of the work.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Funding
The authors received no financial support for the research, authorship and/or publication of this article.
Patient Consent
Informed consent was obtained from all participants prior to inclusion in the study. Confidentiality and anonymity were maintained throughout.
Statement of Ethics
All ethical standards have been adhered to in the course of this research.
