Abstract
Background
Child psychiatric and neurodevelopmental disorders (NDDs) significantly affect children’s physical and psychological well-being, while also placing substantial emotional and financial strain on families. Most existing research on the prevalence of childhood NDDs comes from urban populations, leaving rural communities underrepresented and poorly understood.
Methods
This retrospective study examined medical records of children diagnosed with psychiatric and neurodevelopmental disorders from rural areas of Assam, North-East India. Diagnoses were established according to the International Classification of Diseases, 11th Edition Clinical Description and Diagnostic Requirements (ICD-11CDDR). Descriptive statistics were applied to summarise socio-demographic variables and diagnostic distributions.
Results
Over a 20-month study period, 300 children from rural Assam sought treatment at our hospital, of whom 214 provided consent for inclusion. Among these participants, 36% were diagnosed with a neurodevelopmental disorder, while 82% presented with a psychiatric condition.
Conclusion
Neurodevelopmental disorders impose a considerable burden on families. In rural areas, lack of awareness and stigma frequently delay treatment, exacerbate comorbidities such as epilepsy, and worsen long-term outcomes. These findings highlight the urgent need for community-based epidemiological studies in rural settings to better estimate the true burden of NDDs and to inform policy development and advocacy initiatives.
Plain Language Summary
Children’s mental health problems are common but often overlooked in rural areas of India. This study reviewed medical records from children in rural Assam who were referred by local community health workers, called Swasthya Mitras, to a hospital’s psychiatry department between June 2022 and January 2024. Out of 300 children, 214 families agreed to take part. About one in three children had a neurodevelopmental disorder, such as autism or intellectual disability, while more than four out of five had a psychiatric condition like anxiety, stress-related problems, or mood disorders. The study found that many families delayed seeking help because of stigma, limited awareness, or the belief that traditional healing alone could solve these issues. Most families had low incomes and struggled to afford treatment or travel for follow-up visits. Anxiety and stress disorders were most common, followed by substance use, particularly cannabis, which is widely available in the region. Children with developmental problems rarely returned for follow-up, often due to the lack of therapy and rehabilitation facilities. The results show an urgent need to strengthen rural mental health systems. Training programs like the Swasthya Mitra initiative can help identify problems early and connect families with care. Integrating psychiatry, pediatrics, and rehabilitation at affordable costs would improve access to treatment. Policymakers should focus on creating community-based services that reduce stigma and bring mental health care closer to rural families. This model from Assam could guide other developing regions working to close the treatment gap for children’s mental health and developmental disorders.
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