Depression within An OSC Environment: Children, Young Adults and Caregivers in Delhi, India

Depression is a leading cause of disability globally, with an estimated prevalence of 350 million people (WHO, 2016). Persistent depression, which is often also co-morbid with physical health disorders, can impede daily functioning and lead to grave outcomes such as suicide, a leading cause of death among 15–29 year olds worldwide (WHO, 2016). Vulnerable populations, such as orphaned and separated children (OSC), who have experienced traumatic events are at an even greater risk of developing depression than their non-vulnerable counterparts (Cluver et al., 2012; Overstreet et al., 2017). This 2-year study describes the prevalence of depression among three distinct populations associated with Udayan Care, an organisation working on alternative care for OSC children in Delhi, India. A random sample of OSC (n = 67), a full sample of their caregivers (n = 29), and a convenience sample of recent graduates of the Udayan Care programme (aftercare and alumni; n = 25) were assessed on depressive symptomology during one-on-one interviews using the Center for Epidemiologic Studies-Depression Scale for Children (CES-DC) or the Center for Epidemiologic Studies-Depression Scale Revised, respectively. As a group in both 2015 and 2016, children living within Udayan homes and aftercare/alumni reported clinically significant levels of depression on the CES-DC scale. Average depression scores in both populations increased from 2015 to 2016 with 48% of aftercare/alumni (n = 12) and 70% of children (n = 47) scoring above the threshold for screening clinical depression in 2016. In addition, 1-year cross-sectional data of caregiver mental health suggests 30% of caregivers are also experiencing depression of clinical significance. Although not necessarily surprising, given the past histories and vulnerabilities of these populations, findings support the emphasis that alternative care programmes and mental health professionals have placed on the importance of depression-related care. This is especially pertinent for vulnerable OSC populations which include caregivers of OSC children and young adults transitioning out of residential care and/or alternative care homes. Future research continuing to follow this cohort longitudinally and investigating the connection between depression and other mental health risks as well as resilience in this population may help elucidate the best ways to support the specific needs of these vulnerable groups.