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 Table of Contents  
REVIEW ARTICLE
Year : 2019  |  Volume : 20  |  Issue : 1  |  Page : 3-8

Beyond infatuation and love: Review of adolescent mental health manuals in India


Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India

Date of Web Publication20-Jun-2019

Correspondence Address:
Dr. Janardhana Navaneetham
Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AMH.AMH_1_19

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  Abstract 


Romantic relationship is one among the defining feature and developmental task of adolescence, often considered to have significant influence on the course of other developmental tasks, overall health and wellbeing. Thus the present paper made an attempt to review different mental health promotion manuals developed for adolescence in India with the aim to understand whether those manuals address the emerging issues of adolescence in romantic relationship. Seven manuals were selected for this purpose and reviewed based on its content, methodology, target population and how issues pertaining to romantic relationship has been addressed. It was observed that all the manuals covered different aspects related to developmental needs and concerns of adolescents in general; especially the developmental significance of romantic relationship with its socio-cultural background has received little attention. Therefore this article implied for developing comprehensive manuals on emerging issues of adolescents in romantic relationship as a great need of the time.

Keywords: Adolescents, India, manuals, narrative review, romantic relationship


How to cite this article:
Basavaraju M, Navaneetham J. Beyond infatuation and love: Review of adolescent mental health manuals in India. Arch Ment Health 2019;20:3-8

How to cite this URL:
Basavaraju M, Navaneetham J. Beyond infatuation and love: Review of adolescent mental health manuals in India. Arch Ment Health [serial online] 2019 [cited 2019 Nov 15];20:3-8. Available from: http://www.amhonline.org/text.asp?2019/20/1/3/260768




  Introduction Top


Adolescence is fa crucial period for every individual with ample of rapid physical, psychological, and social changes.[1] Romantic relationship is one among the defining feature[2] and developmental task of adolescence.[3] It is also considered to have significant influence on the course of other developmental tasks.[4] Existing literature in this area is overwhelmingly emphasized on the importance of romantic relationship in the lives of young people as they move from early-to-late adolescence.[5]

On the one hand, healthy romantic relationships have potential benefits for adolescence, and on the other hand, unhealthy relationships pose end number of risks and long-lasting impact on them.[3] Apart from this, quality of romantic relationship can also have enduring effects on self-esteem of adolescence and shape their personal values regarding romance, intimate relationships, and sexuality.[6] Many of these issues are being addressed through various government programs, policies, school mental health program, and adolescent education programs.[7] However, it is estimated that only 1% adolescents receive quality counseling, health, and medical services in India.[8]

Pertaining to mental health of adolescents' school mental health program plays a vital role, even in addressing the concerns related to romantic relationship. In India as a part of school mental health program, primary attention is given to developmental needs, prevention of high-risk behaviors such as substance abuse, sexuality, HIV/AIDS, and promotion of mentaffl health through life skills education, mentfal health orientation to teachers, student enrichment programs, etc.[9] Various governmental and nongovernmental institutions have developed manuals in line with such programs. Even so, very minimal focus is vested upon romantic relationship among adolescents despite of its magnitude which may result in abiding impact on their life. In this context, the present paper made an attempt to review the available manuals in India developed to address mental health promotion of adolescents in romantic relationship.


  Methods Top


The present article is a narrative review of manuals and training modules on adolescent mental health in India with special focus on adolescent romantic relationship. The aim of this article is to understand whether the existing manuals address the emerging issues of adolescence in romantic relationship.

The literature search for the present study was both manual and electronic and carried out using appropriate keywords such as adolescent mental health.

School mental health in India

The research team reviewed manuals and modules on Adolescents school mental health available in Idnia. A researcher could gather total seven manuals which are published and available freely with full text from different sources including website of the Government of India, National Council on Education, and organizations working/publishing resource materials for children and adolescents, National Institute of Public Cooperation and Child Development, Research and Training.


  Results Top


A brief description on the manuals reviewed with its methodology and key areas covered is given in [Table 1]. The results show that most of the manuals are training manuals with activities and reading materials designed for teachers, counselors, parents, and students as its target population, while majority have adopted life skills approach and few used general adolescent mental health programs. Participatory methodology was followed in all the manuals using different techniques such as group activities, case study method, role play, and games. Utmost importance was given to developmental needs and issues, sexuality and reproductive health, substance abuse, enhancing academic competence, stress management, and psychosocial competence (skills) in general as its focal areas. Most of the manuals are field tested and found to be effective in enhancing psychosocial competence and mental health among adolescents. Interestingly, the concept of romantic relationship has been discussed under the domain of interpersonal relationship with peer and opposite sex in almost all the manuals. Case vignettes, case study, and group activities were used to enable adolescents to identify the difference between romance, love, infatuation, etc., emphasizing upon accepting and maintaining healthy relationships, dealing with pressure to have sex, consequences of healthy/unhealthy relationship, and different ways of handling the crisis situation in romantic relationship. Through this attempt was made to enable adolescents to identify their feelings and generate thoughts on healthy ways of dealing with stressors in interpersonal relationship and skill enhancement in this regard. Among the 7 selected manuals, only one manual deals with handling breakup and managing stress in the context of romantic relationship. Surprisingly, the developmental significance of and issues related to romanticf relationship, skill enhancement in maintaining healthy relationship, dealing effectively with the consequences of unhealthy romantic relationship, risk behaviors, and prevention of it have received little attention in all the manuals. Role of school counselors becomes very important while delivering school mental health programs and providing counseling services to address the needs of adolescents.
Table 1: Describes various manuals related to school mental health

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  Discussion Top


As a whole, all the manuals reviewed have focused upon overall developmental needs, psychosocial issues, and skill enhancement in handling them effectively during adolescence. Existing literature in the area of adolescent romantic relationship emphasized on its developmental significance.[10] In connection to it, the manuals also recognized this finding but failed in addressing it holistically by considering it as one part of adolescent concerns. It was also highlighted by the researches that romantic relationship may pose a great risk on adolescence in different areas of life including decreased academic performance, unsteadiness of mental health characterized by depression, antisocial behaviors, and dating violence.[6],[11],[12],[13] The manuals have attempted to address these issues in a general context through skill enhancement to deal with such problems, undermining the influence of romantic relationship them. Studies have also focused upon sexuality and reproductive health in the context of romantic relationship and reported that dating relationships put teens at the peril of sexually transmitted infections and teenage pregnancy. Inducing pressure for sexual activity,[3] especially on girls who have had prior experience of sexual engagement and tolerance toward sexual coercion, is considered to be acceptable among young teens as reported by the researches.[14] Probably because of these findings, manuals have thrown light on premarital sexual relationships, i.e., both consensual and nonconsensual under the heading of sexuality and reproductive health and emphasized upon safe sex practices, prevention of teenage pregnancy, and their rights. Predominately, case vignettes and group discussion methodology were adopted in addressing the consequences of unprotected sex, importance of saying “NO” (assertive skills), and negotiation skills to responding to their partners and to enable adolescents to be in a healthy relationship.

In the west, studies proved that the risks associated with adolescent romantic relationships can be minimized by helping young people to develop skills that support healthy relationships[15] through school- and community-based programs.[16] For instance, expert convening on healthy teen relationships, held at Atlanfta in 2011, recommended the need for identifying quality of relationship and fundamental skills relevant for managing a healthy adolescent romantic relationship, designing a continuum of healthy and unhealthy teen dating behaviors, including diverse youth perspectives to facilitate the development of a definition of healthy teen relationships, and empowering youth to lead decisions about the language and tools used to promote healthy relationships. They have also suggested that healthy teen relationship education can take place in variety of settings, such as communities, schools, and health clinics.[17] In accordance with these recommendations, the manuals reviewed from Indian context also stressed on different areas related to meaning and characteristics of healthy and unhealthy teen relationship along with introducing the difference between infatuation, love, and friendship under the heading of interpersonal relationship. Although based on the review, it was observed that developmental significance of adolescence romantic relationship is not addressed adequately and also issues pertaining to romantic relationship and dealing with the consequences of it is not given much importance. India by virtue of having collectivistic culture the concept of romantic relationship is shaped by end number of sociocultural factors. Often being in romantic relationship, especially during adolescence is considered as something obnoxious, it further worsens if it is a girl. Hence, during recent years, running away from home, child marriage, unsafe sexual relationships and teenage pregnancy are some of the issues of adolescent with romantic relationship gaining momentum for the social science researcher to understand the phenomena and to develop interventions.

Thus, there is an immense need for addressing these issues at family, schools, and community level considering the sociocultural determinants of romantic relationship among adolescence in India. Manuals could be one of the key tools for planning and implementing such programs. Therefore, the focus of the manuals should be shifted from general mental health needs of the adolescents to addressing their concerns related to romantic relationship, designing preventive measures against risk-taking behaviors, and promoting mental health and overall well-being. Apart from this, more attention also needs to be given to research, training, and therapeutic services in the area of adolescent romantic relationship. School social workers have a crucial role in addressing their issues, preventing risk-taking behaviors, and promoting their mental health. School social work being a helping profession having the expertise of diverse sociocultural understanding of the people has a great implication at preventive, promotive, and curative level in this area. School social workers could play a key role in addressing various concerns highlighted by the studies in this area such as support needs and skill development in maintaining healthy relationships without violence, maintaining emotional stability, enhancing parent–teen relationship, balancing other developmental tasks such as academic and career growth and healthy sexual behavior, launching out as responsibilities, marital preparedness, improving family and peer relationships, and promoting mental health and well-being. All these can be achieved through developing comprehensive manuals on emerging issues among adolescence. Alongside research studies also need to be conducted in feasibility testing of such programs and evaluating its efficacy.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Mission NH. Training Manual for Adolescent Health Counsellor Facilitator's Guide. India: National Rural health mission; 2015. Retrieved from: http://www.nhm.gov.in/nrhmcomponnets/reproductive-child-health/adolescent-health.html. [Last accessed on 2016 Apr 20].  Back to cited text no. 8
    
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Kumar D, Bharath S, Hirisave U, Agarwal S, Shah H. School mental health programs in India. School Mental Health: Global Challenges and Opportunities. NIMHANS Publication Bangalore; 2015. p. 95.  Back to cited text no. 9
    
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Quatman T, Sampson K, Robinson C, Watson CM. Academic, motivational, and emotional correlates of adolescent dating. Genet Soc Gen Psychol Monogr 2001;127:211-34.  Back to cited text no. 12
    
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Williams TS, Connolly J, Pepler D, Craig W, Laporte L. Risk models of dating aggression across different adolescent relationships: A developmental psychopathology approach. J Consult Clin Psychol 2008;76:622-32.  Back to cited text no. 13
    
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Albert B, Brown S, Flanigan CM. 14 and Younger: The Sexual Behavior of Young Adolescents. Washington Dc: National Campaign to prevent teen pergnancy; 2003.  Back to cited text no. 14
    
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Wood E, Senn CY, Desmarais S, Park L, Verberg N. Sources of information about dating and their perceived influence on adolescents. J Adolesc Res 2002;17:401-17.  Back to cited text no. 15
    
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Foshee VA, Bauman KE, Arriaga XB, Helms RW, Koch GG, Linder GF. An evaluation of Safe Dates, an adolescent dating violence prevention program. Am J Public Health 1998;88:45-50.  Back to cited text no. 16
    
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Foundation RWJ. Healthy Teen Relationships: Expert Recommendations to Improve Research and Practice on Adolescent Dating Relationships. Atlanta, GA: Centers for Disease Control and Prevention; 2011. p. 51.  Back to cited text no. 17
    



 
 
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