Violence against females, children & elderly and related issues of Mental Health

“Less visible, but even more widespread, is the legacy of day-to-day, individual suffering. It is the pain of children who are abused by people who should protect them, women injured or humiliated by violent partners, elderly persons maltreated by their caregivers, youths who are bullied by other youths, and people of all ages who inflict violence on themselves. This suffering – and there are many more examples that I could give – is a legacy that reproduces itself, as new generations learn from the violence of generations past, as victims learn from victimizers, and as the social conditions that nurture violence are allowed to continue. No country, no city, no community is immune. But neither are we powerless against it. Violence thrives in the absence of democracy, respect for human rights and good governance.”

Nelson Mandela (WHO’s World Report on Violence & Health)

Violence and abuse affect all kinds of people every day world over. It doesn’t matter what race or culture you come from, how much money you make, or if you have a disability. It may take the form of physical and emotional abuse, neglect and sexual abuse. Violence against anyone, in any form, is a crime, regardless of who committed the violent act. It is always wrong, whether the abuser is a family member, a current or past spouse, friend, an acquaintance, or a stranger.

Violence can shatter the life of its victim in many ways. Acts of violence have terrible results for everyone involved, including families, communities, and society. Being a victim of violence is widely recognized as a cause for mental health problems, including post-traumatic stress disorder, depression, anxiety, and panic attacks. Empirical research has demonstrated that exposure to violence affects person’s social, emotional, and cognitive development. Furthermore, such exposure has long-term consequences for a person’s well-being, ultimately affecting their adult functioning.

In India, societal factors and the family set up contribute to the abuse, exploitation and violence against females. Our society encourages men to be aggressive and women to be submissive. Women hold a second class citizenship till date as against their male counterparts despite the various efforts made by our government and policy makers. And it is the women from socially and economically deprived sections of society, which are more at risk to violence and aggression.

The Declaration on the Elimination of Violence against Women adopted by the United Nations General Assembly Resolution in 1993 defines violence against women as: “Any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life.”

Violence against women has been reported all over the world and it has devastating consequences for women, children, and families. It has serious consequences for their physical and mental health. Abused women are more likely to suffer from depression, anxiety, psychosomatic symptoms, eating problems, and sexual dysfunctions. They are more likely to be diagnosed with serious health problems including panic attacks, high risk behaviors such as tobacco and substance abuse and sexual risk taking, as well as migraines, chronic pain, arthritis, high blood pressure, gastrointestinal problems, inconsistent use of birth control, and delayed entry into prenatal care. Effects of violence may also be fatal as it can result in intentional homicide, severe injury or suicide.

There are also reports of child abuse and neglect in families characterized by domestic violence than in the general population. Where national awareness of the impact of domestic violence on women has grown in recent years, recognition of the needs of children who witness such violence has lagged behind considerably. Interest in and concern about children who witness domestic violence appears to be growing in recent years. The mental health professions are increasingly identifying the special needs of these children.

It has been observed that there is an extreme variation in the children’s responses to their experiences with domestic violence. They may emerge relatively unscathed or reveal a range of adjustment problems and psychopathology. Data indicates that these children may suffer extensively and are vulnerable to developing a series of problems. The children’s response to acts of violence around them depends upon what the child actually saw or heard, his/her temperament, his/her age at the time(s) of exposure, the severity and continuity of the violence, and the availability of adults who could provide an emotional support.

The symptoms these children may display include aggressive behavior, reduced social competencies, depression, fears, anxiety, sleep disturbances, and learning problems. They may also suffer from the symptoms of post-traumatic stress disorder, such as bed-wetting or nightmares, and were at greater risk than their peers of having allergies, asthma, gastrointestinal problems, headaches and flu. Many of these problems can be traced to the children’s emotional responses to the violence, such as intense terror, fear of death, and fear of loss of a parent. At times, they may feel guilty, angry and responsible for the violence.

Apart from witnessing violence, many children are victims of such acts. They experience violence at home, within their family and from other children and strangers. A small proportion of violence against children leads to death, but most often the violence does not even leave visible marks. Yet it is one of the most serious problems affecting children today. Much of the violence remains hidden. The fear of punishment from their abuser holds them back from reporting such acts of violence. Most often than not, both the child and the abuser may not see anything unusual or wrong in the child being subjected to violence. It is worth noting that many may not consider an act of violence actually to be violence at all, and view and justify it as a necessary punishment for the child. This belief that they deserved the violent punishment, may leave the child feeling guilty and ashamed. And this is one of the reasons why children are unwilling to speak about it.

Many children around the world experience violence as a regular part of their school experience. Schools, which facilitate the overall healthy development of the children, many a times, become the source of violence and abuse. Apart from enduring the acts of violence, the school authorities victimize the child through their failure to take necessary action against the abuser leave alone preventing such an act. If the act of violence is not enough of a trauma for the child, it is the inaction on the part of the school authorities that disheartens the victim’s hope for any justice. Encouraging the victim to move to another school only adds to the child’s suffering.

The results of school violence can be devastating. Apart from having an affect on the children’s health, it can also affect their learning abilities and willingness to go to school. Many such children either start skipping classes or change schools or drop out altogether. Some even resort to committing suicide. Feeling unsafe going back to same violent environment have often been cited as the reason for leaving the school altogether.

Violence destroys children’s self-confidence and has a bearing on their ability to be good parents in the future. Children subjected to violence have a heightened risk of depression and suicide in later life.

It is important to note that age or gender is no criteria when it comes to being a victim of an act of violence. Violence against elders has also surfaced in the recent years. In maximum cases the abuser is a family member – children or spouses. The factors that make them prone to such an abuse include a history of mental illness, a family history of violence, poor health, substance abuse problems, and lack of financial resources. At times caregivers of elderly people become resentful due to the long term care and support required at this age. Being a victim of violence within the family, the older people live in a corner of the house, lack access to basic necessities and have no financial support. They receive little respect and affection, and have limited access to community-based organisations from which they can benefit through participation.

The problem of violence is much severe and greater than we imagine as our community considers the issue of violence as relevant only to children and women, not as a problem for older people. Our society till date does not recognise any rights of older people to participate in the community or to raise their concerns. Illiteracy particularly amongst older women leaves them with not many options to defend themselves against acts of violence as inflicted by their caregiver. Open wounds, bruises, malnutrition, depression and fearfulness especially in the presence of the caregiver, misuse or stealing of an older person’s money or possessions, and unsanitary or unclean living conditions are a few of the symptoms of violence against the elderly. Violence against elderly also covers misuse of the elderly persons money or property through fraud, trickery or force.

Many health problems are associated with violence and neglect of the elderly. Repercussions of acute trauma, including death, as well as long-term physical and mental problems, such as depression, post-traumatic stress disorder, somatization, suicide, and substance abuse are a few of them. They can suffer from severe trauma: Physical, mental, emotional and behavioural, which manifests itself in social isolation and low self-esteem. It may also result in suicide.

The long-term consequences for the victims of violence can be devastating. They leave life long physical and emotional scars resulting in psychiatric illness, inability to form meaningful relationships, and aggressiveness, which may be turned inward – suicide – or outward in the form of behaviour replicating the abuse inflicted upon them.

While the violence against women, children and elderly takes place all over the world, those from developing countries such as India are more vulnerable because of poverty, illiteracy, lack of support groups, low status of the girl child, ineffective implementation of laws and lack of awareness about their rights. Like any crime that continues to go unchecked, violence whether within or outside the homes directly reflects the health of society as a whole.

Violence exists in a “culture of silence” and denial, and of denial of the seriousness of the health consequences of such acts of violence in the society. The fact that domestic violence against women, children and the elderly has long been considered a “private” affair has contributed to the serious gap in public health policy-making and the lack of appropriate programmes. Given the negative repercussions of violence, there exists a need for programs that can help in providing support to the victims for their healthy psychological adjustment.

In the recent years tremendous efforts have been put in for reaching out to the hidden victims of violence. The society must provide healthy environment for the growth and well-being of all its members and particularly children. And the family acts as the main instrument for protecting them from all forms of violence. Violence needs to be tackled at all fronts in our society and we must refuse to pardon violence against its most vulnerable members.

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