Other factors such as coping skills of parents themselves, child characteristics such as age, level of mental retardation, presence and absence of associated conditions etc. may also contribute immensely how far parents are able to face the challenge of having a child with mental retardation (Peshawaria, Menon, Ganguly, Roy, Pillay, and Gupta, 1995)..

Mental retardation is a serious problem affecting a large number of people. If we consider it alone, its incidence in general population is about three percent (as per WHO surveys) and 2.5% per simple statistical probability. If we consider the WHO survey figure take India’s population about 100 crore (though it is more now) than there are about 3 crore such children. Adding the number of parents (two each) the figure becomes 9 crore. Thus there are 9 crore people who are directly affected by this problem.

MENTAL RETARDATION:

Mental retardation is the most prevalent handicapping condition throughout the world. Since 1992, with the significant paradigm shift in the concept of mental retardation proposed by the American Association on Mental Retardation (AAMR). (Luckasson, Coulte, Polloway, Reiss, Schalock, Snell, Spitalnik, and Stark, 1992) it has been considered that mental retardation refers to substantial limitations in present functioning. Mental retardation, mental deficiency, mental sub normality and mental handicapped are the terms used to refer to the same condition. According to the American Association of Mental Deficiency, Mental retardation refers to “significantly sub average general intellectual functioning existing concurrently with deficits in adaptive behaviour, and manifested during the developmental period.” (Kring, Davison, Neale, and Johnson, 2003, p. 500).

An enormous amount of research and conceptual framework have been identified in the literature that describe the possible causes and contributing factors of parental stress associated with a disabled child and the deleterious effects these stressors have on parent’s well-being.

Singh, Indla, and Indla (2008) conducted a study to see the Impact of disability of mentally retarded persons on their parents. Mental retardation is a highly prevalent and highly disabling condition. In this study an attempt has been made to study both positive and negative impact on parents so as to help manage this problem in the best possible way. Parents of 65 mentally challenged children were selected at the outpatient department of P.G.I. Behavioral and Medical Sciences, Raipur, and two special schools of mentally challenged children and it was done by purposive sampling method.

Results showed that mean age of the parents was 37.43 ± 8.78. Among the parents males were slightly lesser in number. As per the level of education of the parents are concerned most of them had the education of either preuniversity or graduation. Other socio-demographic characteristics noticed were that most of the parents were from urban background, having nuclear family structure; majority of them belonged to lower middle to middle socioeconomic status. Clinical data showed that most of the retarded children's mothers did not have the history of 'infectious diseases' during first three months of pregnancy as well as most mothers did not have any history of severe physical illness. Coming to the clinical profile of the children it was found that most of the children were born normally and very few of them were born by caesarian process.

Due to the problem of subnormal intellect to their children most of the parents of the selected sample, that is, retarded children had problems like 'problem in interpersonal relationship' and 'communication'. But this study gives the heartening finding that most of the parents of the selected retarded children viewed that they have more 'positive impact' than 'negative impact'. This study shows that the overall percentage of positive impact was 55.38 while overall negative impact was 25.26. To these parents having a mentally challenged child in the family is not a 'burden like thing' but they are willing to see the situation more positively and overcome the situation more gracefully.

Upadhyaya and Havalappanavar (2007) found that parents of mentally retarded children face stress and the support from the spouse is an important factor in reducing such stress. Present study compares the level of stress among widows and widowers to that among families where both parents are alive. 154 families having a mentally retarded child, attending Karnataka Institute of Mental Health, Dharwad was studied. Stress among 77 single parents (58 widows and 19 widowers) was compared with that of 77 families (matched group) where both the father and the mother were alive. Test developed by Girimaji, Shobha, Shekhar, and Subba Krishna (1999) for measuring stress and coping in families having retarded children (FISC-MR) was used to evaluate the experienced stress. Results showed that single parents differed significantly regarding total stress and in all four areas of stress (care, emotional, social and financial stress).Stress was high in emotional and social areas compared to care and financial stress. Widows and widowers showed similar care stress. They differed significantly in their social, financial, emotional and total stress. Single parent families of mentally retarded children experience higher levels of stress (total and in all areas) compared to such families where both parents are alive. Total, social, emotional and financial stresses, were higher than the care stress among widows compared to widowers.

Venkatesh Kumar (2008) assessed the psychological stress and coping strategies of the parents of mentally challenged children. A total of 62 parents including both father and mother of the mentally retarded child i.e., 32 fathers and 30 mothers had been studied. To measure psychological stress – Perceived Psychological Stress Life Events scale for parents with Mentally Retarded Children (2003) developed by Venkatesh Kumar and Sheela was used and to measure Coping Strategies-Coping Skills Strategies for parents of mentally retarded children (2004) developed by Venkatesh Kumar were used. The analysis of the results showed that the relationship between psychological stress and coping strategies of the parents of mentally retarded children was negative and highly significant.

Beck, Hastings, Daley, and Stevenson (2004) measured that parents of children with intellectual and developmental disabilities generally report more stress than other parents. Child behavioural features, and specifically their behaviour problems, have been shown to account for some of the variation in parents’ experience of stress. 74 mothers of children with intellectual disabilities completed measures of stress and mental health and reported on their child’s adaptive behaviour, problem behaviour, and pro-social behaviour. Result revealed that the child’s behaviour problems were an independent positive predictor of maternal stress, the child’s pro-social behaviour was a negative predictor of maternal stress, but adaptive behaviour was not a predictor. These results support the need for more research on the pro-social behaviours of children with intellectual disabilities, especially their putative impact on parental well-being.

Lessenberry and Rehfeldt (2004) analyzed the interactions of parents with their children with disabilities can have a profound impact on the progress that a child makes in his or her therapeutic or educational programmers. They argue that an important component of the screening and assessment process is a measure of the stress level experienced by parents. They provide an overview of the different assessment instruments currently used to evaluate stress in parents of children with disabilities, and make recommendations for further research and / or professional use of each instrument.

Baxter (1992) investigated the impact of perceptions on stress experienced by parents of children with intellectual disabilities. Sample comprised of 60 parents of 3-5 years old children, 35 parents of 10-12 years old children and 36 parents of 17-19 years teenagers. Parental stress was found to be related to the extent of child’s dependence and the extent of child’s behaviour problems. An interesting finding of the study is the curvilinear pattern of relationship between stress and the appraised significance perceptions across the three age categories. Most importantly, these perceptions of parents when added to dependence and behaviour problems of the child, account for 50 per cent of the variance in explaining stress in the case of parents of 10-12 years old but only 15 percent in the case of parents of 3-5 years old. The results of the study further support the view that parental perceptions are a vital component to the formulations of family focussed interventions.

Seshadri, Verma, Verma, and Pershad (1983) investigated the impact of mentally handicapped child on the family. The sample consisted of 30 consecutive cases of mentally retarded children. Result showed that there is no significant marital disharmony. Most mothers report a favourable attitude towards the child. Significantly, the higher the level of education, the more favourable is the attitude. It is also seen that the greater the degree of retardation in the child, the greater is the felt burden. Attitude is not significantly correlated to marital adjustment and the burden felt on the family.

Kim, Greenberg, Seltzer and Krauss (2003) compared the mothers who have a child with intellectual disability (ID) or mental illness face a lifetime of care giving responsibilities and challenges. They investigated changes overtime in hoco mothers cope with the challenges of caring for an adult child with disabilities and the effects of changes in coping on maternal well-being. 246 ageing mothers of adults with intellectual disability and 74 mothers of adults with mental illness were drawn from two parallel longitudinal studies of later-life care giving. Result showed that for both groups, an increase in their use of emotion-focused coping led to declining levels of well-being. For the parents of adults with intellectual disability an increase in their use of problem focused coping resulted in a reduction in distress and an improvement in the quality of relationship with their adult child. For the parents of adults with mental illness, an increase in the use of problem-focused coping had no effect on levels of distress, but led to an improved relationship with their adult child.

Upadhyaya and Havalappanavar (2008) studied the various coping strategies used by the parents of mentally challenged individuals; fathers and mothers of 628 mentally challenged individuals are selected from the Karnataka Institute of Mental Health, Dharwad. They are assessed using the Coping Checklist by Rao, Subbakrishna and Prabhu (1989) which taps seven coping strategies namely problem solving, positive distraction, negative distraction, acceptance-redefinition, religion-faith, denial-blame, and social support. Results indicate that fathers and mothers differ significantly at o.oo1 level with regard to use of all the seven strategies. Other than religion-faith and denial-blame, on all other five strategies the mean is more for fathers. Most of the coping strategies remain unutilized by most of the parents to a proper extent. For fathers, most commonly used coping strategies are problem solving and acceptance-redefinition. For mothers, most commonly used coping strategies are problem solving, religion-faith and denial-blame. Both fathers and mothers use problem- focused coping more often than the emotion-focused coping. Fathers use problem-focused coping more often than the mothers and mothers use emotion-focused coping more often than the fathers. Higher educational level, non agricultural occupation, higher income and urban status of the family are the important factors predicting higher levels of coping.

Although the passage of time will mitigate the effects of some stressors on parents and make their responses to stressful situations more routine, it is also possible that with the changing nature of the child and increased expectations associated with growing older, the magnitude of stress that parents experience may increase (Orr, Cameron, Dobson, and Day, 1993). As parental stress increases their mental health and well-being start getting affected.

Mental health is a concept that refers to a human individual's emotional and psychological well-being. Merriam-Webster defines mental health as "A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life."

According to the World Health Organization (WHO), there is no one "official" definition of mental health. Cultural differences, subjective assessments, and competing professional theories all affect how "mental health" is defined. In general, most experts agree that "mental health" and "mental illness" is not the same thing. In other words, the absence of a recognized mental disorder is not necessarily an indicator of mental health.

One way to think about mental health is by looking at how effectively and successfully a person functions. Feeling capable and competent; being able to handle normal levels of stress, maintain satisfying relationships and lead an independent life; and being able to "bounce back," or recover from difficult situations, are all signs of mental health. Some experts consider mental health as a continuum. Thus, an individual's mental health may have many different possible values. Mental wellness is generally viewed as a positive attribute, such that a person can reach enhanced levels of mental health, even if they do not have any diagnosable mental illness. This definition of mental health highlights emotional well being, the capacity to live a full and creative life and the flexibility to deal with life's inevitable challenges (http://www.experience festival.com/a/mental%20health/id/1896037).

Parents experience significant social, emotional, physiological and psychological changes as their child grows. This can lead to considerable fluctuations in their health and well being.

Well-being describes our happiness, confidence, physical condition and general outlook on life. It is about feeling good and taking care of yourself; responsibilities that can often be neglected when juggling the rigorous demands of every day living in the 21st century. Well-being and healthy living go hand-in-hand. Healthy living goes beyond eating a balanced diet, taking regular exercise and avoiding illness. It also reflects the mental, emotional and social aspects of an individual’s life (http://www.kraft. com.au/).

“Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.”

—World Health Organization

Mental retardation which is the most potentially explosive problem of parents of those children who are suffered from this disability gives rise to unhealthy experience of these parents’ well-being. Their whole life style gets affected influencing every aspect of their life including their personal and psychological well-being i.e. relationships with their other children, friends and family members, their marital life, their status in the society. So it can be concluded that if the government adopt some policy for these parents and their children like counselling, providing funds, strengthening preventive health programs, screening all children at a young age, empowering disabled young adults with employable skills, encouraging the private sector to employ people with disabilities. Then these parents would be able to overcome this stressful situation and may assist interventionists and planning social support programmes to contribute in the habilitation programme of these parents.

REFERENCES:

1. Baxter, C. (1992). Appraised significance of intellectual disability for parents of children in three age cohorts: Exploring the stress process. Journal of Intellectual Disability Research, 36, 519-529.

2. Beck, A., Hastings, R. P., Daley, D., and Stevenson, J. (2004). Pro-social behaviour and behaviour problems independently predict maternal stress. Journal of Intellectual and Developmental Disability, 29, 339-349.

3. Girimaji, S. R., Shobha, S., Shekhar, S., and Subbakrishna, D. K. (1999). Family Interview for Stress and Coping in Mental Retardation (FISC-MR): A tool to Study Stress and Coping in Families of Children with Mental Retardation. Indian Journal of Psychiatry, 41, 341-349.http://www.experiencefestival.com/a/mental%20health/id/1896037 http://www.kraft.com.au/

4. Kim, Hea -Won, Greenberg, J. S., Seltzer, M. M., and Krauss, M. W. (2003). The Role of Coping in Maintaining the Psychological well – being of Mothers of Adults with Intellectual Disability and Mental Illness. Journal of Intellectual Disability Research, 47(4-5), 313-327.

5. Kring, Ann M., Davison, Gerald C., Neale, John M., and Johnson, Sheri L. (2003). Abnormal psychology. Chechester: John Wiley and Sons Ltd.

6. Lessenberry, B. M., and Rehfeldt, R. A. (2004). Evaluating stress levels of parents of Children with disabilities. Council for Exceptional Children, 70(2), 231-244.

7. Luckasson, R., Coulte, D. L., Polloway, E. A., Reiss, S., Schalock, R. L., Snell, M. E., Spitalnik, D. M., and Stark, J. A. (1992). Mental Retardation: Definition, Classification, and Systems of Supports. Washington, DC: American Association on Mental Retardation.

8. Olshansky, S. (1962). Chronic sorrow: A response to having a mentally defective child. Social Case work, 43, 191-194.

9. Orr, R. R., Cameron, S. J., Dobson, L. A., and Day, D. M. (1993). Age related changes in stress experienced by families with a child who has developmental delays. Mental Retardation, 31(3), 171-176.

10. Peshawaria, R., Menon, D. K., Ganguly, R., Roy, S., Pillay, R. P. R. S., and Gupta, A. (1995). Understanding Indian Families, Having Persons with Mental Retardation. Secunderabad: National Institute for the Mentally Handicapped (NIMH).

11. Rao, K., Subbakrishna, D. K. and Prabhu, G. G. (1989). Development of a coping checklist-A preliminary report. Indian Journal of Psychiatry, 31, 128-133.

12. Seshadri, M., Verma, V. K., Verma, S. K., and Pershad, D. (1983). Impact of a mentally handicapped child on the family. Indian Journal of Clinical Psychology, 10, 473-478.

13. Singh, T. K., Indla, V., and Indla, R. R. (2008). Impact of disability of mentally retarded persons on their parents. Indian Journal of Psychological Medicine, 30(2), 98-104.

14. Upadhyaya, R. G., and Havalappanavar, N. B. (2007). Stress among Single Parent Families of Mentally Retarded Children. Journal of the Indian Academy of Applied Psychology, 33(1), 47-51.

15. Upadhyaya, R. G., and Havalappanavar, N. B. (2008). Coping in parents of the mentally challenged. Journal of the Indian Academy of Applied Psychology, 34(2), 221-225.

16. Venkatesh Kumar, G. (2008). Psychological stress and coping strategies of the parents of mentally challenged children. Journal of the Indian Academy of Applied Psychology, 34(2), 227-231.

Received on 05.04.2011

Accepted on 20.05.2011