Mental Health Issues 
      Harleen Wallia, Independent Consultant

We do not talk about prostitution or sexuality every day. That is why
when we start talking about them, they really become issues.  I am
going to talk about Mental Health issues and regarding integration.


My premise of this discussion that reintegration is an ongoing
process.  It is not a full stop after reintegration.  There many
things that emerge after reintegration. Reintegration is a part of the
process. Also mental health is not divorced from the general well
being.

What is sexual explotation? How does it impact the child?

It is an abuse of a power relationship. Touching, fondling, to the
actual act of penetration involving an adult or a child, an older
child and a younger child - all are considered child sexual abuse.

Many children who are trafficked into commercial sexual exploitation
have been abused as a child.

There is an impact on the child of child sexual abuse.

1. Child is shocked
2. There is an emotional impact: they are sacred to talk about it to
   their parents.
3. There is trauma, fear, mental stress, and the feeling of revenge
4. Guilt feeling. Is there anything wrong with me? There is a feeling
   of insecurity. The child becomes sexually active or starts hating it.
5. The shame is overwhelming
6. There is a break in trust between the abuser and the abused for in
   many cases there is a close relationship between the abuser and the
   victim.
7. The normal process of development gets affected. 

When you plan a reintegration program the mental health needs to be
taken into account.  The stigma associated also impacts the mental
health.  The child might start feeling that only the people associated
with her work are the ones who are accepting her/him.  Whereas her
family might feel that she is a burden.

There are other health issues: STD, HIV etc.

Three pronged framework for reintegration:

1. Establish safety for the child - whether the child is in the
   community, or in a drop in center, or an institution.  Both
   physical and emotional safety are necessary.  Emotional safety is
   closely linked to mental health.  The care-giver has to give the
   feeling of the emotional safety to the child.  To do that, the
   caregiver has to realize where the child is coming from.

2. Explore the trauma: Unless and until the child has an understanding
   of what is happening to her or him, one cannot go for any cure.  It
   has to be done at child's time or speed.  The caregiver needs to be
   skilled so that you know what to do with this information.

3.  You have to reestablish the ties between the child and his/her
    society.  The biggest hurdle the child/caregiver is the stigma.
    The first thing to establish is whether the family is willing to
    accept the child.  The child should also be given the option to
    choose whether she/he want to go back to the family.  Economic
    security - a set of skills, a support system, a substitute income
    is an important component.  Economic independence gives a sense of
    empowerment and a control is very important to a woman.  Education
    with human development with life skills and social skill based.