The Pocso Act and child mental health

It is mandatory for doctors to register a medico-legal case in all instances of child sexual assault.

The Pocso Act (The Protection of Children from Sexual Offences Act) on enacted on November 14, 2012, throughout India (except the State of Jammu and Kashmir). According to a study undertaken by the Ministry of Women and Child Development on child abuse in 2007, at least 53% of children in the country had faced one or the other forms of sexual abuse.

Before the enactment of Pocso, IPC 375, 354 and 377 could not effectively aim to protect the child due to various legal lacunae in them. The Pocso Act is gender-neutral, and defines a child (male or female) as any person below 18 years of age and enlists the forms of sexual abuse which includes sexual assault, sexual harassment, using a child for pornographic purposes, abetment and attempt to commit a sexual offence and trafficking of children for sexual purposes.

“The Act recognises almost every known form of sexual abuse against children as a punishable offence. The child sexual assault (CSA) is deemed as ‘aggravated’ especially when the offence is committed by a person in a position of trust or authority vis-à-vis the child such as a family member, police officer, teacher, doctor or a caretaker,” says Dr H Chandrashekar, Professor and Head of the Department of Psychiatry, Bangalore Medical College and Research Institute, Bengaluru.

The Pocso legislation emphasises on the principle of ‘best interest’ of the child by providing a “child-friendly atmosphere” through all stages of the judicial process.

Since the Pocso Act enforces the provision of ‘medical care first’ and ‘legal procedures later’, no hospital under the jurisdiction of the Constitution can refuse to admit the victim of CSA for examination and treatment. Also, it is mandatory for doctors to register a medico–legal case in all instances of CSA.

Child and adolescent mental health experts though have appreciated the Act, still feel that there are certain areas in CSA which have not been addressed by Pocso.

“There are intricate complexities while counselling the sexually abused child and its family.  We have come across many instances wherein the family physicians have sought our advice when the abused child and the family have shown reluctance to  get the case reported to the concerned authorities.

“We do not trust the system, if you report, we will kill ourselves”, is the common threat from the parents of a sexually abused child,” says Dr Shekar P Seshadri, Professor and Head of the Department of Child and Adolescent Psychiatry, Nimhans, Bengaluru.

Dr Seshadri says that in order to prevent secondary traumatisation of the CSA victim, instead of questioning the victim on multiple occasions by multiple agencies and in order to strike a balance between obtaining justice for the victim and to cautiously initiate the process of emotional, mental and physical healing and recovery of the child, the police, legal, medical and psychological counsellings should be made available at one stop.

“The whole process of going through this intervention should be made least traumatic for the CSA victim and the parents. Also, it is very important to address the hesitancies of the family about reporting the episode, and the sensitivities involved in documentation, thus addressing the mental health ramifications of an unpleasant episode. A written documentation of the child’s and its family’s version can be made into an official version about the episode” says Dr  Seshadri.

Juvenile Justice Act

The Act has been criticised for it does not differentiate a six-year old child and a 16-year old adolescent. However, the amended Juvenile Justice Act of January, 2016 says that the sexual abuse offenders in the age group of 16 to 18 years, may sometimes be referred to the ‘Adult Criminal Justice System’.

“The authorities concerned also need to be careful about defining sexual abuse of/by teenagers, to rule out a mutually consenting sexual relationship between an adolescent male and female,” opine  mental health experts.

The Pocso Act has resulted in the establishment of special courts for trial of CSA cases and the court also has to determine the amount of compensation to be paid to a CSA-victim, so that the compensation amount can be used for the child’s medical treatment and emotional rehabilitation, because punishment of the perpetrator alone does not ensure healing of the child victim.

As a psychiatry journal of Australia has published the feelings of a CSA victim in the form of a poem: “I asked you for help, you made me repeat it to 14 other strangers... you converted my private nightmare into a public nightmare. I asked you to put an end to my sorrow but you all put an end to my family life...”

Let us hope that by the coordinated efforts of  psycho-analysts, therapists and the legal system, no other CSA victim need to suffer a continued nightmare.

(The writer is a health management consultant and a medical journalist)