Although child mental health problems are prevalent, treatment gap is high. Low literacy level on child mental health problems in the general population and religious and cultural practices may be responsible but has not been extensively studied in Sri Lanka.

To elicit the parental beliefs about causes of child mental health problems and how such beliefs may influence help seeking behaviour.

A descriptive study. The sample comprised of all consecutive new referrals over a period of 3 months to make up a total of 52. Interviewer administered questionnaire was used. Frequency distribution and chi square test was used to analyze data.

Average age was 7.2 years (range 3–16). Main presenting problems were speech delay (n=15, 28.8%) and aggressive behaviour (n=9, 17.3%). Bad astrological period was given by parents as the as the cause in 46.1% of children. Bodhi-poojas and astrological interventions were performed in 61.5% and 44.2% respectively before a decision was made to seek medical help. In 61.6% of children, the delay in getting medical help was delayed as long as 2 years (mean delay 23.5 months). In 30.8%, the delay was the result of inappropriate reassurance given by doctors. There was no statistically significant association between parental educational level and delay in seeking help or use of cultural rituals (p>0.05).

The study highlights the delay in receiving attention for mental health needs and the financial burden on families, indicating the importance of improving mental health literacy of the general public and among medical practitioners.