Teaching children about mental health in school

According to the 2019 NHMS, around 424,000 Malaysian children and adolescents suffer from mental health problems, including anxiety and depression. — Positive Parenting

Last month (April 2021), The New York Times published an article titled How to spot depression in young children.

The author, paediatrician Dr Perri Klass, wrote that “Young children can also experience depression, but it can look very different, which makes it challenging for parents – or doctors – to recognise it and provide help.”

The article listed a few statistics that are absolutely critical, i.e.:

  • Two to three percent of children ages six to 12 can have depression.
  • Between 1-2% of children as young as three years of age are depressed, and
  • More than 7% of children aged three to seven have anxiety disorders.

These statistics are not so foreign to us here at home.

A few weeks ago, we read of the suicide of a nine-year-old girl who hung herself with a sarong at her bedroom window.

Neither is this incident the first we have read on the suicide of a child.

In February (2021), the Green Ribbon Group published an infographic on the mental health landscape of children and adolescents in Malaysia.

The 2019 National Health and Morbidity Survey (NHMS) states that 424,000 children and adolescents suffer from mental health problems in our country.

Meanwhile, according to the international medical student organisation Malaysian Medics International, there are only twenty-odd registered child psychiatrists in the country, with roughly half of them concentrated in the Klang Valley.

The topic of mental health and children or early education also features prominently in the direct messages that the Green Ribbon Group and myself receive on Instagram, involving approximately 70-80% of the messages.

We know that many disorders such as anxiety begin in childhood and adolescence, but we may not know what these disorders look like in children specifically.

Moreover, if it is difficult for us as adults to identify or realise that we are struggling with a mental health challenge, how can we expect our children to know any better?

Work within the system

I firmly believe that prevention is better than cure.

And in order to cater for prevention and early intervention, there must be a push for to improve mental health literacy and resiliency in school.

With such interventions, I hope our children will be able to manage negative emotional responses such as social isolation and humiliation, as well as negative emotional experiences like bullying, which may not only be physical in nature, but also cause severe psychological damage.

This does not mean that we must start from scratch, however.

Rather, we can work within the current system.

For example, as the first point of contact, parents and teachers must be able to detect early signs of psychological distress in children.

The article by Dr Klass notes: “The best way for parents to recognise depression in young children is not so much by what a child says as by what the child does – or stops doing.”

Things to look out for include changes in mood such as less energy or more tantrums, and physical symptoms like stomach aches or loss of appetite.

More outdoor and imaginative play could also be emphasised in our school syllabus, in order to encourage more awareness and understanding of mental health and wellbeing.

Lego, for instance, launched “Small builds for big conversations: Cyberbullying” in November (2020), which focused on building characters like The Oversharer and The Meanie to help generate such conversations.

Parents were given tips (in partnership with Unicef) to help them and their children recognise and prevent cyberbullying.

These tips include knowing the difference between joking and bullying, and encouraging positive social values.

Having honest conversations

During this Covid-19 pandemic, our children transitioned from going to school to schooling at home, and we as parents have had to reset and adjust our daily routines.

The post-pandemic world is going to be different from what we are used to, with considerable impact on the mental health of our children and ourselves.

Perhaps the world will also be a lonelier place as we shift from the physical to the digital.

More emphasis on outdoor and imaginative play will help to keep a balance between human, face-to-face interaction, and online communication.

Our children must know the importance of having heart and courage – qualities that cannot be found in an electronic device.

Self-esteem and emotional regulation are equally as important as literacy and numeracy.

Raising awareness early on would also help to correct the perception that talking about mental health with our children could plant seeds that they themselves have mental health issues.

Such fear is widely associated with suicide, i.e. if we ask about suicide, we risk putting ideas in their heads.

This perception is not only limited to children, but also amongst us adults.

The goal is to be more open-minded, supportive and less dismissive about mental health issues, so that we can have honest conversations with our children.

For parents, this means that we can communicate our concerns and reassure our children that they are always supported and loved.

For our children, it is hoped that they will feel less ashamed about what they are experiencing and more comfortable sharing their thoughts.

Ultimately, awareness and mental wellbeing in early education is a step forward to breaking the stigma and normalising conversations on mental health for future generations.

Tengku Puteri Iman Afzan is the Royal Patron of the National Coalition of Mental Wellbeing and International Patron of World Mental Health Day 2020. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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