Advocating for mental health in children


The problem is more serious when the child withdraws from family and friends, has conduct problems or substance abuse or shows aggression and harms others, or self harms. -123rf.comThe problem is more serious when the child withdraws from family and friends, has conduct problems or substance abuse or shows aggression and harms others, or self harms. -123rf.com

MENTAL health issues are usually associated with adults, but children too can be afflicted.

Indications of children having mental health problems, according to Sunway Medical Centre, Sunway City, consultant child and adolescent psychiatrist Dr Tee Bee Chin, are when they:

> Express feeling sadness and lack motivation in studies or hobbies for a long duration of time.

> Are not getting good sleep or having frequent nightmares.

> Become frequently irritable over small matters, consistently aggressive, threatening, destructive, angry or show violent behaviour.

> Have ongoing worries or fears over a long period of time.

> Claim of bodily aches/bodily symptoms and the root cause cannot be found by doctors, or when such pain only happens on certain occasions such as examination or school days.

> Have loss of appetite or are being picky with food, or have irrational concerns about body image and weight.

> Have poor attention span in studies.

> Show a drop in school performance.

> Have problems fitting in at school or getting along with other children, and refuse to go to school.

Dr Tee shares that the problem is more serious when the child shows aggression and harms others, self harms, withdraws from family and friends, has conduct problems, substance abuse or has suicidal thoughts.

At times, mental health issues that are not resolved in childhood can intensify during puberty, says Dr Tee. – Handout picAt times, mental health issues that are not resolved in childhood can intensify during puberty, says Dr Tee. – Handout pic

In the medical lexicon, common mental issues in children are adjustment disorder with depressed mood and anxiety (triggered by stress), major depressive disorder, anxiety disorder, panic disorder, eating disorder, social anxiety, attention deficit and hyperactivity disorder (ADHD), learning disorder, school refusal, autism spectrum disorder (ASD), oppositional defiant disorder; conduct disorder, and gaming/internet addiction.

Triggers include difficulty in coping with studies or academic pressure, bullying (physical, verbal and/or social), social conflict with peers, loneliness or rejection, parental conflict, child abuse (physical and/or emotional), and lack of a coping mechanism or role model for stress management.

She adds that anxiety, panic and depressive disorders could be prevented with the removal of stresses that trigger them, or when there is conscious effort to keep good mental health.

“Mental health issues in children and adolescents are almost similar. At times, mental health issues that are not resolved in childhood tend to intensify during puberty due to hormonal or physiological changes, higher demands of studies, increased autonomy and independence in adolescent years, more challenging demands of social skills in higher age group, or higher expectations from adults and society,” she says.

While parents can help their children cope with their issues by listening to them and providing parental support, or just being there for them when they feel down, do refer them to child psychiatrists when they cannot manage on their own, she adds.

“There are many ways to help them depending on the parents and patient’s acceptance of the issue, how strong the bond is between parents and child, severity of the mental disorder and comorbidity of other mental disorders, and availability of resources or family support.

“Treatment include cognitive behavioural therapy; talking therapy; therapy dealing with grief, trauma or abuse; play therapy; family therapy, and others.

“Medications are indicated when therapies are not helpful after trials, when there is urgent need to save lives, or concomitantly when other cognitive or behavioural strategies take time to be developed and learned.

“However, some disorders such as schizophrenia, bipolar disorder, ASD, ADHD and LD do not have cures but they can be kept under control with medication or therapy,” she says.

Dr Tee highlights that the development of some mental illnesses like depressive disorder and anxiety disorder in children could be prevented.

“As the saying goes, it takes a village to raise a child. Which means intervention must include holistic approaches such as good and consistent parenting, family resources, support and facilitations from school, community, caring society and effective government policies on children's education and mental health.”

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