Karnataka Today

Importance of Mental Healthcare for Children and Adolescents

Image Credit: Pixabay

“There should have been angels of acceptance, and hope, that helped, this ocean of dejection realise, that his speech system, is merely not able to match up, to his overtly fast brain, processing thoughts at, the speed of light.”

The above is an excerpt of a poem written by a student who had been bullied in school for stuttering in childhood and is a representative of how unacceptance of the above pupil’s predicament has affected the person’s subjective experiences which were often laced with anguish, fear, and dejection.

World Children’s Day is celebrated every year on the 20th of November by the United Nations Organization to raise awareness of children’s rights and to improve their welfare across the world. The theme for World Children’s Day for the year 2021 was, “A Better Future for Every Child.”

Children around the world are considered as a beacon of hope; a symbol of honesty, prosperity, and innocence. They are indeed the future of mankind as the baton of humanity passes down from each generation to the next, as they learn from the environment and later go on to represent our species as adults. Hence, children are cared for and protected by their families and society and their health is often the priority of their environment.

However, do they always benefit from the socially privileged status that has been conferred onto them? Well, they seldom do. Children across the world, especially those living in the third-world countries of sub-Saharan Africa often face sexual exploitation, malnutrition, child labor, lack of access to education, are exposed to infectious diseases (Ingutia, Rezitis & Sumelius, 2020).  It is often considered that even children who are from well-to-do families are relatively unscathed and they have a much higher standard of living. But, that is not true.

Children who come from better societies indeed have more resources and opportunities for children to develop a safer environment to learn than those who are less privileged. But, problems of mental health are also often overlooked even in very rich neighborhoods. Disorders like anxiety, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, depression, and other mood disorders, eating disorders, and post-traumatic stress disorder (PTSD) often hinder the realization of a child’s true potential without discriminating on the basis of the socio-economic status of children. However, children from well-to-do families often have access to resources that can help improve mental health, wheras children with mental health problems hailing from poor families seldom have the resources to help improve their mental well-being.

According to the WHO, more than 1 in 7 adolescents aged 10–19 is estimated to live with a diagnosed mental disorder globally, with South Asia being one of the most affected. Also, another report by the WHO has shown that the prevalence of suicide is 21.1/100,000 population in India which is amongst the highest in Asia, with the number being predominantly contributed by adolescents.

This is due to the cut-throat and unhealthy competition imposed on the students in the form of competitive examinations like the IIT-JEE and NEET, which is also influenced by parental, environmental, and peer pressures, and also due to the evils of the education system in India and capitalism in the form of coaching institutes as they continue to rake in profits by selling the prospects of better job opportunities and then subjecting them to inhumane, treacherous routines, thus treating the students as if they were computers tasked with cracking competitive exams. Also, parental pressure to perform well in these entrance exams may be another cause for their deteriorating mental health.

Parents are considered to be the first line of support for children. Hence, they have a vital role to play in their children’s mental health. It is due to this reason that bad parenting habits are big risk factors for children. For example, being emotionally unavailable, reprimanding too much for childrens’ mistakes, use of corporal punishment, not respecting their feelings and too much pampering, etc., are some of the ways which affect the subjective experience of the child and may lead to them committing to problem behaviors.

It is also worth noting that poor parenting habits can be passed on to children. A study was conducted by Anne-Marie Conn and colleagues, involving parents of 62 young children who were attending a clinic to find out how their own childhoods have shaped their parenting practices. It was found that “91 percent of parents had at least one adverse childhood experience, while 45 percent had four or more, and among their young children, 72 percent had already experienced at least one adverse childhood experience” (Conn et al, 2016). This is problematic as this may lead to a perpetual succession of bad parenting, a chain that needs to be broken to secure the mental health of the family.

This also includes other problems faced by children where they’re not accepted by society and are often mocked at and deprived of the help that they require in their development. This includes students having speech and hearing problems, learning and conduct disorders, obesity, students who identify themselves as having a non-binary gender, or being adopted, etc. The lack of social acceptance being shown in the form of bullying and cyber-bullying, racial or caste discrimination, fat-shaming and so on is often detrimental to the child’s development and can have serious consequences as the scars of their subjective experiences often show up in the form of mental health issues as behavioral problems and insecure attachment, and may also lead to substance abuse.

Biological and genetic factors can also cause mental illness. The imbalance of neurotransmitters can also cause mental health disorders like schizophrenia, OCD, panic attacks, and other mental health disorders. Also, genetic factors go a long way in predicting the likelihood of a person having similar mental health issues, although genetics merely predicts the occurrence and doesn’t necessarily imply that a person would be affected by a disorder. Other biological factors that cause mental illness include infections, brain damage, prenatal damage, and substance abuse.

All this is also not helped by the fact that there is a dearth of mental health infrastructure in India with there being only 0.75 psychiatrists per 100,000 population in India, which is way below the desired requirement of 3 psychiatrists per 100,000 population. Also, there were just 0.15 psychologists available per 100,000 individuals in 2017. This is also not helped by the fact that India had spent 1.3% of its gross domestic product (GDP) in 2015-16 on healthcare with around 0.05% of this healthcare budget on mental health.

With the deficit of mental health facilities being so substantial and with the access to institutions for mental health being very scarce, treatment gaps are also obvious. The treatment gap in mental health is about 50%–60% for schizophrenia, 88% for depression, 97.2% for substance abuse, and 22%–95% for seizure disorders. The treatment gap for common mental disorders is 95% which is higher than the gap in severe disorders which is 76%. This doesn’t include the fact that often mental health disorders often go undiagnosed, especially in rural areas. This is worsened by the stigma associated with and subsequent neglect that is faced by individuals who face mental health problems. (Hossain & Purohit, 2019)

This problem is now exacerbated ever since the Covid-19 pandemic has struck globally, resulting in global chaos. Due to this, one in every seven children has been directly affected by lockdowns, while more than 1.6 billion children have suffered some loss of education. The loss of jobs, concern for the health of family members, lack of face-to-face interaction, recreation and so on also have the potential to threaten the mental health of students indirectly. Also, uncertainties in the form of wars and instability of countries have a big role in adversely affecting the mental health of children across the globe.

However, with these problems, we can also focus on solutions that can positively bring about a change in these dangerous trends. Firstly, the most important changes can be brought at home. Parents can seek to improve the mental health of children in many ways. This includes modeling, positive interactions with children in the form of spending quality time with them. Hence, building trust to ensure that children exhibit a secure attachment with them. Also, the use of an assertive parenting style and a clear definition of boundaries are key to healthy parenting, which in turn ensures the positive mental health of children.

Also, reduction of other risk factors and promotion of the protective factors for children and adults in the form of greater acceptance of their identities and emotional rapport from other family members, friends, and environment would go a long way in preventing the occurrence of mental health complications later in life. Thus, making the environment empathetic and optimal for the development of the children and adolescents. It is also important to emphasize that stigmatization of mental health must be avoided at all levels – family, friends, elders, and society. Hence, stakeholders who are a part of the immediate environment of children and adolescents must encourage and empower them to seek professional help for mental health issues if required.

At the institutional level, greater access to mental health facilities needs to be ensured by building more tertiary health care centers in India that specialize in mental health, especially for children and adolescents. Another important solution would be the integration of child and adolescent mental health services in primary health care.

Also, changes should be made to ensure the availability and accessibility of necessary services and resources in both urban and rural areas for equitable distribution of mental health services. Campaigns for promoting mental health in the community and district levels are also important to bring an end to the stigmatization of people who have been affected with mental health disorders.

Another important solution would be to involve students in the study of mental health from a very early age, preferably from the middle or even elementary school to introduce students to the concept of mental health. This would go a long way in helping children and adolescents identify and recognize mental health problems and also how to seek help if they find themselves entangled in the same too.

Furthermore, counseling of teachers and training them how to effectively deal with students and to identify problematic behaviors and their causes and educating them how to be empathetic to students who are behind the learning curve, have behavioral problems, etc. would also help in the positive development of students. In addition to this, changes should be brought about in the education system in the form of greater focus on the overall well-being of children rather than continuing with obsolete methods of instruction which are ineffective in securing the students’ needs and subsequently their well- being.

Finally, children and adolescents should be allowed to actively participate in the decision-making process of improving their mental health individually and collectively. This also involves giving them the freedom to make their own choice with regards to their education, career choice, and future.

The state of mental health for children across the world is indeed really depressing as many children across the world face harsh environments, inconducive to their growth. It is also sad that other issues faced by children are often given importance but mental health is often overlooked. However, there is hope as organizations across the world, of late, have recognized the importance of mental health and are slowly bringing a change to the current state of affairs.

With an increasing push for awareness and education about the importance of mental health, we hope that every child’s mental health problems are attended to without exception, thus ensuring a better future for every child and an even brighter future for the whole of mankind.

  • Saurav Das is a student currently doing his undergraduate degree in Psychology from MCHP, MAHE, Manipal. He loves participating in various extra-curricular activities, which also includes activities that promote awareness for mental health. He is also very passionate about literature and he writes poems and short-stories. His works have been published on his social media accounts.
  • Tejas Girish Kulkarni is a student currently doing his undergraduate degree in Audiology and Speech Language Pathology (BASLP) from MCHP, MAHE. He too writes poems, many of which are posted on his social media accounts. The poem in this article is contributed by him. He champions the cause of speech language pathology by furthering awareness about the subject through his participation in various extra-curricular activities.
  • Deepa Marina Rasquinha is an Assistant Professor in the department of Clinical Psychology, MCHP, MAHE, Manipal. She has a vast experience of 17 years where she had been involved in research, teaching and counselling. She specializes in Gerontology. She is an avid writer whose works have been published in print and electronic media to create awareness about mental health via its diverse dimensions.
  • Kavyashree K. B. is an Assistant Professor in the department of Clinical Psychology, MCHP, MAHE, Manipal. She has a rich experience of 15 years which was devoted to counselling, research and teaching. She specializes in Adolescent Psychology. She is also an ardent writer as her writings have been published in various journals via print and electronic media.