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Child And Adolescent Mental Health

There is nothing more beautiful than Empowering a child's emotional and psychological wellbeing

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Mental health problems affect about 1 in 10 children and young people. 1 in five school going children have signs of a mental health condition. They include depression, self-harm, anxiety, substance abuse and conduct/ behavioural disorders. 


The emotional wellbeing of children is just as important as their physical health. Good mental health allows children and young people to develop the resilience to cope with whatever life throws at them and grow into well-rounded, healthy adults.

Things that can help keep children and young people mentally well include:

"    being in good physical health, eating a balanced diet and getting regular exercise and rest. Most of today's youth are lost in a virtual world of Facebook, mobile phones, online gaming, new apps, online chats and videos
"    having time and the freedom to play, indoors and outdoors. With today's rigour of curriculum and academic expectations on them, most young people do not have time or the energy to be outdoors, take up a sport or experience and be with nature or animals.
"    being part of a family that gets along well, most of the time. With joint families in our city and country, most children experience and live with family conflict and disputes over various issues that range from financial or business related stress or inter personal conflicts.
"    going to a school that looks after the emotional wellbeing of all its pupils. Sadly very few schools have that philosophy and most do not have in place school mental health programmes or a counsellor.
"    Other factors are also important, including:
"    being interested in life and having opportunities to enjoy themselves
"    accepting who they are and recognising what their strengths are ;feeling they have some control and independence over their own life and decisions
"    having the inner strength and resilience to cope when something is wrong and the ability to have healthy coping mechanisms
"    feeling loved, happy, trusted, understood and secure

Most children grow up mentally healthy, but surveys suggest that more children and young people have problems with their mental health today than 30 years ago. That's probably because of changes in the way we live now and how that affects the experience of growing up.

Today I see so many young children and teenagers with rage, anger or conduct issues. Cases of deliberate self- harm and cutting in adolescent girls is on the rise. Every third teenager is experimenting or abusing a substance. More children are anxious, depressed or stressed as more families and marriages are collapsing. Learning disabilities and autism are on the rapid rise. More children today are being sexually abused.

There are certain risk factors that make some children and young people more likely to experience problems than other children.They don't necessarily mean difficulties are bound to come up or are even probable.

Some of these factors include:
"    having a parent who has had mental health problems or an illness, substance abuse or has been in trouble with the law (genetic factors)
"    experiencing the death of a parent or someone close to them
"    having parents who separate, divorce or have severe marital conflict
"    having been severely bullied or physically, emotionally or sexually abused
"    living in poverty or being homeless or severe financial losses
"    experiencing discrimination, perhaps because of their race, sexuality or religion
"    having long-standing educational difficulties or a specific learning disability
"    Substance abuse
"    Having a long term, chronic or terminal illness

Some worldwide statistics -
"    20% of adolescents may experience a mental health problem in any given year
"    50% of mental health problems are established by age 14 and 75% by age 24
"    10% of children and young people (aged 5-16 years) have a clinically diagnosable mental problem yet 70% of children and adolescents who experience mental health problems have not had appropriate interventions at a sufficiently early age.

The misconception is that childhood is a carefree, trouble-free period in our lives. How many children can express that they do not  worry about peer acceptance, not being invited by friends for birthday parties, being cyber bullied, marks in an examination, or parental expectations? How many can express their severe anxieties and fears when their parents are fighting or deciding to separate or divorce, or when they are struggling with basic reading comprehension or written work in the classroom or not passing in any academic examinations.

Adults often forget that children are powerless and have no control over their own lives, neither do they have inborn coping mechanisms, strategies, or problem solving capabilities. This can be a frightening and frustrating state of affairs to live through day after day. Children face severe insecurities about themselves or their circumstances.  At this point most children feel a sense of helplessness, hopelessness and worthlessness. They feel they cannot generate a solution to solve the perceived problem or don't have the strength or support to do so.

Children and adolescents are far more vulnerable and susceptible to psychological and emotional problems than any other age group today.

Some reasons for delayed intervention -
"    Assumptions that this is a passing phase or a result of a weak mind or fear of being judged or perceived as having a mental problem , discourages timely intervention.
"    Parents sometimes express that they are embarrassed and are consumed with severe guilt and self-blame for their child's condition.
"    Myths and misconceptions about psychiatric and psychological treatments and medications also deter families from seeking help.
"    Many parents feel that psychiatric medications are harmful and have long term side effects. They also feel that these medications cause dependency and have to be taken for life once they've been started.
"    Parents sometimes want a quick fix and don't have the patience that counselling, therapy and most treatments require, sometimes extending to over a few weeks and months.
"    Most people don't know that psychological or psychiatric conditions are caused because of Neuro-chemical imbalances or physiological disruptions in the brain.
"    Many individuals, educators and caregivers cannot recognise warning signs of mental health conditions, as the symptoms are usually unseen or related to behaviours or thoughts in the mind. It's like a silent epidemic.

What must we do? 
In my opinion, as parents we need to act first and in a timely manner and keep emotional judgement for a later stage. Getting timely professional guidance, an accurate diagnosis and initiating early treatment can be extremely powerful in the recovery path, prognosis and progress of your child's mental health condition.

Having faith in your mental health professional is also crucial.
India has very few child psychiatrists- statistics show that there is only one psychiatrist for every four lakh Indians. Also, a multi-disciplinary team approach provides security and hope to many families as the insecurity of one professional's judgement does not arise. Ideally a good work up includes being consulted by a Child/ Adolescent Psychiatrist, Child Psychologist (clinical or counselling psychologist) or a school counsellor.

Being patient is crucial with mental health of the youth. It takes a while for them to build a rapport and have trust or faith in their Therapist, especially when they are already feeling a certain way.

Building that professional and confidential bond so that they may feel safe, secure, accepted and not judged is crucial to the child's recovery and progress.

If pharmacotherapy is needed and medications are prescribed, it is mandatory to also have counselling, psychotherapy, cognitive behavior therapy or rational emotive behaviour therapy (or any other research based approaches or therapies) provided for the young person and their families in a mindful manner.

Recovery rates and rehabilitation have extremely good results for the youth. As informed, educated individuals it is our prerogative to create more awareness with regards to mental health so as to ensure that our next generation are happy and secure individuals; and live more productive and meaningful lives.

There is nothing more powerful than to hold a child who is breaking down... Breaking down or falling apart because he's been severely bullied or just been told that his parents are getting a divorce or that he's failed an exam... There is nothing more gratifying than to help him search for and pick up those broken pieces so that they may be fixed back into that complex puzzle of life... There is nothing more overwhelming than to see a child who was breaking down, now stronger, complete and at peace within himself.

There is nothing more beautiful than Empowering a child's emotional and psychological wellbeing. That's the magic we hope to achieve here at Mpower - The Centre.

Disclaimer: The views expressed in the article above are those of the authors' and do not necessarily represent or reflect the views of this publishing house. Unless otherwise noted, the author is writing in his/her personal capacity. They are not intended and should not be thought to represent official ideas, attitudes, or policies of any agency or institution.


Dr Zirak Marker

The author is Medical Director - Mpower; renowned child and adolescent psychiatrist

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