When it comes to discussions about mental health, most people would think that adults would be the ones who struggle most with issues like depression.
In the National Health and Morbidity Survey (NHMS) 2019 released by the Ministry of Health in June this year, it was revealed that 2.3% or approximately half a million adults in Malaysia had depression.
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Children’s Mental Health Problems 2019
What is even more alarming, however, is that the same report showed that children were even more affected by mental issues. More than 424,000 children in Malaysia were recorded to have mental health problems.
Titled The Silent Epidemic on Chapter 15, it was found that children’s mental health issues were most prevalent from the ages of 10 to 15 years. Girls tended to have more mental issues than boys, scoring as high as 8.4% among all adolescent girls. The causes attributed to their mental problems include:
- problems with peers (42.9%);
- conduct problems (15.9%);
- emotional problems (8.3%); and
- hyperactivity issues (2.3%).
Suicidal Tendencies in Children (2017 Report)
Rewind two years and the (NHMS) 2017 shows an even grimmer picture. Their key findings on the State of Adolescent Mental Health on Chapter 8 indicates that Malaysian children harbor suicidal tendencies, with more girls having higher suicide ideation (10.8%) and suicide planning (7.8%) than boys (ideation: 9.1%, suicide planning 6.8%). However, boys were more likely to actually attempt suicide (7.0%) than girls (6.9%).
Taking both genders together, suicide behaviour was found to be highest among Form 1 students, with most of this occurring in urban centres (10.9%), as opposed to rural areas (8.8%). Suicide ideation (meaning: having thoughts), however, was highest in Wilayah Persekutuan Kuala Lumpur.
Suicidal behaviour in children has been slowly rising from 7.9% in 2012 to 10% in 2017.
In terms of mental health published in Chapter 22 of the report:
- 1 in 5 children was revealed to be depressed
- 2 in 5 had anxiety issues and,
- 1 in 10 was said to be stressed.
Two out of the three categories showed that more girls than boys had mental problems:
- 42.3% of girls were affected by anxiety issues as compared to boys (37.1%)
- 10.3% of girls were stressed more than boys (8.9%)
- But 18.9% of boys had depression as compared to girls (17.7%)
These statistics show that mental health problems in children are a case for concern in Malaysia. But what should parents watch out for as signs they should pay attention to and what can parents do?
Children’s Mental Health Disorders & Warning Signs
The most common mental health disorders that can affect children and adolescents, say Mayo Clinic and WebMD, include:
- Anxiety disorders: Children with anxiety disorders respond with persistent fears, worries or dread to certain situations. They may also show physical signs such as nervousness (anxiety), feeling tense and fidgety, rapid heartbeat, sweating, and using the toilet often.
- Disruptive behaviour disorders: Children with these disorders tend to defy rules and often are disruptive in structured environments, such as school.
- Pervasive developmental disorders: Children with these disorders are confused in their thinking and generally have problems understanding the world around them.
- Eating disorders: Eating disorders such as Bulimia, Binge-eating or Anorexia Nervosa revolve around body images such as weight, body shape and food. Eating disorders can harm the heart, digestive system, bones, and teeth and mouth, and lead to other diseases. Teenage girls and young women are more likely than boys or men to develop eating disorders.
- Learning and communication disorders: Children with these disorders have problems storing and processing information, as well as conveying their thoughts and ideas.
- Attention-deficit/hyperactivity disorder (ADHD): Compared with most children of the same age, children with ADHD have difficulty paying attention or concentrating. They cannot seem to follow directions, are easily bored or frustrated with tasks, need to move constantly (cannot sit still) and are impulsive.
- Autism spectrum disorder (ASD): Autism spectrum disorder is a neurological condition that appears in early childhood — usually before age 3. Although the severity of ASD varies, a child with this disorder has difficulty communicating and interacting with others. Symptoms include abnormal body posturing or facial expressions, repetitive body movements such as hand flapping, rocking, spinning, abnormal tone of voice, poor eye contact, delay in speech and language comprehension, does not respond when the name is called, obsessive attachment to unusual objects such as rubber bands, keys, light switches or things that spin or rotate.
- Eating disorders: Eating disorders are defined as a preoccupation with an ideal body type, disordered thinking about weight and weight loss, and unsafe eating and dieting habits. Eating disorders — such as anorexia nervosa, bulimia nervosa and binge-eating disorder — can result in emotional and social dysfunction and life-threatening physical complications.
- Depression and other mood disorders: Depression is persistent feelings of sadness, emptiness and loss of interest that disrupt a child’s ability to function in school and interact with others. Bipolar disorder results in rapidly changing extreme mood swings between depression, tearfulness and moodiness and extreme emotional or behavioural highs like euphoria, aggressiveness, and hyperactivity that may be unguarded, risky or unsafe.
- Elimination disorders: Disorders that affect behaviour related to using the bathroom. Enuresis, or bed-wetting, is the most common of the elimination disorders. Bed-wetting may not necessarily be caused by physical problems such as having bladder issues or drinking too much water before bedtime. It could also be caused by psychological distress due to the home or school situation, being bullied, low self-esteem and others.
- Post-traumatic stress disorder (PTSD): PTSD is prolonged emotional distress, anxiety, distressing memories, nightmares and disruptive behaviours in response to violence, abuse, injury or other traumatic events.
- Schizophrenia: Schizophrenia is a disorder involving distorted perceptions and thoughts. It’s a mental illness that tends to run in families and will usually show up during the late teens through to the 20s. Schizophrenia causes a person to lose touch with reality (psychosis) resulting in hallucinations (hearing voices, seeing things), delusions, and disorganized thinking.
- Tic disorders or Tourette syndrome: These disorders causes a child to make uncontrollable movements and sounds like repetitive and rapid shoulder shrugging, eye blinking, or facial grimacing or repeatedly clear throat, hum, sniff, snort or squeal. The average age of onset is 3 to 9 years of age and affects boys three or four times more than girls.
Warning Signs
- Persistent sadness or worry — two or more weeks
- Withdrawing from or avoiding social interactions
- Hurting oneself or talking about hurting oneself
- Talking about death or suicide
- Frequent outbursts, anger or extreme irritability
- Aggressiveness or out-of-control behaviour that can be harmful
- Drastic changes in mood, behaviour or personality
- Changes in eating habits
- Weight loss
- Difficulty sleeping
- Frequent headaches or stomachaches
- Difficulty focusing or concentrating
- Changes in school performance
- Avoiding or missing school
What Parents Can Do
With 424,000 children grappling with mental health issues, Befrienders Kuala Lumpur patron Tan Sri Lee Lam Thye gave the following advice in a recent report.
“The modern world we live in today presents many wonderful advanced technologies. They also come with a high level of stress, even to children at a young age, unfortunately.
“If you are concerned about your child’s mental health, please reach out for help. Speak to a professional, a psychiatrist or a counsellor.
“The ability to recognise that a child needs help is crucial as early intervention can improve their well-being. With proper care and treatment, most mental health issues can be treated.”
Lee said children go through many constant changes in their upbringing, such as going to a new school, meeting new friends and all these can make them feel stressed or anxious.
What’s more, now with the restrictions of the on-going COVID-19 pandemic, children have to stay at home and do online learning while coping with staying at home.
Naturally, there would be additional stresses for them as well as for the parents who may also have to work from home.
He said parents play a significant role in ensuring their children’s mental well-being, and a home filled with love and care could have a positive impact on children’s mental health.
Open Communication Lines
Lee said encouraging healthy conversation by listening actively and allowing children to talk without being judgmental and critical helps build an openness in children. In this manner, they will be more likely to express themselves freely.
“This means they would be more open to talking about their problems, including difficult and uncomfortable feelings, and reaching out for help whenever they encounter difficulties in the future.
“Spending time together doing positive activities helps build stronger connections and instil self-care practice in children.
“Show them it’s essential to take care of our mental health, which includes eating a balanced diet and getting adequate sleep.”
Should you need someone to talk to or provide emotional support, call The Befrienders KL at their 24-hour helpline:03-7627 2929. If you prefer to WhatsApp or SMS, the number is 016-8036945 or you can visit their Facebook page here to message.
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