Mental health is a state of well-being in which an individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a meaningful contribution to their community.
Mental health is a critical component of individual, family, community and national wellbeing and prosperity.
The mental wellbeing of children and adolescents is important for their emotional development, social development and even physical development.
Children and adolescents need more than food and shelter in order to thrive and reach their full potential.
In addition to meeting their physical needs, we need to love and be emotionally engaged with children and young people.
We need to help them explore their environment and facilitate learning as well as to guide and discipline them when this is required in order to empower them for the challenges of life.
How can we support the mental wellbeing of children and adolescents?
- Love and positive engagement: Children need love just as much as they need food. Love starved children will struggle to develop physically and emotionally. Parents and caregivers need to make deliberate effort to understand their children so that they can express love in ways that are meaningful for their children. In today’s busy world, many parents and caregivers sadly often replace time spent with their children with gifts and material treats. Quality time is critical to engaging positively with children and young people, understanding them and being a loving caregiver.
- Effective parenting: ideally parents and caregivers should aim to be authoritative in their parenting approach, this means a child is ensured of unconditional love, care and support but also is aware of appropriate, firm boundaries for their behaviour. This approach helps young people to develop a healthy self-esteem but also shapes pro-social behaviour that will help them thrive in the community they are a part of. Research shows that parents who love but do not discipline are indulgent, parents who discipline but do not love are authoritarian and parents who neither love nor discipline are neglectful. Indulgent, authoritarian or neglectful parenting make it difficult for children to thrive.
- Acknowledge emotions and coach on how to handle difficult emotions: We all experience emotions and children and young people will often learn how to deal with difficult emotions by observing how their parents and caregivers deal with them. Families can provide an environment where emotions can be safely expressed and where young people can learn how to manage difficult emotions in healthy, respectful ways. As parents and caregivers we can deliberately model how to handle difficult emotions by not always hiding our difficult emotions but sometimes allowing our children to see us face and manage difficult situations. This helps them realise that we are not perfect, that we also face emotional challenges but we can express and manage them in healthy ways. This however means we as parents and caregivers need to learn to acknowledge, express and manage our emotions and get help for our own emotional problems if we need to.
- Facilitate development of strong family relationships and friendships: The ability to form meaningful relationships is a critical part of mental wellbeing in both children and adults. We need family and friends as part of a healthy support network. We should not live life alone and our children should not either.
- Teach problem solving and encourage a positive perspective to life: Problem solving is a critical life skill. Life is full of challenges and how we cope depends a great deal on how we are able to approach this challenges and develop solutions to them. A positive, hopeful perspective to life is also critical to maintaining mental wellbeing. We can help children become more resilient by helping them develop a healthy perspective and stay hopeful even in adversity.
- Believe in your child and their unique purpose for being: When someone in our life believes in us and believes we are unique and that we have a unique purpose in life, this will help us build a positive self-image and a positive outlook about life despite of any challenges we may face. Life challenges can leave young people discouraged and disillusioned with who they are and what they are capable of doing in life. Parents and caregivers need to safeguard the mental health of young people by believing in them and reassuring them that they have a positive role to play in our families and communities.
Common mental health problems children and adolescents can face?
Children and young people can face a variety of mental health challenges including:
Neurodevelopmental disorders: These include autism (a disorder of social interaction and communication that can severely impair ability to interact effectively with others and to learn); attention deficit hyperactivity disorder (difficulties maintaining sustained concentration and challenges with hyperactive and impulsive behaviour) and Learning difficulties (these can include intellectual disability but also specific learning challenges in reading, writing and mathematics).
Behavioural problems: While all children may have some periods of being difficult behaviourally, some children have severe challenges with pro-social behaviour that can result in difficulties functioning at home and at school. These include oppositional defiant disorder (frequent anger, irritability, arguing, hostility and defiance toward parents and other authority figures) and conduct disorder (aggressive, destructive, and deceitful behaviours where a child wilfully violates the rights of others).
Mood and anxiety problems: Children may also face challenges with depression and anxiety but they may express these problems differently compared to adults. Children may have an irritable mood, persistent tantrums, selective mutism (being unable to speak in certain usually social situations usually due to anxiety), frequent seemingly stress related physical health symptoms (e.g. stomach aches and headaches), delay in development or decline in development often after a major stressor (e.g. bedwetting in a child who had now been fully toilet trained when a younger sibling is born), and deterioration in school performance.
Effects of psychological trauma: Children who have been exposed to traumatic events may show signs of psychological effects of trauma such as flashbacks, nightmares, being easily startled and avoiding any reminders of the trauma. Uniquely children may re-enact the trauma as they play.
Substance misuse: Children and adolescents are increasingly becoming exposed to alcohol and substances and can development substance use problems quite early in life. The earlier young people start using substances, the higher the risk of developing complications of substance use including dependence, physical health problems, social dysfunction and challenges with school and learning.
What can we do as a society and as a nation to address the mental health needs of children and adolescents?
Invest in child and adolescent mental health services: Decentralised, integrated mental health services for children at health facilities as well as through the school health system is essential for children and adolescents to access support when they need it.
Include mental health education in the school curriculum: to ensure young people are aware about issues of mental wellbeing and are given the tools and strategies to maintain their mental wellbeing as they face the challenges life brings.
Training and support for parents: Many of us became parents with little training for the job we were setting out to do. In the past children were raised in villages with a lot of support from extended family and grandparents for parents to lean on. As our lifestyles are changing and our families are becoming more nuclear, it is critical that parents are provided with training and support in the changing role of parenting. This can be done through schools, churches and other platforms of community leadership.
If you think that you or child or young person that you know may be struggling with a mental health problem, please contact your nearest health care provider and get help.
* Dr. Chido Rwafa-Madzvamutse is a consultant psychiatrist. Feedback: Whatsapp: +263714987729