Mental Health And Emotional Well Being In Children

 Illustration: Chelsea Beck

By Wasim Rashid Kakroo

MENTAL health is an important part of children’s overall health and has a complex interactive relationship with their physical health and their ability to succeed in school, at work and in society. The emotional wellbeing of children is just as important as their physical health. Both physical and mental health affect how we think, feel and act on the inside and outside. Good mental health allows children and young people to develop the resilience to cope with whatever life throws at them and grow into well-composed, healthy adults whereas ignoring the mental health needs of a child or teenager may lead to life-long consequences for the child or teenager.

According to one estimate, mental health problems affect about 1 in 10 children and young people. They include various types of internalizing disorders such as mood disorders, anxiety disorders and externalizing disorders such as Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), Conduct disorder etc. and are often a direct response to what is happening in their lives.

Alarmingly, however, a significant percentage of children and young people who experience a mental health problem have not had appropriate interventions at a sufficiently early age.

Suggestions to help children keep themselves mentally healthy:

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
• having time and the freedom to play, indoors and outdoors
• being part of a family that gets along well most of the time
• going to a school that looks after the wellbeing of all its pupils
• taking part in local activities for young people.

Other factors are also important, including:

• feeling loved, trusted, understood, valued and safe
• being interested in life and having opportunities to enjoy themselves
• being hopeful and optimistic
• being able to learn and having opportunities to succeed
• accepting who they are and recognizing what they are good at
• having a sense of belonging in their family, school and community
• feeling they have some control over their own life
• having the strength to cope when something is wrong (resilience) and the ability to solve problems.

Dealing with change:

Mostly things that happen to children don’t lead to mental health problems on their own, but traumatic events can trigger problems for children and young people who are already vulnerable to develop mental health issues of various types.

Changes often act as triggers: 

changing residential place or school or the birth of a new brother or sister, for example. Some children who start school feel excited about making new friends and doing new activities, but there may also be some who feel anxious about entering a new school environment.

Teenagers often experience emotional turmoil as their minds and bodies develop. An important part of growing up is working out and accepting who you are. Some young people find it hard to make this transition to adulthood and may experiment with alcohol, drugs or other substances that can affect mental health.

Risk factors 

There are certain risk factors that make some children and young people more likely to experience problems than other children, but that doesn’t necessarily mean difficulties are bound to happen.

Some of these factors include:

• having a long-term physical illness
• having a parent who has had mental health problems, problems with alcohol or has been in trouble with the law
• experiencing the death of someone close to them
• having parents who separate or divorce
• having been severely bullied or physically or sexually abused
• living in poverty
• acting as a carer for a relative, taking on adult responsibilities

What mental health problems commonly occur in children? 

These are some of the mental health problems that can affect children and young people.

• Depression affects more children and young people today than in the last few decades. Teenagers are more likely to experience depression than young children.
• Self-harm is a very common problem among young people. Some people find it helps them manage intense emotional pain if they harm themselves, through cutting or burning, for example. They may not wish to take their own life.
• Generalised anxiety disorder (GAD) can cause young people to become extremely worried.
• Very young children or children starting or migrating from one school to another school may have separation anxiety.
• Post-traumatic stress disorder (PTSD) can follow physical or sexual abuse, witnessing something extremely frightening of traumatising, being the victim of violence or severe bullying or surviving a disaster.
• Children who are consistently overactive (‘hyperactive’), behave impulsively and have difficulty paying attention may have attention deficit hyperactivity disorder (ADHD). Many more boys than girls are affected, but the cause of ADHD isn’t fully understood.
• Eating disorders usually start in the teenage years and are more common in girls than boys. The number of young people who develop an eating disorder is small, but eating disorders such as anorexia nervosa and bulimia nervosa can have serious consequences for their physical health and development.

Importance of early intervention:

Let us suppose there is a boy namely Rashid who is being physically abused by his father at his home and often acts out aggressively at school. His behavior is a natural reaction to the abuse, but his behavior may also mark the beginning of undiagnosed conduct disorder. His teachers simply see him as a troublemaker and continually punish his behavior. Later, Rashid drops out of school as a teenager because he finds it a harsh and unwelcoming environment and is anxious to leave his abusive home and fend for himself. However, holding down a job is difficult because Rashid often clashes with his coworkers and supervisors due to his aggression. Rashid has also begun to self medicate by abusing alcohol and has been arrested a number of times for alcohol and drug abuse. By the time Rashid finally receives a proper diagnosis of his conduct disorder (characterized by delinquency, lying, stealing etc.) and substance abuse, he is in his thirties and his mental health problems have become deeply ingrained. These mental health issues will require extensive therapy, which Rashid probably cannot afford without a job. Things could have been very different if Rashid was referred to a Clinical psychologist in his childhood who could have diagnosed him and offered effective treatment.

What help is available? 

Parental help

If children have a warm, open relationship with their parents, they will usually feel able to tell them if they are troubled. One of the most important ways parents can help is to listen to them and take their feelings seriously. They may want a hug, they may want you to help them change something or they may want practical help. However, it’s beneficial and even important to get help if your child is distressed for a long time, if their negative feelings are stopping them from getting on with their lives, if their distress is disrupting family life or if they are repeatedly behaving in ways you would not expect at their age.

Professional help 

If your child is having problems at school, a teacher, school counselor etc. may be able to help and if these professionals feel that the child needs some serious help, they can refer a child to professionals such as Clinical Psychologist/Psychiatrist etc.

Different professionals often work together in Child and Adolescent Mental Health Services. Parents can visit IMHANS at Badamwari Srinagar where IMHANS in collaboration with UNICEF have established a CHILD GUIDANCE AND WELL BEING CENTRE where such children and adolescents with various mental health issues are treated for free. This centre has a team of professionals available to deal with the various mental health issues of the child. The team includes Child Psychiatrist, Clinical Psychologists, Mental Health counselors, Psychiatric social workers, Occupational therapist, remedial educationists, speech therapists, professionals who deal with autistic children, lawyers etc among others. Parents can also visit professionals in private practice to help their children resolve their issues.

Conclusion:

In conclusion, parents and caregivers need to take responsibility towards the mental health and emotional well being of children and adolescents so that we as a society are able to produce a generation of mentally sound citizens who help in evolving the human race in a much better way. Otherwise ignoring the mental health needs of our younger generations may lead to social, economic and psychological burden that we may be unable to replenish for generations to come.

• The author is a Consultant Clinical psychologist by degree and profession and works as a Child and Adolescent Mental Health Therapist at Child Guidance and Wellbeing Centre, IMHANS, Badamwari Kashmir. Email: [email protected] 

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