CHILDREN’S mental health is important, as they are part of our future. Therefore, it is crucial to recognise and acknowledge that children have emotions and can hurt, despite their young age and immaturity.
Apart from allowing them to play as much as they want to help develop different skill sets, it is also important to watch over their mental health.
In sharing further, Starcatcher Psychological Services co founder and clinical psychologist Hazel Saw Huey Szee shared her thoughts about the following:
Sarawak Tribune: What are some of the most common mental health disorders affecting children today?
Hazel: Some of the most common mental health disorders that are diagnosed among children are neurodevelopmental disorders such as Autism Spectrum Disorder, Attention Deficit Hyperactive Disorder, and Intellectual Disability.
There are also other disorders, such as anxiety disorders and depressive disorders, which are becoming quite prevalent among children due to academic pressures, family dynamic issues, social relationships with peers, and more. However, we have to be aware that anxiety and depressive disorders manifest themselves rather differently in children as compared to adults.
ST: How can people recognise them?
Hazel: For neurodevelopmental disorders, it is crucial for caregivers to be aware of some common developmental milestones. If they notice a child experiencing significant delay in some of these developmental milestones, do consult healthcare professionals. Early interventions are very important. If teachers or healthcare providers are notifying you about their observations of your child, indicating a possibility that your child is showing signs of a neurodevelopmental disorder, do not dismiss it.
For other mood disorders like anxiety disorders and depressive disorders, caregivers might notice changes in behaviour, such as the child becoming more isolated or more irritable, losing interest in things that he/she used to like; changes in academic performance, experiencing difficulties concentrating in school or having frequent absences from schools; any new unexplained, physical symptoms that emerged, to name a few.
ST: How has the COVID-19 pandemic specifically impacted children’s mental health?
Hazel: During the COVID-19 pandemic, children are particularly vulnerable to the stressors caused by such a global crisis, as it disrupts their routines, social interactions, and sense of safety.
Increased Anxiety and Fear
The uncertainty and constant exposure to news about COVID-19 then created a sense of fear and anxiety among many children. Children can pick up on the fear and anxiety of the adults as they witness the responses of their caregivers to the COVID-19 pandemic. Older children and adolescents were particularly affected by fear of getting sick themselves or losing loved ones.
Social Isolation and Loneliness
One of the most significant impacts was the loss of social interaction. Many schools were closed, and children could not interact with their peers. Social isolation has cost many children (especially young children) in their emotional development. A lot of COVID babies become very anxious around strangers or social situations due to the lack of social exposure during the COVID-19 pandemic.
Disruption to Routine
The closure of schools and extracurricular activities resulted in many children losing structure and predictability in their daily lives. Without these routines, many children struggled to adapt to learning, such as online learning, had difficulty focusing, or developed unhealthy habits such as increased screen time. The increase in screen time also resulted in more behavioural difficulties and tantrums as children became addicted to gadgets.
Academic Stress and Learning Gaps
Some children found it difficult to adjust and adapt to virtual classrooms, especially those with attention difficulties or those from lower-income families who were without access to necessary technology. The lack of face-to-face interaction with teachers and peers also meant that some students had a harder time staying engaged or receiving the support they needed. Signs of stress can include frustration with schoolwork, a sudden decline in academic performance, feelings of inadequacy, or a lack of motivation.
Grief and Loss
Many children experienced grief due to the death or illness of family members or close friends, which was exacerbated by restrictions on visitation or funerals. Even if children did not directly lose a loved one, they might have felt a sense of collective grief due to the widespread loss and suffering in their communities.
Increased behavioural Issues
As a result of the stress, some children displayed changes in behaviour, including more frequent tantrums, aggression, or defiant behaviours, especially among younger children who lack coping skills.
Family Dynamics
Parents, too, were under immense stress during the pandemic, whether due to financial concerns, health worries, or balancing work and home life. This stress often had an indirect impact on children, as parents may have had less time and emotional energy to support their children through their own struggles. Some children may also experience domestic violence due to parental stress or from being confined in the same space for too long a period of time. Family members’ mental health also has an impact on children’s mental health. This dynamic could contribute to increased family tension and conflict, further affecting children’s emotional well-being.
ST: How can parents effectively encourage open communication about feelings with their children? What are some healthy coping mechanisms parents can model for their children?
Hazel: Parents can first encourage open communication by being open themselves about their feelings to their children. Many times, we are upset or frustrated with the difficult behaviour or emotions that children expressed. A big part of it is because it is difficult for us to sit with those difficult emotions. When we are able to sit with these difficult feelings and be intentional with our response without denying or suppressing the existence of these difficult emotions, not only are we able to support and guide our children through tough emotions or sit with their difficult emotions, we are also modelling healthy responses and healthy relationship with our own emotions.
And when we slip up or make a mistake, we have to first be able to forgive ourselves and do the “repair” work (i.e., apologise when a mistake happened, process honestly our thoughts and feelings, and acknowledge our shortcomings). It is also important for children to witness that mistakes are acceptable and sincere repair is possible in the family. It allows our children to accept their own flaws, be open to learning from mistakes, contemplate better responses, and, at the same time, take initiative and responsibility to “repair”.
ST: Why is fostering resilience considered essential for children’s mental well-being? What are some specific skills or strategies parents can teach their children to foster resilience?
Hazel: Resilience is the ability to bounce back from a crisis. Children need these skills in order to survive in our world. Unfortunately, the reality of this world is that it can be rather harsh, hardship will definitely come your way. Learning to navigate crises and difficult situations are important livelihood skills that will help us not just to survive but also thrive in life.
As parents, apart from modelling good coping skills, it is also important to not shield children from hardship. Things like chores, natural consequences of an action, are important events in our children’s lives.
Personally, as a therapist and a parent, I think it is important to allow and even welcome hardship in our children’s lives (even though it might be difficult to watch). For instance, if we witness our child being bullied/sidelined in the playground, unless it is life and death, I do not suggest intervening or jumping in too quickly to the rescue. Hold ourselves back and observe — see how the child responds and fair for themselves. After that event, you can process with your child what had happened earlier at home. Brainstorm what he/she can attempt the next time.
However, there will be times when an intervention is warranted — such as when your child or another child is being potentially harmed (i.e., physical violence). Stepping in these times is also necessary to allow your child to feel safe.
Teaching your children when to seek external help is also an important resilient skill that should not be downplayed.
ST: Why is it important to break the stigma surrounding mental health, particularly for children?
Hazel: Breaking stigma around mental health is crucial to increase help-seeking behaviour as children are vulnerable and dependent on another adult/caregiver. Seeking help is not up to them. So it is crucial for other adults/caregivers to feel safe enough to step out and bring these children for help when needed.
The impact of an event on children’s mental health is also often overlooked. They are often viewed as being “too young” to understand or be affected by an event. Many adults find it difficult to accept that mental health disorders can plague children too. Hence, interventions are not sought even when there are clear signs of mental health issues.
ST: How can our community and schools foster an environment that promotes good mental health in children? How do they influence children’s mental health?
Hazel: It is important for schools and communities to begin implementing policies that include mental health consideration. Schools and communities can build their architecture with children’s mental health in mind. Curriculum and cultures are also something that would shape one’s mental health. It is time for us as a community to step up for our children and begin reconsidering our words, actions, and cultures — becoming more aware of the effects of what we are doing and intentionally, mindfully moving toward approaches that are healthier not just for children’s mental health but for mental health in general.
ST: How important is the role of families in supporting children’s mental health, and how can schools and communities better engage parents in this process?
Hazel: A lot of mental health issues among children are very much tied to their environment, such as school and family life. It is therefore very crucial for families to take charge and be actively involved in preserving children’s mental health. This includes creating a healthy environment for them at home, allowing emotional expression, and being emotionally aware as well as resilient themselves so that they can model good coping for children. The dynamics at home will impact a child. This is why we see children from divorced homes sometimes pay the price for parental conflict.
Schools and communities can educate parents and work hand in hand to communicate with parents frequently, especially if the school notices any red flags with regard to their children’s mental health, so that early intervention can happen. Schools should also be open to feedback or opinions from parents about their children. Allow some hardships for children in the community/school setting. Though yes, some well-meaning protective parents might not take it well, the school/community has a role to play in continuously informing parents of their intentions as well as educating them on the reasoning behind each action done.
ST: What mental health resources should be available in schools, and what are best practices for ensuring children can access them?
Hazel: I think a team of dedicated teachers who are committed to enhancing the children’s mental health (including counsellors) is important. The presence of this team should be made as loud as possible. Mental health programs can also be organised to increase awareness of mental well-being, equip children with mental health resources, educate them on the available support in the schools, as well as where to go to access them should they need it.
Beyond that, the education system also needs to include mental health studies. Children need to learn coping skills from young and one way to do so is through school education and modelling by their teachers in school.
Breaking the stigma is also important, which is why conversations about mental health should happen as often as possible. Without stigma, it is easier for children to step into the counselling office to seek help when they need it. It is also necessary for schools to often have awareness events that talk about mental health as well as where to seek help when he/she needs it.
