Childhood and adolescence are critical stages of life for mental health. This is a time when rapid growth and development take place in the brain. Children and adolescents acquire cognitive and social-emotional skills that shape their future mental health and are important for assuming adult roles in society. The quality of the environment where children and adolescents grow up shapes their well-being and development. Early negative experiences in homes, schools, or digital spaces, such as exposure to violence, the mental illness of a parent or other caregiver, bullying and poverty, increase the risk of mental illness. To know about the causes and remedies of mental health issues in children, Rising Kashmir’s health correspondent, M Peerzada interviews senior Paediatrician Department of Paediatrics GMC Srinagar, Dr Suhail Naik, who speaks about how to take care of children
How do you define mental health in children?
Child mental health is defined as the complete well-being and optimal development of a child in the emotional, behavioural, social, and cognitive domains. Children's mental health is often defined as different from adult mental health and more multifaceted because of the unique developmental milestones that children experience.
As the children are developing and achieving milestones in different domains of development, the mental health problems may be reflected as difficulties in psychological, and emotional development and social relationships and behaviour. When problems in these mentioned areas of development are persistent and severe and cause impairment of functioning, they are defined as mental health disorders.
What mental health disorders are seen in children?
Various mental health disorders can affect children, including anxiety disorders. Anxiety disorders in children manifest as persistent fears, worries, or anxiety that can significantly interfere with their ability to engage in play, attend school, or participate in age-appropriate social interactions.
Attention-deficit/hyperactivity disorder (ADHD): Compared with most children of the same age, children with ADHD have difficulty with attention, impulsive behaviours, hyperactivity or some combination of these problems.
Autism spectrum disorder (ASD): Autism spectrum disorder is a neurological condition that appears in early childhood usually before age 3. A child with this disorder has difficulty communicating and interacting with others.
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.
Depression and other mood disorders: Depression is persistent feelings of sadness and loss of interest that disrupt a child's ability to function in school and interact with 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 in perceptions and thoughts that causes a person to lose touch with reality (psychosis). Most often appearing in the late teens through the 20s, schizophrenia results in hallucinations, delusions, and disordered thinking and behaviours
How can parents come to know that their child has some kind of mental disorder?
There are 11 simple signs a child may have:
Feeling very sad or withdrawn for two or more weeks.
Seriously trying to harm or kill themselves, or making plans to do so.
Sudden overwhelming fear for no reason, sometimes with a racing heart or fast breathing
Involved in multiple fights, using a weapon, or wanting badly to hurt others. Severe, out-of-control behaviour that can hurt themselves or others.
Not eating, throwing up or using laxatives to make themselves lose weight.
Intensive worries or fears that get in the way of daily activities.
Extreme difficulty in concentrating or staying still that puts them in physical danger or causes school failure.
Repeated use of drugs or alcohol.
Severe mood swings that cause problems in relationships.
Drastic changes in their behaviour or personality.
What are developmental disorders in children?
Several different developmental disorders can affect children. Some common ones include Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), Intellectual Disability, Specific Learning Disorder, Language Disorders, Tic Disorders, Neuromotor impairment -cerebral palsy and convulsions.
Where should they go for help?
If parents feel that their child is having any developmental issues or mental health issues, they should immediately discuss the concern with their paediatrician or child specialist and it is then the responsibility of the doctor to screen the child for different mental issues and advise the parents accordingly as the treaty plan usually requires a well-coordinated team effort for the optimal solution
How are mental disorders diagnosed in young children?
To make a diagnosis of a specific mental or developmental disorder, a detailed history, clinical examination, different developmental screening and specific tests, and or using DSM V criteria are essential to make a diagnosis.
Which mental disorder is often seen in children and teens?
The common mental health disorders are different types of anxiety, depression, conduct disorders, attention deficit hyperkinetic disorder, autism spectrum disorders and neuromotor impairment.
How are children with mental health problems treated?
A coordinated effort of paediatricians, developmental paediatricians, child psychiatrists, behavioural therapists, occupational therapists and special schools are must to treat disorders comprehensively. Common treatment options for children who have mental health conditions include:
Psychotherapy: Psychotherapy is also known as talk therapy or behaviour therapy. Psychotherapy is a way to address mental health concerns by talking with a psychologist or other mental health professional. With young children, psychotherapy may include playtime or games, as well as talk about what happens while playing. During psychotherapy, children and adolescents learn how to talk about thoughts and feelings, how to respond to them, and how to learn new behaviours and coping skills.
Medication or pharmacotherapy: Drugs like stimulants, antidepressants, anti-anxiety medication, antipsychotics or mood stabilizers are used as part of the treatment plan.
How important is mental health? How to protect and improve mental health?
Well-designed mental health promotion and prevention programs and interventions can enhance the well-being of children and mitigate the escalation of problems. As stated by the World Health Organization, “mental health is more than the absence of mental disorders”; mental health is fundamental to health and overall wellbeing because “without mental health there is no health.
Mental health issues at a young age affect children and adolescents all around the world in all societies. According to the WHO, up to 50% of mental disorders during adulthood have their onset in adolescence and up to 20% of children and adolescents experience some mental disorders. An important problem is that about 70% of children and adolescents with mental disorders do not receive an appropriate intervention at the right time.
What should parents do to monitor the mental health of their children?
Monitoring the mental health of children is crucial for their well-being. There are many ways parents can take to effectively monitor and support their children's mental health.
Create an open and non-judgmental environment where your child feels comfortable discussing their feelings, thoughts, and concerns. Encourage them to talk about their day and any challenges they may be facing.
Pay attention to changes in your child's behaviour, mood, and habits. Be alert to signs of distress or unusual behaviour, such as withdrawal, aggression, or excessive mood swings.
Build a strong foundation of trust with your child so that they feel safe confiding in you about their emotions and experiences.
Ask open-ended questions about their feelings and experiences to encourage them to express themselves more fully. Monitor their eating, sleeping, and daily routines. Changes in these patterns can be indicators of stress or mental health issues.
Sometimes, children just need someone to listen to them without offering immediate solutions or judgment. Be a supportive listener and validate their feelings.
Educate yourself about common developmental milestones and age-appropriate behaviors. This will help you distinguish between normal development and potential mental health concerns.
Be aware of common signs of mental health issues in children, such as excessive worry, frequent sadness, changes in appetite, difficulty concentrating, or withdrawal from friends and activities.
Does violence of any kind affect the mental health of children?
Violence of any kind can significantly affect the mental health of children. Exposure to violence, whether as victims or witnesses, can have long-lasting and detrimental effects on their emotional and psychological well-being.
Children exposed to violence may experience a range of emotions, including fear, anxiety, anger, and sadness. These emotions can become overwhelming and impact their ability to cope with daily life.
Violence can lead to trauma in children. Traumatic experiences can manifest as flashbacks, nightmares, and intrusive thoughts, leading to conditions like Post-Traumatic Stress Disorder.