Children’s mental illness jumps to 20.3%

The National Health and Morbidity Survey 1996 found that the prevalence of psychiatric morbidity in children between 5 to 15 years old was at a high percentage of 13%.

The latest survey shows that the rate has shot up to 20.3%. Malaysian children are under tremendous stress and many are unable to cope with the pressures from the education system, their homes and their peers.

At that time when these survey results were first tabulated in 1996, the Ministry of Health already viewed this as a major public health problem. In 2004, it was announced that the Ministry of Health was now going to pay more attention to mental health.

However, we note from the recently released Third National Health and Morbidity Survey 2006 — conducted 10 years after the Second Survey — that the prevalence of psychiatric morbidity in children and adolescents has risen to 20.3%.

Under the recommendations section of this latest survey report, the Ministry of Health firstly proposes that detailed research be carried out as a follow-up to establish the causalities of such high prevalence of psychiatric morbidity in children and adolescents, and that funding be accorded high priority by relevant agencies.

In 2004, CAP had already expressed concerns and hoped that when it comes to tackling the problems of mental health, the root causes could be identified with accuracy, and thus, satisfactorily addressed. Otherwise, inappropriate action would be taken, while the statistics continued to rise.

Why is detailed research into the diagnoses and causes being recommended so many years later, when the alarm bells should have been ringing and serious action taken 12 years ago, after the release of the earlier survey findings conducted in 1996? How much longer will it take for detailed research and when then will major action be taken?

What about the Ministry’s Institute of Medical Research (IMR)? Have there been no studies in the interim period during the 2 surveys that could have been used for formulating sound and effective policies aimed at halting the upward trend in children’s mental problems? Studies on mental health that have already been carried out by IMR, public universities and other research institutions could have been widely disseminated and used appropriately.

Why have there been no regular updates on the situation and the reasons for the worsening state of affairs over the years, whereby the whole nation could have been made to sit up and also be roped in to help in the implementation of effective measures?

Children start out in life with incredible potential. It is a shame when such potential is crippled due to mental problems, even at very early ages. In the absence of local studies, overseas studies that have been rigorously carried out, those already reviewed and reported in reputable journals, can be identified and used as a reference for urgent action.

Just as an example, overseas studies previously have shown that children who spend long periods in day care are more likely to become aggressive bullies by age 4. They were also found to be fearful, shy and sad compared to other children. Perhaps one of the reasons for worsening mental health in Malaysian children is the fact that many parents now hand over the care of their children to babysitters outside the home.

Evidence from oversea studies has also shown that daycare at nurseries, for children under the age of 2, can lead to increased incidence of antisocial behaviour and aggression. These effects were evident even in children who are in daycare for as little as 12 hours a week. It may well be that policies need to be initiated to facilitate mothers to take care of their children at home, at least during the child’s formative years.

Stress related to factors such as poverty, poor parenting, deplorable physical living conditions, bullying, exposure to domestic violence, sexual abuse, divorce in the family, death of a parent, discrimination and other hardships have all been linked with mental health problems. These problems are all extremely serious, and can be tackled immediately and effectively — without waiting for local research results.

The pressures of school can also affect the mental health of children, especially the weaker ones. Much has already been said about the state of education in the country, and the Ministry of Health could push for a sound revamp of the schooling system as soon as possible. Teachers who oversee kindergartens and Standard One have to be carefully handpicked. This is the entry point for children into formal schooling, and as it is, the occasion can already be traumatic for a child. It can be made all the worse when a teacher is less than understanding, and this may adversely affect the child’s whole approach to education.

The effects of excessive exposure to environmental toxins such as heavy metals like lead, can also manifest as problems such as attention deficit syndrome or hyperactivity. Children are sometimes treated with powerful medicines for these conditions, when what is needed may simply be to identify and eliminate the cause.

Even exposure to television before the age of 2 has been linked to creating symptoms such as attention deficit. This is possibly because the abnormal pace of the television does not allow a young child to focus properly.

The people look to the Ministry of Health for sound and prominent leadership in the area of health — especially to arrest the worsening trends of psychiatric morbidity in our youngsters.

Learn how to protect vulnerable children and provide guidance for their mental and physical development and how even school can affect their lives in the CAP Guides, Protect Your Child and How School Affects Your Kids