Mental Health Disorders In Kids: What Can Parents Do?

According to the World Health Organisation (WHO), "In recent years, there has been increasing acknowledgement of the important role mental health plays in achieving global development goals, as illustrated by the inclusion of mental health in the Sustainable Development Goals.

Depression is one of the leading causes of disability." The pandemic has worsened the situation for many and added to the triggers leading to further stress on mental well-being.

Covid 19 has brought out the severity of the global mental health crisis so much that it is feared to be the next big pandemic. This brings the attention and the urgency to ACT NOW.

Mental illnesses are similar in children. However, since the symptoms can differ, it becomes difficult for parents to recognise the need. To understand how to diagnose and get the help needed by our children, I reached out to Chandra Ramamurthy, a Clinical Psychologist and a grief & resilience researcher. She has been a therapist, active trainer, and educator in the mental health field, focusing on suicide prevention.

Q. What are mental health disorders?

A. A mental health disorder is often referred to as mental health condition, mental illness or even a psychiatric disorder. We are increasingly choosing terminology that is rights-based and enabling. Hence mental disorder is preferred over an illness. These behaviour patterns or conditions cause impairments (cognitive, emotional, behavioural) in daily functioning. The impairment can manifest in terms of severity, the duration of the symptoms and even the recurrence or coexistence of other disorders. Mental health disorders are usually diagnosed by a mental health professional, a clinical psychologist or a psychiatrist, who uses tools to evaluate the reported symptoms scientifically.

Q. Can young children get mental health disorders? At what age can they get it?

A. Mental health disorders in children often manifest as delays in developmental milestones. The symptoms may range from the inability to regulate emotions to lacking social skills according to the normal childhood development process. These symptoms may differ due to age and usually disrupt functioning at home or school. Children usually may not be able to express their feelings, and parents may feel stigmatised to report the symptoms or even seek help to economic constraints -exacerbating the problem. Some common mental health disorders or developmental disorders are Autism Spectrum disorders, ADHD and even post-traumatic disorders due to abuse or trauma. Children are also increasingly being diagnosed with anxiety, eating, and even depression or mood disorders.

What Is Mental Health?

Q. How do we recognise if our child suffers from any mental illness?

A. Any deviation from the normal development milestones or behaviour as reported by the child or even noticed by teachers, peers or caregivers should be monitored, and concerns should be brought forth to a paediatrician who may recommend evaluation by a child psychologist.

Q. Few reports imply that the pandemic resulted in developmental delays in infants and toddlers. Your thoughts?

A. The COVID-19 pandemic was like no other and has caused significant mental health issues among adults and children. There have been significant development delays in children as their normal functioning was totally disrupted due to numerous factors associated with COVID-19. It will take us some time to assess the real impact of the pandemic though we know for certain that it has been detrimental to the mental health of all human beings.

Mental Health And Causes

Q. Can we truly understand the cause of the illness? Is it genetic?

A. Health is often viewed through the Biopsychosocial models, a class of trans-disciplinary models that examine the interconnection between biology, psychology, and socio-environmental factors. These models specifically examine how these aspects play a role in topics ranging from human development to health and disease, to information processing, to gender and conflict.

Q. Are there triggers that can lead to mental health disorders? Parents, peers, Environment etc.?

A. Physical health has its triggers in low immunity that allows for illness. In the same way, there are many triggers for mental health also. The most common are stressors, anxiety etc. The triggers can come from any source, the environment (workspaces, schools etc.) or individual interaction.

Q. How does Parenting cause them in the child?

A. Parental expectations can cause stress in a child. Having a conversation with your child, being their friend and managing expectations at both ends can reduce stress.

Mental Health And Prevention

Q. How can parents ensure the good mental health of their children?

A. We often stress about physical health checks but barely pay attention to mental health checks. Often symptoms like low mood are brushed off as insignificant. Parents can ensure that they pay attention to their children's mental health by providing them with a balanced diet, avoiding stressors and ensuring that they are in tune with their needs. The parent needs to be the child's best friend.

Q. Is there a specific diet that can help?

A. A specific diet helps nutrition for the body, brain, and overall fitness. Well-being is not only physical but mental fitness as well. The focus needs to be on a well-balanced diet as each food has its specific function, and there is enough research on the harmful effects of certain food categories like junk food.
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Q. What all treatments are available?

A. Treatment for mental health disorders is available depending on the kind of disorders, symptoms, severity, and frequency. A mental health professional, essentially a psychiatrist and or a psychologist, evaluates this. Mental health disorders are like any other illness and need the same attention as physical disorders.

Q. What should one look for in a therapist while taking their children for a consultation?

A. A good therapist builds rapport, takes time to assess the problem using scientific tools and formulates a treatment plan with the client's support and consent/assent. Typically, licenced psychiatrists and therapists are the best way forward,

Q. There is a lot of taboo and stigma attached to mental health disorders. How to handle them and teach our kids to handle them?

A. The Stigma and discrimination attached towards mental health disorders will take time to change. This awareness can only be slowly started at individual, societal and community levels and may finally trickle to the national level. We can first learn at an individual level that it's okay not to be ok and then work towards slowly accepting variations in mental health.

Mental Health And Resources For Caregivers

Q. Are there support groups for parents?

A. Parents who have children with specific disorders have formed specific support groups.

Q. How should parents ensure enough self-regulation?

A. Self-regulation is a sign of good emotional health and is important in behaviour. People with trouble with self-regulation are offered the technique as a part of behaviour therapy.

Mental Health: The Current Scenario

Q. A friend, sometime in 2006, went to a reputable hospital to consult a psychologist on what seemed like depression-like symptoms. The doctor told her, "Stop being so sad. Try to stay happy." Have we come a long way since then? Isn't this how often family members ignore depression in adults, let alone a child?

A. A family member may have varied reasons for ignoring the symptoms of mental disorders in children. Most are linked to stigma, lack of access and economic constraints. There is a need to educate and raise awareness among parents, caregivers, and society, in general, to reduce stigma towards mental disorders and accept it as another health condition.

Q. Is mental illness, the diagnosis and treatment, only an urban Indian concern?

A. Mental illness, diagnosis and treatment are universal concerns. People in rural India have less or no access to mental health care and often have to rely on the existing negligible primary health care services for their mental health. The lack of access makes people hesitant to report or even postpone seeking help. People travel to bigger hospitals and facilities only when the disorder absolutely disrupts daily functioning. Increasing awareness can enable people to get timely help and access to early interventions that can improve the individual's prognosis.

Q. Is the helpline for mental health support effective?

A. The helplines in India have had some self-reported impact. There has been no scientific assessment of their efficacy. Most therapists do recommend face-to-face therapy over online modes of mental health care delivery as many nuances like non-verbal cues are lost in tele counselling or even counselling through internet platforms like zoom.