Prioritise your child’s mental health

At his school, Eldrine was the best student in the 2022 Uganda Certificate of Education exams. The 16-year-old scored 12 aggregates despite missing school for the entire first term while battling schizophrenia. The teenager had always been a model student and did not have any symptoms until he joined Senior Four and started hearing voices, which affected his concentration in class.
“He performed so poorly in the beginning of term exams but since it was post Covid-19, I thought he had just declined because he had not been studying,” his mother says.
With time, it was hard for Eldrine to stay in class. His mother took him to several hospitals but without a proper diagnosis and believing it was maybe witchcraft, she tried several churches for exorcism to no avail. 
A friend then recommended a psychiatrist who diagnosed Eldrine with schizophrenia, a mental illness characterised by delusions, seeing or hearing things that do not exist, trouble concentrating, lack of motivation and withdrawal.
While Eldrine was lucky that his mental health problem was diagnosed, many children with mental health challenges are unable to get the support they need.
Important
Childhood and puberty are critical stages for both physical and mental health. During this time, children and adolescents acquire cognitive as well as social-emotional skills that shape their future mental health and are important for assuming adult roles in society.
Without treatment, children with mental health issues are at an increased risk of failing in school, dependence on social services, self-harm and even suicide. 
Dr Joyce Nalugya, a psychiatrist with special interest in child and adolescent psychiatry and mental health at Mulago National Referral Hospital, says parents and family members should be the first to notice if a child has problems with their emotions or behaviour.
She adds that mental health challenges in children are categorised into developmental, behavioural (such as attention-deficit/hyperactivity disorder) and emotional challenges that affect how the children feel. Anxiety disorders and depression are the commonest emotional mental health challenges that affect children.
Triggers
The exact cause of mental health problems among children may not be known but a combination of factors can trigger them. Poor parenting styles with parents or guardians that are extremely rude and cruel can cause a spark for children to develop a condition that affects their emotions or how they behave. 
Children become depressed when their parents are sick, dead or are unable to provide love and care consistently in cases of separation. At such a time, a child may feel neglected and may throw tantrums or become stressed. 
Children living in abusive environments (such as homes where there is domestic violence) are prone to developing mental health challenges since they are always worried. It may be emotional, physical or sexual abuse by a relative or even people in the neighbourhood. 
Congested school programmes that deprive children of enough sleep and play, non-supportive and rude teachers, children who bully others can increase the risk of mental health challenges in children. 
If the family welfare is bad and children are not able to get basic needs, they can be mentally challenged whenever they compare themselves with others that can get all the necessities. Such children will also be hungry and malnourished, which also contributes to poor mental health.
Poorly managed infections and malaria during pregnancy and mothers who take alcoholic drinks when they are pregnant expose their children to mental health challenges according to Dr Nalugya. When such a child is born, alcohol is present in their bloodstream and can interfere with the development of their brain and other critical organs, structures, birth defects and neurodevelopmental abnormalities.
Signs
Dr Faith Nakalema, the head of department, Applied Psychology in the College of Humanities and Social Sciences, Kampala International University, says it is important for any parent to understand their child’s personality. A child may be an introvert and their behaviour is just observed while others are outspoken and freely talk about almost everything. 
Mental health challenges in children can be identified depending on their stage of development.
“It is vital that parents know that there are different behaviours that come up in children depending on their age. Adolescents for instance usually develop eating disorders by either eating very little food or too much. Such challenges can be overcome by helping a child understand and appreciate who they are,” Dr Nakalema says.
What to do
Dr Nalugya advises parents to immediately seek medical attention when they notice questionable behaviour in their children.
“Parents should be mindful about the mental health of their children and any unusual behaviour should be reported for assessment, which is free at all government health facilities such as health center IVs, general hospitals or Mulago and Butabika National Referral Hospitals,” she says. 
 “Parents should adopt parenting styles that do not spoil children but help them to thrive and survive. As a family, you must learn to support each other,” Dr Nakalema adds.
She adds that a child should have social survival skills such as negotiation, decision making and assertiveness, to help them solve problems. If they are not able to, they need help through counselling or parenting. 
“Ensure that you switch off television, put away the phones and have a time for the children to express themselves,” Dr Nakalema advises.

Prevalence
According to the World Health Organisation (WHO), mental health conditions, developmental disabilities, depression, anxiety and behavioural disorders are major causes of illness and disability among young people.
“Globally, 10 percent of children and adolescents experience a mental disorder, but majority do not seek help or receive care. Suicide is the fourth leading cause of death in 15-19 year-olds. The consequences of not addressing mental health and psychosocial development for children and adolescents extend to adulthood and limit opportunities for leading fulfilling lives,” states a WHO report.