When young people are struggling with mental health issues, the one thing they need more than anything else is connections with others – whether friends, caregivers or mentors. 

However, many people fear acknowledging mental health issues due to their own negative associations or a lack of expertise on how to handle such problems, according to Professor Mark Tomlinson, lead editor of the 2022 South African Child Gauge and co-director of the Institute for Life Course Health Research at the University of Stellenbosch.

This lack of acknowledgement can create a “vicious cycle” in which young people, feeling that they cannot connect, withdraw further.

“We need an openness, where it’s okay to talk about [mental health],” said Tomlinson. “All of us will go through a period where we lose a loved one… or various things happen in our lives – we lose a job, we fail a grade – [and] we’re going to struggle. The best thing to get through that is actually connecting with other people.”

Tomlinson spoke as part of a Daily Maverick webinar on “Child and adolescent mental health: Finding Solutions”. The discussion was chaired by Mark Heywood, Maverick Citizen editor. Lilah Davies, a 14-year-old reporter from RX Radio – a radio station run by and for children operating from the Red Cross War Memorial Children’s Hospital in Cape Town – joined Tomlinson as a speaker.

The webinar was the second in a series on “Child and Adolescent Mental Health”, representing a joint initiative between RX Radio, Daily Maverick and the Children’s Institute at the University of Cape Town. Many of the questions posed during the webinar were compiled by the young reporters of RX Radio.

Tomlinson described mental health as a continuum, stretching from those who are incredibly happy and well-connected, to those who are struggling with severe mental disorders.

“Those are the two extremes, and… all of us, young people, old people… all of us at various times move up and down that line,” he said.

Some stress in a young person is normal and can be good, in that it is a source of motivation. However, stress becomes worrying when it is chronic and prevents a person from being able to engage in their normal activities.

“That’s where they may need some more professional help. It’s almost when the stress becomes a little bit toxic, as opposed to just a good kind of stress,” explained Tomlinson.

State of mental health

As a young person, Davies said that she has noticed a deterioration in mental health among her contemporaries in recent years, in part because of the types of issues to which young people are exposed.

“I think that definitely in this day and age, social media, whether it be the things that we see, the expectations that we’re kept up to… can definitely put a very hard strain on your mental wellness,” she said. “Misinformation and lies spread by the internet can also be something leading to bad mental health.”

Climate change plays a big role in the younger generation’s mental wellbeing, as most young people have grown up with an awareness of the climate crisis.

“I think the reason it affects the young people of today is because the world that we are ruining is the world that we’re going to be living in. So, I think that’s why we’re scared of [climate change],” said Davies.

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Mental disorders are often thought of as “sitting in the brain”, said Tomlinson. While this is partly true, there are social determinants such as poverty, violence and other external factors that can have a profound effect on levels of stress and mental wellbeing among young people.

Who is responsible?

Relationships are not only the most important means of addressing a young person’s mental health, but also a two-way street, according to Tomlinson. As such, everybody is responsible for mental health, including teachers, caregivers and young people themselves.

“The core of everything is the relationship – build trusting, thoughtful, caring relationships with your children, with your nieces, with your nephews, with other young people in the community. And through your actions, show them that you’re somebody who can be trusted,” he said.

Tomlinson acknowledged that sometimes family or community members can be the source of a young person’s mental health struggles.

“The [young person’s] connection doesn’t have to be necessarily with the parents, if they’re part of that toxic mix,” he said. “It could, for example, be a really good… [and] trusting relationship with a teacher.

“The other side of that is then, very often, toxic relationships can actually be fixed, can be improved… Of course, that’s not always possible, but where it is – particularly if it’s within the family itself – then that really is absolutely vital, because we are all drawn to our families.”

Peer groups can play an important role in children’s and adolescents’ mental health, by creating spaces in which young people feel supported and cared for.

“People often talk about peer pressure… in a negative way, not in a good way, but in fact it can be both,” said Tomlinson. “It can be, and is for so many young people, an absolutely amazing thing.”

South Africa continues to have a shortage of mental health care services for the support of young people. This is problematic as the longer mental health struggles go untreated, the worse they will get, according to Tomlinson.

“In cases where medication… is needed, or therapy or a variety of things, then if you get in there early with treatments, as well as other preventative activities, that’s incredibly good,” he said. “So, we need more services, and we need to push for more services.”

Davies and Tomlinson agreed that there should be a closer relationship between South Africa’s departments of health and education, and an effort to make mental health professionals accessible at schools.

“Many children will say that school is one of their favourite places to be due to their friends… and the people that they surround themselves with, and I think that school can almost become a second home for some,” said Davies. “So, I think that having that kind of support at a school would be really good [for young people].” DM/MC