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There is a need to turn words into actions – children’s mental health and psychosocial well-being matter

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Carmel Gaillard is the programme manager for child safety and protection at the Nelson Mandela Children’s Fund.

What makes the statistics about child suicide and mental illness more horrific is that child and adolescent mental health is often misunderstood across families and communities. There is a need for more pronounced conversations, education, involvement and solutions.

In recent years there have been much-welcomed discussions on the importance of mental health and how we should focus all our efforts on this key healthcare aspect, and how we should support those openly seeking help, and those not willing to openly speak out. While this is welcomed, it has had its limitations as we have seen less focus on children, and how and why mental healthcare and ultimate wellness are also pivotal for them.

The reality, which we should all endeavour to change, is that children cannot always play second fiddle on issues that really matter to them. We have to acknowledge that the time has come for children to occupy deserved spaces such as fair and equal commentary in the media.

One of the relentlessly ignored challenges faced by children today is neglect, particularly on the status of their mental health and psychosocial well-being. We need to do better. We should implore ourselves to.

One of the steps the Nelson Mandela Children’s Fund (NMCF) has taken to spotlight the mental health rights and concerns of children is to partner with the Regional Psychosocial Support Initiative (REPSSI), an organisation that has dedicated its efforts to facilitating better access to psychosocial support for all girls and boys, in east and southern Africa.

The facts are more than concerning. 

Children who exhibit symptoms of stress, anxiety, depression or challenges with regulating, feeling or expressing emotions, are too often called naughty, strange or dealing with spiritual affliction.

The South African Society of Psychiatrists (Sasop) tells us that one in seven children live with treatable mental health conditions. They further estimate that only 10% of these children are able to access necessary mental health treatment due to lack of specialists and enough facilities. This is dire. 

What are we going to do about it? Surely, we can do better for children.

What makes the above statistics more horrific is that child and adolescent mental health is often misunderstood across families and communities. There is a need for more pronounced conversations, education, involvement and solutions.

The situation painted by Sasop is exacerbated by unfair and crude labels, as children who exhibit symptoms of stress, anxiety, depression or challenges with regulating, feeling or expressing emotions, are too often called naughty, strange or dealing with spiritual affliction.

As the NMCF, our view is that the most effective approach to promoting child mental health and psychosocial well-being in resource-constrained contexts is to focus on the prevention of ill health. 

How can this be done?

Through strengthening awareness among the general population, having conversations about the types of relationships and actions that support good child mental health, and harnessing the commitment, skills and knowledge of all citizens to support children emotionally, socially and mentally, particularly where they are daily, at places such as home, school, online and parks.

Child safety

The other key issue we cannot ignore, or merely gloss over, is child safety. The reality is that mental health and child safety are interrelated. Suicide demonstrates this interrelation. The fact is that one in nine teenage deaths in South Africa is through suicide. That’s a scary statistic.

A few weeks back, we learnt that since the beginning of 2023, 40 children, just in Gauteng, have died by suicide. The South African Depression and Anxiety Group has confirmed that at least 25% of South African teenagers have thought about ending their lives. Suicide, depression, anxiety and traumatic stress may be caused and exacerbated by adverse childhood experiences such as abuse, domestic violence and bullying. Similarly, caregivers with compromised or poor mental health or psychosocial well-being are more likely to subject their children to neglect, abuse and violence.

Read more in Daily Maverick: Child and adolescent mental health services are in crisis, says report – this is what the Health Department aims to do about it

On 4 and 5 October, the NMCF and REPSSI, together with other east and southern African organisations, will be hosting the 2023 Psychosocial Support Forum here at home. It’s far from being just a talk shop. It’s a forum that seeks to come up with solutions, involve interested stakeholders and seek to do better.

This forum seeks to make sure that when the 2025 edition of the same gathering comes up, strides should have been made that paint a positive picture when addressing children’s mental health issues, and their ultimate psychosocial well-being, preferably being made a priority. Once the forum is done, there is anticipation that the proposed learning exchange will propel access to effective support for the children we serve.

We cannot continue as if it’s business as usual. Our children need us to act and implement the solutions we often come with. Child mental health needs us to act decisively in the interests of our children. Let us not disappoint our children, while we expect them to have a better future, where child mental healthcare is prioritised. DM

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  • Louise Louise says:

    Carmel, thank you for a very caring and thoughtful report on the heartbreaking sadness that surrounds too many children today. Children need to be protected by responsible adults and allowed to be innocent children. Children are not emotionally capable of handling unproven and divisive agendas such as “critical race theory” or ridiculous claims that a man can become a woman and vice versa. Added to that, children should not be taught or exposed to material that is pornographic in nature. Children are known as dependents for a very good reason – they are DEPENDENT upon us as parents and guardians. Children should also not be experimented upon for medical purposes and forced to take medication that is not safe nor effective.

    In short, teachers should teach children the basics of reading, writing and arithmetic plus languages, history and science. Children also need to understand good behaviour and discipline and learn to think for themselves.

  • Natalie75 says:

    It’s really encouraging to see this being addressed in South Africa. However, I do feel the idea of ‘discipline’ really needs a good decent look at.
    In general I have found that ‘discipline’ mainly consists of shouting, isolating (such as time-out) or hitting a child, even from a very young age, for doing something perceived as ‘naughty’. Naughty = crying, being upset, doing, touching or saying something they ‘should not’.
    In reality it is the one doing the ‘disciplining’ that fail to see that the child is simply developmentally incapable of managing these emotions or actions yet. This child need support or probably better examples, and in a lot of cases a lot of sympathy and guidance to learn about emotions and how to deal with them.
    As parents, guardians and carers we have to look at it from that’s child’s perspective before taking action.
    Hitting / spanking or isolating a child does not counts as discipline; it is creating fear (and is simply unforgivable). This fear leads to suppression of emotions, hiding issues and in the long run a likely cause of depression i.e. bad mental health.

  • Dominic Rooney says:

    “Mental health” – another racket. The small number of genuinely sick people is being drowned by all the ignorant people climbing on the bandwagon, claiming mental fragility – grow up, for Heaven’s sakes. Resist the tide of infantilism infecting society. Heard a fellow on the radio yesterday claiming he was “traumatised” by the cancellation of a TV series.

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