The Unspoken Epidemic: Children Are Victims Of Mental Health

Children are supposed to be happy and carefree! It’s difficult to talk about children who may be suffering from mental health problems. But, it’s also incredibly important to have an open dialogue about it. 

Mental health issues are growing in prominence and severity and children are not immune to them. It’s real, as real as a broken leg, open wound or bruise. If we ignore it, we deny our children the voice to be heard and to voice their struggles.

In 2019, 424,000 children were found to have mental health problems in Malaysia^[1].

• 8.4% of girls had mental health problems.
• 8.8% of the rural population suffer from mental health problems.
• 9.2% of the B40 group have mental health issues.
• 9.5% of young ones facing mental health issues are between 10-15 years old.

It is also found that children from families earning from less than RM1,000 to RM1,999 have the highest instances of mental health issues. On the flip side, only 2.3% of children from families with an income of RM10,000 were diagnosed with mental health issues^[2].

In order to get down to the bottom of this hidden epidemic among the young, we have to understand the battles young people are facing these days. The 2019 National Health and Morbidity Survey highlighted four reasons why mental health issues are on the rise among children.

Reason #1: Peers Problem (42.9%)^[1]

One of the main peer problems faced by children is peer pressure. Peer pressure is the internal or external pressure felt to behave in certain ways, which make up many of our social constructs.

When peer pressure demands children to act in ways that they’re not comfortable with, it can affect mental health by decreasing self-confidence and lead to poor academic performance, cause distancing from family members and friends, or increase chances of depression and anxiety. If left untreated, this could lead to self-harm or suicidal tendencies.

Besides peer pressure created by in-person interactions, the availability and use of social media 24/7 has the potential to amplify feelings of peer pressure.

SOLS Health managing director and clinical psychologist Ellisha Othman says that the urban poor community are particularly susceptible to mental health issues.

Urban poverty is a risk factor for mental health issues and illnesses. Peer acceptance is important to young people and for these youths, they feel that they do not have that from some of their schoolmates. This is because the urban lifestyle, which is fraught with commercialism and materialism, causes teenagers to compare themselves to their more well-to-do friends. – Ellisha Othman, SOLS Health managing director and clinical psychologist^[3]

One of the most common social media misrepresentations is when people post only the “best” versions of themselves, creating a false sense of reality. This can lead to young people comparing the true reality of their lives to the “perfect” lives of others and feel the pressure to keep up.

There are also many forms of cyberbullying and online aggression such as hateful comments, harmful online challenges and trolling which all contribute to greater negative peer pressure amongst children^[4].

Reason #2: Conduct Problem (15.9%)^[1]

Conduct problem, also known as conduct disorder, is a type of behaviour disorder. It is when a child has antisocial behaviour^[5]. Antisocial behaviour is regarded as a social behaviour that violates social norms and lacks judgement and consideration for others and may present itself in unacceptable social behaviour such as crimes, abuse, addiction^[6].

When young people are exhibiting these aggressive behaviours, they tend to get shun off by others, alienated or labelled as troublemakers or a nuisance. What we fail to see is that these problems are related to mental issues.

In schools, if you are from the PPR, the authority figures, such as police, parents and teachers, may already label you in certain categories or because you’re from the PPR may think that you’re not smart, may be lazy or a troublemaker. This negative contact with forms of authority can also build up and it affects their self-esteem and self-identity and as teenagers, identity is very important. – Ellisha Othman, SOLS Health managing director and clinical psychologist^[3]

Reason #3: Emotional Problem (8.3%)^[1]

We go through a myriad of emotions on a daily basis. For children who experience a harsh childhood with strong and often traumatic feelings, those experiences are hard to process and even harder to forget. For example, children who are trapped in an abusive or dysfunctional family may go through emotions of anger, anxiety, frustration, grief, or guilt.

Studies have shown that abused children often live in high-risk areas, low socioeconomic levels, and unsafe neighbourhoods. Abused children are more commonly from lower-income families that are struggling to survive financially. Financial stresses brought home by parents with the extra attention of inconvenient home conditions can cause the outburst of anger, rage and child abuse^[7].

On February 20, 2019, a 12-year-old boy was abused by his own mother and stepfather until the child suffered severe injuries all over his body. The child was abused using a rice cooker wire, with several afflicted injuries on his body. It is believed that his stepfather worked as a bus driver^[8].

Yet another case was reported around the same time when a five-year-old was so severely abused, the little boy eventually succumbed to his injuries. He was abused by his stepfather who worked as a farm worker^[7].

Reason #4: Hyperactive (2.3%)^[1]

Hyperactivity, also known as attention-deficit disorder (ADHD) is marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development^[9].

Hyperactive children can feel out of control. People might not understand what the child is going through and could perceive the child as acting out or being difficult, resulting in criticism and unnecessary punishment. This can make the child feel isolated, depressed, or lead to feelings of low self-esteem.

Hyperactive children may be labelled as inattentive, disruptive or uncontrollable, but in fact, they are facing mental health issues and need to be heard.

How Can We Help?

It is hard to imagine the level of stress and pressure children and young people face today. The stresses of life coupled with the need to find their identity can be all too overwhelming. While we’d like to think children should always be happy and carefree, the reality can be much different. How can we help?

1. Create a safe space and encourage open communication

Let children and young people know that they can always talk about their issues and not be labelled or judged. Many childhood mental health issues go undiagnosed because they are ashamed or fearful to talk about their feelings, or simply not know how to put them into words^[4].

For younger children, drawing or expressing their feelings in other ways help. Parents and guardians need to pay attention. Ideally, safe spaces should be at home, however in the event that the home is not a safe space for young people to open up, they need to know that there are communities around that are willing to be the listening ear. School teachers, extended family and friends need to look out for the young people around us.

2. Build awareness and understanding about mental health

Education and awareness will help students detect and cope with mental health issues if and when they experience it. Education gives access to teachers and educators to talk openly about these issues^[10]. Children and young people should not have to look too far or find it difficult to access help and awareness when needed.

“We need to enhance adolescent knowledge of mental health issues and increase awareness of available mental health resources. This is important to strengthen our efforts to prevent mental health issues and we need to work together to enhance efforts to fix the barriers to provide adolescent-friendly mental health services.” Dr Roslaili Khairudin, Health Ministry Family Health Development division^[3].

3. Get professional help

At times, informal intervention may not be sufficient and professional help is necessary. Besides therapy, medication may help improve neurotransmitter activities to regulate emotions and thought patterns. Public hospitals offering mental health services include Hospital Permai (Johor Bahru), Hospital Bahagia (Perak), Hospital Bukit Padang (Sabah), and Hospital Sentosa (Sarawak)^[11].

The cost of mental therapy is said to be expensive and only for the urban, but it is not entirely true. Here is a list of providers who provide mental health services ranging from free to below RM100.

• Mercy Malaysia helpline
• Befrienders provides emotional support 24/7 through their helpline and centres.
• Malaysian Mental Health Association (MMHA) services start at RM50
• Mentari is a community mental health centre initiated by the Ministry of Health, Malaysia
• Lifeline Association Malaysia offers free consultation service face-to-face, over the phone or email.
• SOLS Health provides financial assistance to eligible clients who need professional mental health services
• Relate Malaysia services starts at RM45 for a 50-minute psychotherapy session with an intern. Special 95% discount for session for frontliners.
• Cara Cara Mental Fitness‘ therapy starts at RM80
• Life Line Association Malaysia is an NGO focusing on mental health – focusing on Mandarin speakers. 辅导组由一群受过专业培训的义工，透过电话、电邮或面谈，聆听大众倾诉各种生活议题。
• SNEHAM Malaysia is an NGO focusing on suicide prevention, focusing on Tamil speakers. சிநேகம் – தற்கதற்கொலைகளை தடுக்கும் ஹெல்ப்ன்லைன்
• Tenaganita provides information, advice, and counselling to refugees, migrant and domestic workers, women and children in crisis, and victims of human trafficking.

If you notice something unusual but are not in the position to intervene directly, contact Talian Kasih at 15999 or WhatsApp 019-2615999, a 24-hour hotline established by the Ministry of Women, Family and Community.

Explore Our Sources: 

1. Institute for Public Health. (2020). National Health and Morbidity Survey (NHMS) 2019: Non-communicable diseases, healthcare demand, and health literacy—Key Findings. Link.
2. Ministry of Health Malaysia. (2019). National Health and Morbidity Survey 2019 Technical Report – Volume I. Link
3. Rajendram, R. (2019). Poor Students Face More Mental Issues. The Star. Link.
4. Helping teens deal with peer pressure. Children’s Health. Link.
5. John Hopkins Medicine. Conduct Disorder. Link.
6. Wikia.org. Antisocial behaviour. Link.
7. Abu Baka, N. et al. (2020). Understanding and addressing child abuse: Case Study of B40 Community. Faculty of Applied Social Sciences, University Sultan Zainal Abidin, Terengganu, Malaysia. Link.
8. Free Malaysia Today. (2019). Parents arrested over abuse of 12-year-old boy. Link.
9. Attention-Deficit/Hyperactivity Disorder. National Institute of Mental Health. Link.
10. Ibrahim, N. et al. (2020). The Effectiveness of a Depression Literacy Program on Stigma and Mental Help-Seeking Among Adolescents in Malaysia: A Control Group Study With 3-Month Follow-Up. SAGE Journals. Link.
11. Malaysian Healthcare Performance Unit National Institute of Health. (2016). Malaysian Mental Healthcare Performance: Technical Report. Link.