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More pupils facing academic anxiety, peer pressure and family problems are seeking help at the Institute of Mental Health
 The boy was only 10 years old, but he trashed a classroom and broke tables and chairs into splinters in a colossal fit of anger.
Not a cartoon case of “Hulk, smash!”, the Primary 4 pupil suffered from attention deficit hyperactivity disorder (ADHD), a condition that results in disruptive behaviour in a child, linked to anger management issues.
He is one of an increasing number of school children being referred to the Institute of Mental Health (IMH) for stress, depression and rage-related problems.
Predictably, academic anxieties, family problems such as divorce and abuse, and peer pressure are among the reasons cited by experts for the rise.
Dr Daniel Fung, who is senior consultant and chief of the child and adolescent psychiatry department at IMH and who is treating the unnamed boy, says that
more than 3,000 child patients are currently seeking help for mental disorders at the institute’s children’s clinic. Child patients are between the ages of six and 19.
The number of children warded for aggressive, suicidal or hallucination tendencies at the institute jumped by 35 per cent within the last five years, from 259 cases in 2005 to 351 cases recorded last year.
Its child outpatient cases have also grown by 16 per cent since 2005 to reach 3,126 last year. The figure peaked at 3,627 in 2008. More than half were young patients aged between six and 12 years old.
ADHD was the most common complaint among the child patients treated there, followed by behavioural problems related to child abuse, depression and anxiety, learning disorders and autism.
Counsellors and psychiatrists say the reasons could be increased academic stress, as well as peer and family pressure to do well in school. Other forms of stress: a lack of guidance and communication between parents and their children, dysfunctional families and addiction to blogging and gaming.
Perhaps, it is a sign of the increasingly fast-paced, high-strung times. A 2007 study by IMH of 2,139 healthy primary school children showed that 12.5 per
cent of them exhibited signs of emotional and behavioural problems such as being withdrawn, having delinquent behaviour, being anxious and being
depressed.
But, while the increasing number of minors seeking help for mental conditions may seem alarming, it also signals the higher awareness about such psychological disorders among caregivers. With more information about and less stigma attached to their analysis and therapy, parents and educators these days tend to explore treatment options if they perceive their children
to have a problem.
Dr Ken Ung, consultant psychiatrist and psychotherapist at Adam Road Medical Centre, says half of his patients are walk-ins, while the rest are referrals from school counsellors, teachers, general practitioners, doctors and lawyers.
Full-time school counsellor at Ang Mo Kio Secondary School, Mrs Jothi Thyagarajah, 56, says the parents and students she sees these days feel less negative towards counselling.
“Ninety per cent of parents are willing to work with us when they know that their child needs counselling. They also want to actively help their child recover,”
she says.
She adds that teachers and parents should not ignore a child’s mood swings or uncharacteristic quietness or restlessness. Do not brush it off as part of growing up or mischief, she says.
She says that among the Secondary 1 students she has counselled in her five years of experience, a few had problems that went undetected when they were in primary school.
One parent, who declines to be named, says her alarm bells went off when her 15-year-old daughter started crying hysterically just before a debate session.
The teenager was usually confident and had no problems singing in front of a crowd of 500 in church. She was eventually referred to the Ministry of Education and IMH’s Response, Early Intervention and Assessment in Community Mental Health programme, where she is getting help from a group of psychiatrists, nurses and social workers. She is suspected of having anxiety disorder.
Her mother says: “I want to know what the problem is and what I can do, so that I can manage it.” Mindful that drugs commonly prescribed to adults for conditions such as depression can have adverse side effects on children’s developing brains, doctors usually do not give young patients such medication as a first option, says Dr Fung.
With treatment methods such as psychotherapy or “talking treatments”, he adds, at least 20 per cent of patients eventually recover and learn to cope better. Most importantly, treating children with psychological issues requires the patience and support of their parents.
Explains Dr Fung: “Children are not masters of their own fate. Behind every anxious child is an anxious parent, so we work with parents from day one
to help the child get better.”
Dr Ung says he ropes in parents to help as co-therapists and coaches to help their children at home. Involving parents in the recovery process, he adds,
gives positive moral support and encouragement to the children.
Thomson Paediatric Centre’s principal psychologist Frances Yeo agrees. She has observed that children who attend regular counselling sessions with supportive parents recover in about two months, dependingon the severity of their condition.
She cautions that mental disorders that surface in childhood and adolescence should be treated early, before they carry over into adulthood.
When to sound the alarm
Experts LifeStyle spoke to say that a child might need professional counselling if these symptoms persist for more than a few weeks:
- Displays an abrupt change in temperament
- Becomes more withdrawn
- Loses interest in activities he/she used to enjoy
- Becomes aggressive towards others
- Seems emotional, depressed, moody, irritable or scared most of the time
- Experiences a loss of appetite
- Feels anxious and restless
- No longer sleeps well
- Refuses to attend school, or his/her school results plummet for no apparent reason
- Expresses abnormal and negative thoughts such as suicide
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