KUALA LUMPUR, June 10 – Children are deemed to be the future makers of every nation.

However, the 2019 National Health and Morbidity Survey (NHMS 2019) released recently has highlighted an escalating mental health crisis among Malaysian children, calling it "the hidden epidemic”.

According to the survey results, a whopping 424,000 children or 8.4 per cent aged between five and 15 were found to have mental health problems in Malaysia.

It also highlighted that of the total, 8.8 per cent live in rural areas, 8.4 per cent are girls, 9.5 per cent are aged between 10 and 15, and 9.2 per cent are from the B40 low-income group.

Referring to the NHMS 2019 report, Malaysia Society of Clinical Psychology president Dr Lynne Yong said it was evident that a sizable portion of children in Malaysia were stressed and had a hard time coping on a daily basis.

Citing the survey, she noted that those at risk were the ones with social and economic problems as these factors were known to lead to higher childhood adversities.

According to Dr Yong, children were the future of any society, hence, if a sizable portion of them cannot contribute meaningfully to the nation, it would affect the whole country socially and economically.

Echoing similar sentiments, Malaysian Mental Health Association president Datuk Dr Andrew Mohanraj also regarded children as the future makers of our nation and said the mental health issue among kids should be addressed to ensure a resilient and productive nation.

"Children with pervasive psychological disorders and especially those with untreated development disabilities must have their treatment needs to be met adequately as their condition can affect their life-long health.

"Consequently, society as a whole will be deprived of their positive contribution as adults [if their condition is left untreated],” he added.

Rural vs urban setting

According to Dr Andrew, there was a general understanding that rural settings could be a protective factor against stress-related mental disorders.

However, he cautioned that there was a greater likelihood of rural children with psychological challenges or developmental disabilities to have their conditions go undetected, under-diagnosed and having less access to proper treatment.

"They are also less likely to see a mental health professional or a therapist due to logistical issues and financial considerations.

"More importantly, children need to grow up in a safe and nurturing environment irrespective of it being an urban or rural setting,” he added.

Dr Andrew also warned that children living with mental health conditions, and especially those with developmental disorders may face tremendous challenges at home, school and with friends.

"If their needs are not adequately addressed, their condition can become more complex with the transition into adolescence.

"It is more likely that due to their vulnerability, they become more affected by other so-called normal children at school – leading to low self-esteem and poor performance.”

At times, he added, due to poor detection of cases, such children with behavioural symptoms were labelled as mischievous or disobedient by the school system.

Teachers’ role

As children spend most of their waking hours at school, Dr Yong said it would be beneficial for teachers to learn about mental health issues to assist in early identification of children with mental disorders for early interventions.

She said teachers can also learn how to provide support to such students.

However, Dr Yong noted that it must be clear that teachers are not counsellors or therapists, and it was not their role to diagnose or label children.

Dr Yong also acknowledged that teachers were already overworked and their mental health needed to be protected as well.

"Teachers can support, identify and refer on [the children with issues] to school counsellors who are better equipped with the training to further support such students and refer them to higher levels of care if it’s required.”

She also said it would be better for the Education Ministry to include topics on resilience, positive social interactions, coping skills and information on how to seek help into the curriculum.

What needs to be done?

Although there were many ongoing initiatives by the government and private sectors to tackle the mental health issues in Malaysia, Dr Yong said more efforts should be implemented within the context of the family, schools and societal system.

She, however, regretted that the stigma of mental disorder was still very strong in society, which may prevent children from getting the help they need.

To break the stigma, Dr Yong said families needed to be supported and schools need to have adequate counsellors, programmes and facilities to support children in distress.

"Society needs to know where they can seek affordable mental health care and be protected against discrimination,” she added.

Dr Yong also called for better mental health policies in Malaysia as well as more clinical psychologists in the public sector as access to mental health support in the country was limited at the moment.

"For example, there are approximately 200 trained clinical psychologists in the whole of Malaysia and only 30 clinical psychologists in government hospitals.

"Private psychologists are beyond the financial means of most families, hence, there is no point identifying children in distress if we do not have available and accessible treatment for them.”

Dr Andrew, on the other hand, said due to tremendous efforts done by government agencies and non-governmental organisations (NGOs), the treatment gap for children with developmental disorders was being narrowed.

However, he said a multi-sectorial approach involving various government agencies, mental health NGOs and parent groups was needed to ensure the psychological and treatment needs of the children.

"Mental health leadership is crucial for this initiative to succeed.”