Dubai, United Arab Emirates, November 20, 2018: The world now has more young people than ever before — of the 7.2 billion people worldwide, more than three billion are younger than 25 years, making up 42 per cent of the world population. According to World Health Organisation, around 1.2 billion of these young people are adolescents aged between 10 and 19.
On Universal Children's Day, Dr Nadia Dabbagh, Consultant Child and Adolescent Psychiatrist at Rashid Hospital and Programme Lead for the Mental Health Strategy at DHA, speaks about child and adolescent well-being.
Adolescence is a critical time of life. It is a time when people become independent individuals, forge new relationships, develop social skills and learn behaviours that will last the rest of their lives. It can also be one of the most challenging periods. Rashid Hospital's psychiatry department counsels more than 300 new children and adolescents per year as outpatients, in the wards and in the emergency department.
Dabbagh says the majority of adolescent patients suffer from anxiety and mood
disorders, eating disorders, obsessive-compulsive disorders as well as psychotic disorders including schizophrenia. “At this age we find girls suffer from depression or anxiety as they tend to internalise their feelings. On the other hand, boys suffer from behavioural problems and conduct disorders as they externalize their feelings.”
“Not all cases need psychiatric counseling. Parents need to be alert and keep the channels of communication open with their children by actively listening to their children, building trusting relationships by getting to know and understand them so they can detect when they are facing difficulties. This is a crucial part of parenting. Once the parent picks up signs that need attention, they can intervene and through involving other family members, caregivers or teachers they may be able to resolve the problem.
“However, there are some situations where cases need to be brought for medical attention promptly. Sometimes due to societal pressures and cultural barriers, parents bring their children in late. A rule of thumb is that if the young person's emotional or behavioural difficulties have got to the point of impairing function — such as refusing to go to school or other important daily tasks such as self-care, or is talking of self-harm or drug use is suspected, it is time to get professional guidance immediately to avoid any further harm coming to the young person.”
Dr Dabbagh says the conditions present at different ages. “At a younger age, we see cases of ADHD, speech delay, developmental delay, autism spectrum disorder and the faster we recognise developmental delays the better it is in terms of managing the condition through early intervention services such as school readiness programmes and integration into mainstream school with the appropriate learning support. In older children, we see anxiety, separation anxiety, phobias and mood disturbances. Psychotic disorders such as schizophrenia and bipolar disorders are rarely seen under the age of 12.”
She adds that listening and being there for your children to provide safety, stability and consistency as well as encouragement for kind and social behaviour are cornerstones of positive parenting. At the same time, it is important to teach children problem solving and stress coping mechanisms so they can face the world with the necessary tools to overcome challenges and setbacks.
Supporting children's mental health:
1. Being there: Offer stability and security. Parenthood cannot be delegated.
2. Consistent positive parenting: Promoting and encouraging positive behaviour, spending time playing with children and positive reinforcement for pro-social behaviour, which include helping, sharing and cooperating.
3. Boosting their sense of confidence: It is important to praise the efforts of your children and to focus more on the efforts rather than the achievements. This helps build their self-esteem and confidence.
4. Problem-solving: Instead of solving the child's problem, involve them in the process in thinking of different solutions. The problems can be simple day-to-day ones from ways to rebuild a tower of LEGO that has fallen down or having forgotten a book at school to more serious dilemmas such as failing important exams or dealing with changes or loss.
5. Set clear expectations and boundaries: Good parenting involves being able to offer a combination of warm, caring and kind behaviour along with the ability to set firm boundaries. Children need boundaries to feel safe and to prepare them for the real world. The golden rule is that children cooperate better when they are positively motivated and rewarded. Oppositional behavior can be ignored or redirected but overt defiance or aggression such as hitting, dangerous behaviour or the use of swear words needs to be addressed as unacceptable. However, the overall focus must be placed on motivating and encouraging children through a positive approach. The non-monetary rewards — such as smiles, praise, hugs and offering your time and interest — can be equally effective rewards to gifts or other treats.
6. Pick your battles: Too many fights damage your relationship with your children and can lead to persistent defiant oppositional behavior and a potentially angry or depressed young person who won't be performing as his or her best. A positive behavioural approach and techniques such as distraction and redirection to deflate the situation are much better first-line approaches to negative behaviour.