Ignorance and the stigma regarding mental illness among adolescents exacerbates the problem. Photo: iStock
As the world grapples with numerous challenges, there’s one crisis silently gripping our communities: the tragic epidemic of teen suicide. Behind closed doors and veiled smiles, a growing number of adolescents are facing overwhelming mental health struggles, often with tragic consequences.
After several mothers called on him for help after their children took their own lives, Dr Shlomo Brook started thinking about how he could help young people.
When a teacher told him about her struggles over five children in her school dying by suicide, he knew he had to do something to address the mental health crisis among teenagers.
“Lately, I see an alarming increase in tension, anxiety, and depression among teenagers,” says the psychiatrist from Krugersdorp. This compelled him to write a book, Teenager’s Stress, Anxiety and Depression, about teenagers’ mental health issues. He followed it up with Teenager’s Workbook for Stress, Anxiety and Depression, an interactive book with illustrations and easy psychological therapeutic exercises.
The books stem from his observations in his practice and aim to empower teenagers, parents, and teachers with knowledge. He believes that life making ever higher demands on young people and the pressure to perform contributes to the problem. In addition, children are still bearing the consequences due to the almost two-year isolation during the Covid-19 pandemic.
“This caused them to spend more time on social media because their normal way of being socially active has been disrupted. This leads to higher levels of stress, anxiety, depression, aggressive outbursts, alcohol and drug abuse, self-harm and suicide.”
According to the World Health Organisation (WHO), one in seven (14%) children between 10 and 19 years old struggle with a mental health issue. Suicide is the leading cause of death among this age group. Alcohol abuse in this group is 13.6% while 4.7% of them use marijuana.
The overwhelming majority of mental health illnesses emerge in children’s teenage years. Nevertheless, this is rarely recognised by the young people’s parents or guardians.
A team of researchers examined close to 200 global studies in which about 700 000 patients participated. The results, published in 2021 in the journal Molecular Psychology*, show that almost half (48.8%) of people struggling with mental health issues had symptoms before their 18th birthday.
The study highlights the importance of early intervention with mental health issues in adolescents and teenagers.
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“Early diagnosis and treatment in the initial stages can have significant benefits for the patient and steer their life course in a new, positive direction,” says Brook.
Teenagers’ psychiatric illnesses already affect their performance during their school career and worsen during tertiary study. Relationships with family, friends, and colleagues also suffer. The untreated condition causes young people to turn to self-medication, which in turn leads to substance abuse, addiction, and ultimately suicide.
Ignorance and the stigma regarding mental illness among adolescents exacerbate the problem.
“This is one of the biggest obstacles that prevents parents from seeking help for their children. Psychiatric stigma can come from different sources, such as personal and social beliefs.
“Within black communities, cultural factors play a big role. People often believe that the diseases do not exist or attribute them to witchcraft,” says Brook.
But it’s common for parents from all communities and backgrounds to dismiss it as “something that will blow over”, or they think that their children “just need to be stronger”.
“Every now and then I see teenagers whose parents are baffled as to how they and their child ended up in my consulting room. The parents are looking for answers and want to leave as soon as possible.”
This approach prevents teenagers from talking openly about their feelings and getting help in time.
He says many of his teenage patients do not understand that their negative feelings are symptoms of anxiety or depression. They don’t know how to articulate it or what’s wrong with them.
“It starts with mild symptoms, but before long it takes over their lives.”
According to Brook, most teenagers try to hide their symptoms. “I only see them when the symptoms become unbearable and lead to dysfunctional behavior. Sometimes the first consultation is after a suicide attempt, which adds shame and guilt to an already difficult situation.”
Usually, the patients do not know stress, anxiety, and depression’s pathology and have “even less information about how it can be treated”.
There is also a misperception about psychiatric medication, which is why Brook added an appendix to his book in which the action of antidepressants, anxiety, and psychoactive medications is explained understandably. This type of medication is also often subjected to stigma with descriptions such as “crazy pills”, “crutches” or “addictive drugs”, which prevent patients from receiving the correct treatment.
Parents mainly determine which medical intervention or resources their children have access to. Numerous studies show that children do not get the right treatment for conditions such as attention deficit hyperactivity disorder (ADHD), because their parents have wrong ideas about the medication.
Misconceptions that medications such as Ritalin and Concerta are a gateway to drugs and addiction, can stunt development and drug the child are common fears among parents, though numerous scientific studies endorse the safety and effectiveness of the drugs.
He emphasises that the book is not a substitute for a psychological or psychiatric consultation, which he still considers to be the best solution. However, he also realises that many South Africans do not have access to the right experts.
According to the South African Society of Psychiatrists (Sasop), a psychiatrist in the private sector will generally only see a new patient in an emergency if they are referred by a general practitioner.
Psychiatrists have months-long waiting lists and some do not accept new patients. In the public sector, things look even more dire – Sasop reckons that three-quarters of all South Africans do not have access to the necessary psychiatric help, due to a huge lack of money and trained therapists.
“Only 5% of the national health budget is allocated to mental health, while 36% (an increase of 8% since the Covid-19 pandemic) of South Africans experience emotional distress,” says Sasop in a statement.
Brook says teachers are usually the first to notice when something is wrong with a pupil.
“However, they are mostly not equipped to provide the necessary support and facilitate treatment.”
In the next phase of this project, Brook wants to offer free workshops for teachers on teenage mental health.
“Unfortunately, I can’t get to every school personally, so I want to work with partners to reach more teenagers,” he says. He calls the project “Go nna le Tshepo”. In Tswana, it means “There is hope”.
“How many teenagers are helped depends on how many people offer their time. Everyone who’s involved in a teenager’s life in one way or another can make a difference with the correct information,” he says.
Brook says teenagers today have a shorter attention span than ever. “For this reason, I simplified the content and wrote in a comfortable style with illustrations to make the reading experience easy.”
He says he used the most common questions his patients and their families ask him as a starting point. His answers are based on his own experience, as well as the medical literature he has researched.
Both books consist of sections in which topics such as academic pressure, social media, bullying, romantic relationships, sex and pregnancy, obesity, self-harm, and suicide are discussed.
Teenager’s Stress anxiety and Depression and Teenager’s Workbook for Stress, Anxiety and Depression are available from Takealot and Brook’s consulting room at the suggested prices of R340 and R250 respectively. The books are sold at cost price.
People who want to get involved in the Go nna le Tshepo project or order copies of the books can contact Brook on 011 954 1959.
* Additional source: Molecular Psychology: “Age at onset of mental disorders worldwide: Large-scale meta-analysis of 192 epidemiolocal studies”.
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Anyone with mental health problems can call the South African Depression and Anxiety Group’s (Sadag) 24-hour mental health helpline on 0800 456 789.
Sadag’s WhatsApp counseling line can be contacted from 09:00 to 16:00 at 076 882 2775.
The South African Mental Health Federation can be reached on 011 781 1862 and LifeLine South Africa on 0861 322 322.
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