The causes of mental health issues go beyond the pandemic. Here’s why

Issues can arise from early childhood experiences, and early intervention is key to supporting the young through uncertain times, says expert

While there is a risk of experiencing mental health problems at all stages of life, most conditions in adults arise in adolescence, says a World Health Organisation report. PHOTO: GETTY IMAGES

As the world grapples with pandemic disruptions, issues of mental health and well-being have become increasingly prevalent.

Cases of anxiety and depressive disorders rose by 25 per cent in the first year of the pandemic, according to the World Health Organisation’s mental health report this year.

But is Covid-19 the cause? The same report states that while there is a risk of experiencing mental health problems at all stages of life, most conditions in adults arise in adolescence.

Among young Singaporeans, the signs are worrying. A survey of 607 respondents across all ages in March by the People’s Action Party youth wing showed that two in five people have personally experienced mental health struggles; critically, for those aged 15 to 35, it was one in two.

While the Government intensifies efforts to address and support these issues, how well do we understand the importance of mental health in early childhood?

Dr Philip Fisher, a professor at Stanford University in the US, was a keynote speaker at the inaugural Centre for Holistic Initiatives for Learning and Development (Child) conference at the Grand Copthorne Waterfront hotel last month.

Dr Philip Fisher says that early intervention is key, along with increased awareness and social acceptance. PHOTO: YONG LOO LIN SCHOOL OF MEDICINE, NATIONAL UNIVERSITY OF SINGAPORE

A psychologist, Dr Fisher, 58, spent the last 10 years researching the effects of early life experiences on brain development. He also developed early childhood intervention programmes for children from challenging socio-economic backgrounds.

Dr Fisher shares some of his thoughts.

Q: What is mental health and how important is it to individuals and society?

A: Physical health is only one part of well-being. The extent to which people have difficulties with their emotions, moods and behaviour can have devastating impacts on individuals and their relationships. 

Poor mental health can also increase the risk for obesity, cardiovascular diseases, diabetes and other diseases of ageing. This means we must pay closer attention to emotional well-being and mental health when assessing overall health.

With the Covid-19 pandemic, geopolitical conflicts and climate change, it has become very difficult for people globally, especially the young.

To them, the world doesn’t seem to have the same predictability as before – that is if you work hard, you’ll get ahead and things will be okay.

Today’s uncertainty is a cause of much anxiety when thinking of the future ahead.

Q: Mental health issues such as depression and anxiety have risen in recent years, particularly among the young. Why is this so?

A: Historically, we knew that emotions fluctuate during childhood and adolescence, and didn’t consider it as a clear psychological or psychiatric diagnosis such as adult depression.

But awareness has increased in recent years. Social media has contributed to this as more people share information openly and freely, changing the way people perceive mental health issues.

Social forces are also a concern for the young. It affects their perception of the future, more so than adults, who have generally achieved financial security, established professions, built relationships and have families.

For the young who are developing their identity, it seems harder for them to achieve those things in what is perceived as an uncertain environment.

Q: How does one identify such issues, especially for parents with young children?

A: There is a very broad range of what is considered to be typical development. Some kids learn to walk and speak earlier than others, while some may take a longer time. 

But the majority end up on track, and do not necessarily require more attention just because they are slower. We can clearly understand the extent of support needed by first understanding a child’s trajectory, and how it evolves over time.

If there is development and progress, we can be optimistic. More attention is required when he continues to fall further behind and is not making progress.

Another aspect is social-emotional development in early life. A child’s ability to regulate emotions, focus on tasks, and interact with peers are some skills that, if lacking in development, would call for intervention. 

Q: What are some misconceptions and stigmas about such issues?

A: Mental health difficulties have a long history of being linked to moral issues. People don’t think the same way towards a physical illness, like a child with cancer or childhood diabetes.

There is also tremendous variation across cultures when seeking help for mental health difficulties. In some cultures, it's more acceptable than in others.

Growing awareness has had positive effects in destigmatising the way people think, but it can still be a barrier to people seeking support. Parents may be concerned that once there's a label of a particular diagnosis, it will stick with a child.

There are many effective treatments and strategies to help address these issues that are inherently treatable, just like other health issues.

People have to understand that mental health issues are not uncommon, and that they are treatable and don't represent a defect.

Q: Why is early intervention critical, especially among the younger generation? What are the consequences if left unaddressed?

A: Children grow up in an environment of relationships, and this promotes mental health and well-being in the early years. It helps children to thrive and offset the effects of daily stresses.

Also, the most amount of brain development happens in the early years when the brain is growing. Evidence shows that investments in early intervention have the biggest payoffs in this area.

In the absence of that, if children are struggling in school or lack healthy relationships due to mental health issues, they are less likely to become productive members of society, and not contributing to the economy or the relationship fabric of society.

Early difficulties may go away, but for the most part, it's better to pay attention to those and provide the support necessary to avoid the long-term costs on the healthcare system down the road.

Brought to you by Yong Loo Lin School of Medicine, National University of Singapore

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