Mental health one of the top reasons primary school kids called helpline in 2023

SINGAPORE - More primary school pupils have been calling to ask about mental health at a national helpline, showing increased awareness and curiosity about the topic.

Mental health became one of the top five most common topics that Singapore’s young children anonymously asked the Tinkle Friend service in 2023, alongside issues related to school, peers and family.

Mental health-related concerns among these children – mainly aged 13 and below – include self-image struggles and emotional distress that presents as fear, anger, anxiety and low moods.

The Tinkle Friend helpline, which marks its 40th anniversary in 2024, was launched by Singapore Children’s Society in 1984 for primary school children who needed a listening ear. An online chat service was added in 2014 amid the growing usage of digital devices.

Over the past decade, Tinkle Friend has handled more than 46,000 chats and calls. It has served an average of 5,200 chats and calls annually for the past five years. This is a 32 per cent increase compared with the preceding five years, which had an average of 3,900 chats and calls.

From 2015 to 2020, casual chit-chat was the main and most common topic for the children, a spokesman for Singapore Children’s Society told The Straits Times. This refers to the children talking about their day, their hobbies, or sharing jokes.

“Underlying the chit-chat is also a sense of loneliness where the children have no one else that they can turn to and a desire for connection,” he said.

Among the children who called or chatted with Tinkle Friend in 2020, almost half were upper primary school pupils aged 10 to 12.

In 2021, school-related issues started taking precedence and it has since remained the top topic of Tinkle Friend chats. These refer to academic stress, struggles with managing co-curricular activities, challenges with teachers and transitional stress when facing assessments and examinations.

The spokesman said Tinkle Friend usually observes a higher number of calls and chats after school holiday periods in January, July and September.

Children often reach out to the service to share about their day because of boredom, loneliness or when they have no one else to talk to, he added.

“It could also be a way for them to try Tinkle Friend before deciding whether it is safe enough for them to share deeper concerns. It takes time for children to build trust and to be ready and willing to share some of their concerns with us.”

Some children take as long as five chats before they reveal to Tinkle Friend the challenges they are experiencing.

The Tinkle Friend helpline and chatline are manned by staff and trained volunteers. Singapore Children’s Society has started conducting mental health training for its volunteers in recent years for them to better support children with mental health needs.

An analysis of Tinkle Friend chats related to mental health in 2020 and 2021 found that many children often felt very dismissed and invalidated when sharing their difficulties or struggles with the adults in their lives.

“Parents and teachers tended to downplay children’s difficulties, saying that the children’s concerns were not serious, or that children are too young to have mental health struggles,” said the spokesman.

Children also experienced some unempathetic responses from adults, such as being laughed at or scolded for sharing their thoughts and feelings.

“There was a lot of embarrassment and shame preventing children from sharing their mental health struggles,” the spokesman said, adding that the act of seeking help for mental health support was also stigmatised.

“Children feared being seen by their peers and family as ‘attention-seeking’. They were fearful of receiving parents’ judgmental reactions, as some parents seemed to believe that people who seek help are weak.”

In one instance, Tinkle Friend conducted a mental health check-in with a girl who said she was feeling overwhelmed. The team worked to understand why she felt that way and how it impacted her daily functioning.

The child reported having disrupted sleep at least twice a week, persistent fatigue and loss of interest in activities, and admitted to hurting herself to cope. It took a few sessions of speaking to the child before she felt ready and consented to speak to the school counsellor for further support.

She was previously not sent to the school counsellor as she did not display any disciplinary or behavioural issues.

“Tinkle Friend’s persistence in advocating for early intervention and addressing the child’s worries helped her take that first, often scary, step towards receiving support,” the spokesman said.

If children who call in disclose a risk of harm to themselves or others, the team will work towards getting identifiable information of the child, and work with adults in the child’s life or the authorities to ensure their safety.

“In one case, a child presented with high suicide risk. The team informed the police, who managed to locate him and brought him to a place of safety with his family,” said the spokesman for Singapore Children’s Society.

Although the service is anonymous, the team has a duty to report a case to the authorities if the child is at risk of danger, he added. “This ensures the safety and well-being of every child and young person.”

What adults can do to help

1. Validate children’s difficulties: While children’s problems or sources of pain and fear might seem small or trivial to adults, these are very real and painful to them, said the Singapore Children’s Society. It is important for adults to recognise that children’s feelings are valid, and to not dismiss their concerns as trivial.

2. Respond empathetically: Communicate to children that you understand what they are sharing about their struggles. Do not berate or laugh at them.

3. Encourage conversations about mental health: Tell children that experiencing mental health difficulties is not something to be ashamed of, and create a safe space for them to talk about mental health.

4. Normalise help-seeking: Communicate to children that seeking help is not an act of weakness, and encourage them to seek help if needed. Model by speaking openly about it as a potential avenue of support and support them through the process.