• Impact of the economic crisis on child mental health

Consequences of poor education

1. Poor health
2. Shorter life expectancy
3. Poverty
4. Unemployment
5. Low salary
6. Gender inequality
7. Social isolation
8. Engagement in illegal activities
9. Impossibility of (adequate) participation in political and social life

Sri Lanka is currently experiencing a severe economic crisis, which is predicted to get worse before it gets better. With the soaring prices of food, many citizens are forced to skip their meals, and the scarcity of fuel has crippled most services. As the situation affects the entire population, irrespective of social strata, negative thoughts are spreading and being shared in a naturally human response to the crisis.  This issue also has a huge impact on the mental health of children. The Morning spoke to Karapitiya Teaching Hospital Consultant Child and Adolescent Psychiatrist Dr. Darshani Hettiarachchi about the ongoing crisis’s impact on child mental health.  Following are excerpts from the interview.      As a child and adolescent psychiatrist, have you seen any increase in mental health conditions during this time of crisis in the country? Yes, there has been a significant increase in child and adolescent mental health issues during this period. Most of these conditions are linked with behavioural problems such as poor anger control, impulsive behaviour, irritability, and frustration. Parents commonly complain about the sleep disturbances of their kids. Mental health conditions like anxiety, depression, and Post Traumatic Stress Disorder (PTSD) are abundant. Excessive use of the internet, and sometimes internet addiction, are inevitable at this time. As school routines are constantly being disrupted, lack of interest in school work and deterioration of school performance is common. What do you think are the main causes for these conditions? There are multiple reasons for mental health issues in children. In the current situation, children have very limited opportunities to engage in pleasurable activities and enjoy their childhood due to current financial and social constraints. Their education is grossly affected due to multiple reasons, such as irregular physical school days, deficiencies in online education, uncertainty about exam dates, and trade union actions. With these factors, they are experiencing a sense of uncertainty about their education, as well as about their future. Unfortunately, most of the adults responsible seem to have completely forgotten that children need education, and hence, education has been given the least priority. Furthermore, most adults themselves are not in a stable psychological state due to the current economic and political crisis, and they are not in a position to provide proper psychological support to their children. In this circumstance, children are witnessing domestic violence fuelled by the economic and political crisis. International research evidence confirms that excessive watching of TV programmes containing violence and aggression can result in worries, anxiety, sleep disturbances, nightmares, and even PTSD among children, and leads to high chances of using aggression as a way of solving problems. Unfortunately, many children have had to experience and witness violence with the massive public unrest prevalent across the country during the last few weeks. This can have significant adverse consequences on their psychological well-being. Some children lost their parents as a result of the violence, and may experience prolonged grief. Do you think it is good for children to be part of the protests, even the peaceful ones? People have different viewpoints about this. It is accepted that children and adolescents too have a right to express their views, ideas, and opinions. In that sense, children and adolescents getting involved in peaceful protests can be accepted. However it is important to consider the age of the child and their level of understanding about what they are doing. Otherwise, children might learn to model adult behaviours while not knowing the consequences. If they get confused about their behaviours and get mixed messages from adults, it may negatively affect their long-term personality development and problem solving skills. In certain instances, children also had to face violence and were victimised into trauma while taking part in the peaceful protests. These traumatic experiences may result in adverse short-term and long-term psychological consequences among children. Children are curious about the country’s situation, so how should adults best explain this to them? As I mentioned earlier, when explaining something to a child, we always have to consider the age of the child, their level of intelligence, their capacity to understand what is being said, the level of resilience, their emotional status (whether the child is anxious, worried, or frightened) and the child’s immediate support system, such as having trusted adults around. At all times, the very first thing is to reassure the child that they are safe under your care. When explaining, always use simple language that they can understand. Do not give too much information, and do not tell them things you are unsure of. Always try to approach the child in a positive way and try to make them hopeful about the future.  You can tell them that even though we are facing a difficult situation in the country at present, it will gradually pass with time. You should not place the blame on anyone for being responsible for this crisis, as it might create anger and negative thoughts in children. Give them some examples of countries like Japan, where they have become successful despite facing several disasters. It will give them hope and motivation.   What is your view on the closing of schools for almost two years? What could be the impact of this move on our future generation? The importance of education cannot be underestimated. It is our firm belief that all children deserve a chance to obtain a quality education, as it is the best way for them to realise their true potential. We all have to accept the fact that our children did not get a proper education during the last two years mainly due to the Covid-19 pandemic.  According to current data, less than half of all schoolchildren had access to online education during that period, which was also not up to the expected standards. There was a significant vacuum in school education during this period, and children from rural and remote areas were the most affected. Most schools were unable to complete the expected curriculum and most national-level school exams got delayed. Even though children from affluent families and schools with good facilities were able to continue their education with minimum disturbances, poor children from rural and remote areas were grossly affected. There is a high possibility that this will limit the opportunity of children from low socioeconomic backgrounds to access higher education, no matter how intelligent or capable they are. The current economic crisis will further worsen this situation and widen the gap in social inequality. Unfortunately, this prolonged school closure has become a normal phenomenon to many of the authorities responsible and even to many parents. In this context, closing schools has become the first solution for many problems the country has faced in the recent past. Ideally, school closure should be considered as the last option. This continuous disruption of education will have a significantly adverse impact on the nation. This will further perpetuate poverty and limit the job opportunities available to people. Studies have shown many negative effects of poor education, and we will have to face these in the future if our education system is interrupted further without proper interventions. What is your advice to parents and teachers amidst this crisis? Firstly, parents and teachers should focus on their own mental wellbeing and look after themselves; only then will they be able to help children. Try to spend more time than before with children, and understand their worries and concerns. Explain the current situation of the country in a simple manner according to their age and level of understanding. Do not give them too much information. Explain in a positive manner that this will settle with time. Try to maintain their daily routine as much as possible and continue their education with minimum disturbances. Make every effort to send your child to school daily. Give them additional breaks and encourage them to engage in pleasurable or leisure activities like music, dancing, creative work, reading, writing, etc. Avoid watching TV programmes or social media content that contain violence and aggression in front of children. Try to keep children away from situations where there is potential for violence or aggression, and try to avoid discussing the current situation of the country in front of children. Adults should understand that solving current problems in the country is their responsibility and not of the children’s. Most importantly, let children live out their childhoods.