One in 7 children facing mental illness

One in seven youths in sub-Saharan Africa are experiencing a mental health condition. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviours.

The UN Children’s Fund (Unicef) found most children in the region have little access to mental health services, according to their “State of the World’s Children” report released on Tuesday. 

The survey forms part of the fund’s Changing Childhood project in which around 20,000 people were interviewed by telephone in 21 countries. The interviews represented two groups: people between the ages of 15 and 24, and those 40 and older. The full findings of the project will be released in November. 

The basic findings on mental health figures in the region are:

• In sub-Saharan Africa, one in seven young people live with a mental health condition.
• Self-harm is the fourth most common cause of death among 15 to 19-year-olds and a top cause of years lived with disability.
• For many of these children, access to mental health services is out of reach. Not every country has a policy for child mental health.
• Many are deterred from seeking help by stigma and misconceptions that equate mental health with witchcraft or spiritual possessions and a general lack of awareness among people that recovery is possible.
• Access to services is hampered by a scarcity of trained workers and professionals, and specialised mental health services remain largely located in urban centre, unreachable by most, and these services lack focus on the specific needs of children and young people.
• The human cost of the situation is devastating for children, adolescents and families, and the financial cost — the costs of inaction — tops $393bn (R5.9-trillion) a year.
• Research in the region on the scope of needs, prevalence of mental health conditions and cost-effective, culturally appropriate interventions are limited.
• In several countries in eastern and southern Africa, children have witnessed horrific acts of violence and destruction of homes and livelihoods from war, violence and weather-related emergencies. This leaves long-lasting wounds unless treated.

According to the study, displaced children, or children on the move, are generally known to be at higher risk of mental health disturbance with growing evidence indicating some refugee youth face long-term persistent psychological difficulties.

There are approximately 3.3-million internally displaced and 1.7-million refugee children in eastern and southern Africa, which is a significant number of children “vulnerable to acute and potentially chronic mental health challenges”.

“Conflicts, internal displacements and migrations, international sanctions and economic deterioration are all reported in and across the region.”

As an example, in South Sudan, 4.5-million children are in need of humanitarian assistance due to the effects of years of prolonged conflict, chronic vulnerabilities and weak essential services. According to the study, 1.6-million people are internally displaced in the country and many are children.

Covid-19 has left 2-million children without schooling between March 2020 and May 2021, and these Sudanese children add to the 2.8-million who were not in school before the pandemic.

“The stress on their mental health is very real. South Sudan is also experiencing significant protection concerns and affected populations continuously express fear about  persistent insecurity, human rights violations and gender-based violence. Only 6.5% of at-risk children have access to psychosocial support and other child protection services.”

Madagascar has seen a deterioration in its socio-economic situation after natural disasters and disease outbreaks, including Covid-19.

“Decreased access to and demand for social services due to the pandemic has significantly affected households, communities and systems, and exacerbated the vulnerability of children and their mental health,” says the study. 

“Deprived of protective school environments and given the increased stress and economic pressure in families, children are at heightened risk of experiencing violence and exploitation, including child marriage and child labour.”

In the first semester of 2020, the number of Madagascan children referred to protection services decreased by 50% or more compared with 2019, “highlighting the need for responsive child protection services and stronger monitoring”.

“An increase in climate-related emergencies and disasters are anticipated in the region which frequently affect the already vulnerable, resulting in exposure to multiple stresses and increasing the risks for mental health.”

Unicef reports several countries in eastern and southern Africa have experienced a high number of sudden onset and protracted crises and emergencies, with limited capacity to respond.

“Women and children in particular can get ‘lost’ in these situations. The protective environment weakens, needs go unrecognised and exposure to these adverse experiences, especially in early life and when not managed or supported, can precipitate lifelong mental health challenges.”

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