The South African Society of Psychiatrists Almost (SASOP) reports during Child Protection Week that one in seven children have a treatable mental health condition but most carry the burden through to adulthood.
This they say is due to South Africa’s lack of specialists and facilities to support their unique needs.
Dr Alicia Porter, a board member at SASOP, said South Africa only has 30 specialist child and adolescent psychiatrists, most who are in private practice where access is limited by affordability.
State-funded specialist child and adolescent mental health facilities are only available in Gauteng with four service units Kwa-Zulu-Natal having one and the Western Cape with only two.
The organisation stated that the Covid-19 pandemic exacerbated the situation for the country’s 22 million children and teenagers.
As a result, said Porter, it is estimated that only 10% of children and adolescents needing mental health treatment are able to access it.
“Children and adolescents have not been spared from the mental health impact of the Covid-19 pandemic, with anxiety and depression symptoms in under-18s globally estimated to have doubled,” she said.
“South African children’s right to good mental health, and right of access to age-appropriate mental healthcare, is already being failed by the public healthcare system and has been worsened by the impact of the Covid-19 pandemic.
“We as psychiatrists have been calling for urgent action for a long time. We need to act now to protect the next generation and prevent the socio-economic consequences of poor mental health,” said Porter.
Mental health conditions are the leading cause of illness and disability in children and teens.
Between 50-80% of adult mental health disorders originate in childhood, impacting on physical and mental health, increasing the risk of substance abuse, and limiting opportunities for education and employment.
Mental health professionals expect that the disruption to family and school routines, fear of being infected or losing loved ones and may have a long-term negative impact on children’s mental health and extend into adulthood.
A lack of understanding and acceptance of mental health leads to families that seek help often being stigmatised within their extended families, communities and the healthcare system.
“Child and adolescent mental health is not prioritised, which is reflected in the lack of dedicated funding, human resources and facilities, and frequent unavailability of psychotropic medication. This is worsened by the lack of insight and understanding of what child and adolescent mental health entails and what services are needed,” said Porter.
In addition, she said, in the face in inadequate resources and capacity, the government over-relied on non-profits to compensate for the lack of public services.
“Government makes it difficult to manage cases that require collaboration and cooperation of the departments of health, education and social development,” she said.
“South African children’s rights in the mental health sphere will only be fully realised if we move beyond policies to full implementation with investment in training, staffing and facilities that make appropriate treatment accessible to the most vulnerable in our society,” she concluded.
The key priorities highlighted by psychiatrists to be addressed if South Africa were to improve child and adolescent mental healthcare are:
• Updating of policy, and enabling implementation across all provinces through greater investment in specialised child and adolescent mental health facilities and services.
• Improving intersectoral collaboration across the departments of health, basic education and social development, and enabling multi-disciplinary team approach to managing cases.
• To aid with mental health promotion and awareness, as well as screening and early detection, primary care nurses should receive training in mental health specifically focused on how these conditions present in children and adolescents.
• Teachers should be trained in identifying mental health conditions, in mental health promotion and in basic counselling, while mental health skills training should form part of the school curriculum in order to assist with building coping skills and resilience in children and teenagers.
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