Children too are victims

One in every five children suffers from mental health problems or mental health disorders in Sri Lanka."Yes, the World Health Organization states that 20% of our population suffers from either mental health problems or mental health disorders and our own surveys tally with this figure," says Prof. Hemamali Perera, Consultant Child & Adolescent Psychiatrist, Faculty of Medicine, University of Colombo.

A "mental health problem" is when a child develops symptoms that indicate that his/her mental health is not at its optimum due to an external stress factor, explains Prof. Perera adding that it is dubbed a "disorder" when it is identified as a mental illness.Taking children in the age group 4 years to 13 years, the most common condition singled out by Prof. Perera is "disruptive behaviour".

Disruptive behaviour could be a sign of hyperactivity

Parents who have children prone to disruptive behaviour are reluctant to talk about their behaviour in front of the child. "Aney doctor don't discuss it in front of him/her," has been the whispered request by many a parent to this Child Psychiatrist.

She, however, disagrees. "This is exactly what we need to discuss in front of the child. Otherwise, this type of behaviour goes on and there comes a stage when such parents are actually battered by the child. Some mothers come distressed and helpless."

What is disruptive behaviour?

This is when the child is very difficult to manage and becomes uncooperative, defiant, oppositional, aggressive and violent.

How does this happen?

It may not only be outside or external pressures and academic demands but could also be due to developmental aspects, says Prof. Perera pointing directly to the lack of time devoted to children by their parents. "In the early stages, if a child does something wrong, it goes undetected and parents are not around to show them what is acceptable and what is not. There is no stimulation for the child from the parents and at the same time there is no limit-setting by the parents, providing the child with clear guidelines. Mean-while, parents try to compensate that by being over-permissive."

The worst is that parents don't have authority, MediScene learns. Bad behaviour is excused with knowing looks and 'Boys will be boys' comments.

Stressing the importance of clear limit-setting, Prof. Perera says that one does not need to resort to corporal punishment to get the message through. The limits should be clearly spelt out to the child and if the child does not heed them certain privileges enjoyed by the child could be withdrawn for a while.

However, according to Prof. Perera who runs a clinic at the Lady Ridgeway Hospital for Children, at the same time it is important to identify whether there are learning difficulties and attention deficit disorders which could be frustrating the child.

If you have a child who is easily frustrated, cannot concentrate, does not achieve as well as expected, gets into fights frequently, is aggressive…then recognize it as a problem and see a psychiatrist, she urges. Citing an example, Prof. Perera says, if a child starts taking down a lesson but stops half way and writes gibberish, loses books regularly, teachers should take heed and inform the parents who can then consult a doctor.

A child with serious behaviour problems can be recognized as early as 3 years of age. Untreated, such problems will persist into later childhood, adolescence and young adulthood, sometimes with serious complications, she adds.