Adolescent mental health: where to get help

Untreated mental health issues in childhood disrupt a child's ability to function at home, at school and in the community, explains Joanna Kleovoulou, clinical psychologist and founder of PsychMatters Centre in Johannesburg. "Yet because there are so many myths and misconceptions around mental health in general and because many parents attribute real diagnosable mental health issues to 'a teen phase', they are often reluctant to seek help."

She adds that parents may be concerned about the stigma or about labelling their adolescent. They may feel ashamed or embarrassed or that it's all their fault. They may also be anxious about what lies in store in terms of treatment or the possible need for their child to go onto medication. "The sad thing is that mental health issues in children are becoming increasingly prevalent. That is why it's so important to closely monitor your adolescent's mental wellbeing and to seek professional help as soon as you pick up anything of concern."

Just being a teenager - or is there a bigger problem at hand?

Literature and common beliefs claim that teens are disobedient and difficult to relate to, says clinical psychologist Darrian Long. "These difficulties are a by-product of hormonal changes and growing up, and usual symptoms include mood swings, outbursts, disruptive (and sometimes destructive) behaviour, or even just being oppositional (antagonistic or hostile)".

The World Health Organization (WHO) states that teens still depend on adults for their physical, emotional, scholastic, social and spiritual development and guidance while navigating their sense of independence, says Joanna, "So as a general guideline, symptoms become concerning when they are frequent, longer-lasting, occur at an unusual age or cause significant disruption to your child's and family's ability to function."

Watch out for depression

According to the South African Depression and Anxiety Group (SADAG) teen suicide is more common than usually thought. "Each year in South Africa about 9% of all teen deaths are caused by suicide," says Darrian. "SADAG claims that the fastest growing age to commit suicide is young people under 35, specifically female suicides between the ages of 15 and 19. However, research indicates that although more females attempt suicide, more males are successful due to the methods they use."

Darrian says signs of depression in children and teens are similar to that of adults, except that younger children may not have the verbal skills to express their feelings or fears and teenagers may lack insight or are impulsive. He encourages parents to be on the lookout for these non-verbal signs:

• Loss of interest and persistent sadness
• Being angry or irritated more often
• Frequent crying
• Spending a lot of time alone
• Missing school often
• Sudden change in behaviours and school performance

How to support your child

The WHO describes adolescence as a crucial period for developing and maintaining social and emotional habits important for mental wellbeing. There are several factors that can contribute to stress during this stage in life, including a desire for greater individuality, peer pressure, sexual identity exploration, and increased access to and use of technology.

Many teens have trouble adjusting to adolescent changes, explains Darrian. "They may find it difficult making friends or have internalised doubts about themselves. Some children are confrontational and have issues with following instructions or with authority figures" There are quite a lot parents and caregivers can do to help their teens in dealing with their problems especially during those difficult times.

This includes:

• Encouraging a loving environment that's open and understanding
• Being mindful of your reactions. A rule of thumb to remember is that an escalated adult cannot calm an escalated teen or child.
• Learning behaviour management techniques that will help to control outbursts and teaching such techniques to your child or teen. (see resources below)
• Exploring the option of dialectical behaviour skills training: an evidence-based process to help your child to regulate feelings, learn to be more mindful and learn emotional control and interpersonal skills.

Where to get help for your child

"It takes courage to reach out if your teen needs help and it's important to remember that you're not alone," says Joanna. "The good news is that mental health disorders are treatable, however, do try to seek professional advice as early as possible. This will prevent problems from becoming severe and will also lessen the effect they have on your child's development."

Joanna explains that there are many different approaches to helping teens struggling with mental health problems. You can turn to psychiatrists, GPs, psychologists or social workers. Alternatively, you can turn to religious organisations for help if you don't have access to a professional. In most communities there are government clinics that can assist at reduced rates or free of charge. Many mental health care professionals do offer services at reduced rate and even at no cost, depending on the need.

Joanna adds that mental illnesses, like many medical disorders, require ongoing treatment. "Psychotherapy and medication (when required) can both significantly help. Constructive lifestyle changes (exercise, nutrition) are also part of the treatment protocol as well as parental guidance. Educating yourself about your child's difficulties is a good way to show support and understanding and will also go a long way in helping you to cope."