Missing mental health education?

Various studies have shown that the risk of mental health problems increases when children who have faced poverty, abuse or violence, especially in poor countries like Nepal, enter their teenage years and reach youth.

Adolescence is defined as the age group of 10 to 19 years. Various studies have acknowledged that failure to address adolescent mental health problems can have physical and mental effects in adulthood. Therefore, mental health education has become indispensable in poor countries like Nepal.

Looking at the statistics of the Nepal Police for the last five years, 123 children committed suicide in Kavre. This figure shows that one in six suicides during this period were children. According to the police data, 83 percent have some kind of mental health problem. According to data from the World Health Organization (WHO), adolescents around the world are at risk of mental health problems. One in seven 10- to 19-year-olds experience a mental health problem, which is 13% of this age group. Major causes of illness and disability in adolescents include depression, anxiety, and behavioral disorders. Likewise, suicide is the fourth leading cause of death among the 15- to 29-year-old age group.

Healthy sleep, regular exercise, problem solving, learning various skills and managing emotions are important adolescent learning. This requires a supportive environment in the family, school and community. But in the current situation depression, depression and anxiety are increasing due to various economic and social reasons such as increasing use of social media, unemployment, domestic disputes, drug use, sexual violence, crime. Psychiatrists say that this problem is becoming more serious when no one expresses their feelings openly because of shame, fear and stigma, because they can't talk openly at school, family and even among their friends.

It is estimated that 1 in every 7 teenagers worldwide experiences a mental health condition. Most of these are undiagnosed and untreated. Adolescents with mental health conditions are particularly vulnerable to social discrimination, stigma (affecting willingness to seek help), academic difficulties, risky behaviour, physical ill health and human rights violations. The more risk adolescents are exposed to, the more negative the impact on their mental health. The quality of home life and relationships with friends have a direct impact on mental health. Violence (especially sexual violence, domestic violence and bullying), socio-economic problems are also major risks to mental health.

Some are at high risk of mental health problems due to living conditions, racial discrimination, lack of access to support and services. Adolescents from ethnic or sexual minority backgrounds or other discriminated groups are also at increased risk of various mental health problems. Adolescents with chronic illnesses, autism spectrum disorders, intellectual disabilities or other neurological conditions are especially at high risk of this problem.

According to WHO, 3.6 percent of 10 to 14-year-olds and 4.6 percent of 15-19-year-olds experience anxiety disorders. Similarly, 1.1 percent of 10- to 14-year-olds and 2.8 percent of 15- to 19-year-olds are estimated to have depression. Some of the symptoms of depression and anxiety include not wanting to talk to anyone, being alone, thinking too much, being lazy, losing interest in things you enjoy doing, and increasing negative thinking. Anxiety and depression can profoundly affect school attendance and school work.

Behavioral disorders are more common in those just entering adolescence than in older adolescents. They have trouble concentrating, overdoing any activity, acting without regard to consequences, restlessness, impetuousness and haste. According to data, 3.6 percent of 10 to 14 year olds and 2.4 percent of 15 to 19 year olds have such problems. Such behavior is directly and adversely affecting the academic condition of the students and it is developing different criminal mentality. Anorexia nervosa is an eating disorder that typically occurs in adolescence and adulthood. Worrying about gaining weight, if you feel that you are getting fat even when you are thin, then you have problems with eating unhealthy food, stomach ache, and feeling weak. Some teenagers have abnormal weight gain.

Suicide is the fourth leading cause of death among adolescents (especially those aged 15–19). Risk factors include harmful use of alcohol, domestic violence, abuse, failure in love and access to suicide instruments. A major root cause of all these factors is the negative impact on mental health. Unable to control your emotions, the mind can encourage various such negative things. Harmful behaviors such as drug use or risk taking for sexual violence begin in adolescence. Therefore, in the current situation, it has become inevitable for adolescents to recognize and address their mental health. The starting point for this is the school or educational institution. Schools are places where adolescents spend most of their time and interact with peers along with academic learning structures and develop social-emotional skills. Teachers, schools, staff, and peers can identify, address, and mitigate adolescent risk factors and mental health conditions.

Another key strategy is to conduct teacher workshops in the school environment to promote teacher well-being. Such programs can improve teachers' mental health, which has already been found to be associated with higher social and emotional well-being in students. In the classroom, teachers engaging more effectively with students, establishing creative classrooms, teaching ways to use technology, and more can impact student well-being.

Schools in developed western countries as well as in some states of India are conducting various programs keeping in mind the mental health of adolescents. Programs like School Mental Health, Talk with Counsellor, R U OK are actively being implemented. In every place like school, college, they are organizing awareness campaigns to discuss mental health questions, problems and solutions and not to make it a subject of stigma. In the context of Nepal, some associations have started such work but are not able to operate it actively. There is zero effort from the government and stakeholders. Because mental health is still viewed as inferior.

In schools, colleges or other educational institutions, adolescent studies should be taught along with teaching about mental state, emotional intelligence, personality types and especially stress management in student life. Therefore, local governments and schools need to actively take initiatives to build a healthy society. No health without mental health means health is not possible without mental health. Only if mentally healthy children and adolescents can be raised, the country and society can have healthy, strong and happy youth. Therefore, the important question is - when to teach about mental health education at school level?