PETALING JAYA: With over 400,000 children in the country believed to have been struggling against mental health issues even in the pre-pandemic days, experts say things could only have got worse with Covid-19 anxiety.

       A National Health and Morbidity Survey (NHMS) survey in 2019 found some 424,000 children fighting to cope with mental health issues, indicating that the problem had reached epidemic proportions even then.

       Malaysian Mental Health Association president Datuk Dr Andrew Mohanraj confirmed that there was a spike in mental health cases among children during the movement control order period and at the height of the pandemic.

       “This was also consistent with the increase and the nature of calls received by our helplines. Children being forced to stay at home did bring about psychological issues due to their inability to take part in normal activities, made worse by poor interaction with peers and academic difficulties,” he said.

       Dr Mohanraj, who is a consultant psychiatrist, said although many children had shown resilience and “bounced back” during the gradual return to normalcy, for others it could be a long process.

       He said a child’s overall development including academic performance could be affected without early detection of childhood mental health issues and quick intervention.

       Children could also be affected by the goings-on in their families, with parents also affected by anxiety and depression, he pointed out.

       “Life-changing issues such as divorce and change of school can be devastating to some children,” he added.

       Dr Mohanraj said parents, teachers and school counsellors play a synergistic role in early detection of mental health problems and protecting the mental well-being of children.

       “Teachers should have additional training to notice red flags and alert the parents and school counsellors involved,” he added.

       He advised parents to spend quality time and have healthy and constructive communications with their children, saying they should avoid discussing their own difficulties such as financial and marital issues in the presence of their children.

       He also said parents demonstrating love and acceptance and helping their children set realistic goals would do wonders to the child’s self-esteem, adding that good mental health played a significant role in attaining developmental milestones.

       “In adolescent children, parents can seek the help of another family member whom the child respects to approach the child, in the event the child does not want to open up with the parents,” he added.

       Mental Illness Awareness and Support Association president Anita Abu Bakar said that parents should talk to their children and allow them to express their feelings without judging them.

       It is also important for parents to provide empathy and compassion, which could be done in a family circle session so that children will know it is a safe space.

       She said there were several steps for parents, schools and teachers to help identify mental health struggles among children, including those from the B40 group.

       One would be proper dissemination of vital information on major disorders among children for them to become familiar with.

       “At schools, we need to have teachers who are engaged in mental health first-aid training. They must also take compulsory courses to be aware of mental health issues among students.

       “It is also vital to set up open communications between teachers and parents – for instance, informing parents when a child is struggling or displaying symptoms of distress or mental health issues,” added Anita.

       University of Cyberjaya’s Faculty of Psychology and Social Sciences dean Assoc Prof Dr Anasuya Jegathevi Jegathesan said the first two years of the pandemic was a long time for children to have had limited social interaction.

       “Children who used to be quite confident are now more shy, have more social anxieties coming in, and the impact of that is going to take some time for the kids to overcome,” she said.

       She said while parents still left their homes to run errands, children were left at home during the MCO and travel restrictions.

       “On top of that, you’ve had lack of skills for kids. In those two years, they did not learn the skills required for socialising.

       “Children are now back at school – some love it, some are acting up, and some are more shy. And there are some who are finding it difficult, while others hide behind their masks,” she added.

       Anasuya noted that cases of abuse had also risen during the pandemic, and school – which was a safe haven once – was not accessible at the time.

       She said unlike the days when families were bigger and children indulged in physical activities and games freely, the circumstances were different now.

       “Now, we have smaller families and there are fewer people for children to talk to. Back then, children could play around the neighbourhood freely and it was quite safe too,” she added.

       Mindset change specialist Rajan Rajadurai said besides social anxiety, there was also a delay in a child’s development during the various lockdowns.

       “In terms of the development of younger children, there was a delay in their motor skills and speech (development),” said the founder of Lil’ Ninjas Dojo, a multi-activity centre for children at the Atria Shopping Gallery here.

       “We have had children who came to our centre being shy, lacking in social skills and having no confidence. But they showed improvement when they could come out and interact,” he added.

       Rajan said apart from school, a holistic approach was needed for children’s mental health and children needed to participate in activities to develop their social skills and increase their confidence.

       “Parents must also encourage their children to face problems and challenges head on instead of waiting for the problem to resolve itself,” he added.