Socio-economic problems and a lack of health facilities to adequately assist children and teens suffering from mental health issues has been identified as a major challenge facing young people.
The South African Child Gauge released its annual report this week which put a spotlight on the adversities that were eroding the children’s mental health.
Academic institutions and the United Nations Children's Fund (UNICEF) South Africa have urged the government to make better investments in to the mental health issues affecting young children.
South African Human Rights Commission (SAHRC) chairperson, Advocate Bongani Majola, said due to historical neglect and underinvestment in mental health, there were "serious gaps" in the prevention and care for children and adolescents.
Majola said the Covid-19 pandemic intensified pressures on children and adolescents and, as a result, "a whole generation’s mental health and well-being has been jeopardised by the pandemic.“
"Children and adolescents feel afraid, angry and anxious because their routines, education, recreation and family finances have been disrupted,“ he said.
High levels of racial inequality, gender inequality, poverty and malnutrition, disability, gender-based violence (GBV) at home and violence against children were also listed as contributing factors.
Majola said human rights were interrelated in nature, and thus the deprivation of one right could lead to the infringement of one or several others.
"The SAHRC documents that many children on the move do not have legal documentation due to a myriad of factors, including the lack of birth registration, loss of documentation, death of parents and delayed applications at Home Affairs.
"The lack of legal documents (means) children have been unable to access education, welfare support, medical care and adequate nutrition. The lack of access to such basic human rights deprives children, thereby putting them at a disadvantage in terms of cognitive, emotional and physical development. In contrast, children who enjoy these rights have a better quality of life," noted Majola.
He said while the government had adopted policies to help with mental health issues, which had been delegated for implementation at the provincial level, none of the provinces had a policy or implementation plan to support the national policy.
"This indicates that mental health and mental health for children and adolescents is not given priority on the policy agenda," said Majola.
The Child Gauge also found that few health facilities had dedicated 72-hour mental health assessment wards for adolescents, which left them to be accommodated in adult wards and in most cases - medical wards.
Often the assessments were predominantly performed in "unsafe, inappropriate structures often by inadequately trained staff who lack the appropriate skills and expertise".
The UNICEF South Africa’s U-Report poll of 2021 to 2022 found that 65% of young people with mental health issues did not seek help.
The organisation’s Christine Muhigana said: “When we ignore the mental health of children, we undercut their capacity to learn, work, build meaningful relationships and contribute to the world.
“When we ignore the mental health of parents and caregivers, we fail to support them to nurture and care for their children to the best of their ability.
“Responses to mental health and psychosocial problems in a given population need to be multi-layered and multi-sectoral. We also need to ensure that mental health indicators are present in national health information systems and in programme evaluation,” said Muhigana.
A masters' student at UCT who was part of the Child Gauge research team, Chuma Busakwe said most young people relied on social media and the internet for information on mental health.
"Some felt mental health was not relevant to them while others felt they did not know how to approach it. Most households and communities also attach a stigma to it" said Busakwe.
Director of the Children's Institute, Professor Shanaaz Mathews, said beyond the mind, the quality and state of the environment also mattered in mental health.
“The characteristics of a neighbourhood, whether it is peaceful and clean or violent and dirty, has a bigger impact on the mental health of the people who live in it than their own individual predispositions,” said Mathews.
Two-thirds (63%) of children in South Africa lived in poverty, frequently in environments where the stress of material insecurity was made worse by inadequate services, discrimination and violence, she noted.
Meanwhile, 39% of children lived beneath the food poverty line, where food insecurity further intensifies the pressures and conflict at home.
“These children and adolescents are at particular risk of poorer mental health which can perpetuate an intergenerational cycle of poverty, violence and ill health,” added Mathews.