Children’s mental well being and the role of psychotherapy
Childhood mental, emotional, and behavioural disorders can result in persistent issues that may have an impact on the health and wellbeing of kids, families, and communities. The earlier mental health issues are treated, the less trouble kids have at home, at school, and in making friends. It can support healthy adult development as well.
Promoting mental health for all children, offering preventative intervention to children at risk, and providing treatment for children with recognized illnesses are all parts of a public health approach to children’s mental health. A crucial element in enhancing mental health is psychological therapy. Psychological therapy for kids may be combined with medicines depending on the nature and severity of the issues. The Besana Mail Community Roundtable and Weekly Guest Host Onita Sibanda discusses issues around mental wellbeing with Mertha Mothema Nyamande.
OS: Welcome to The Besana Mail Round Table Discussion, where we discuss children’s issues. I am joined by Mr Nyamande. Today’s topic is Children’s mental well being and the role of psychotherapy. We welcome you Mr Nyamande! Kindly introduce yourself.
MMN: Good Evening all. It is such an honour to be here tonight, to share with you a little on this subject of psychology. So my experience spans 47 years but with an enhanced understanding of the subject since 1998. So we are talking 25 years in the field.
OS: Thank you!
You are a specialist in the fields of Mental Health and Psychology/Psychotherapy, in particular psychological trauma. How is the situation in regards to mental health in Zimbabwe?
MMN: I started off as a mental health nurse, giving medication and managing mental health patients on the wards. From here, I studied further into the field of psychology and psychotherapy. I specialised in dealing with psychological Trauma as an area of special interest. So any issues to do with Trauma, I can help.
I worked in the UK for the most part of my career, and only came back home to Zimbabwe just over 2 years ago. The situation in Zimbabwe needs a lot of work. We are behind in a lot of things. Our infrastructure is outdated. The hospitals require a little uplifting to be fit for purpose. The staff need upskilling so as to fully appreciate what mental health really is about. Likewise, our laws also need amending.
At present our services only cater for the severe end of mental disorders/illnesses, where people would have deteriorated so much to the point of needing admission into mental institutions.
Largely we only do this when someone becomes a danger to themselves or to others. Such can be avoided by having services that can identify these problems early and intervene to prevent deterioration. The provision of psychological services is at a minimal, especially in government services. And private care is too expensive for the average citizen. And as the economy continue to get worse, and so the pressures.
OS: Very true. Let us talk about children and substance abuse in our communities! What can be the cause of an increase in drug and substance abuse?
MMN: Children are learners of life, and whatever we expose them to, they will take as gospel, and normalise. So there is a lot of problems that us as parents are oblivious to, and we unconsciously burden our children with. Simply because these things have also happened to us when we were younger, we may have also normalised abusive practice. So, the more we continue to burden the children, the more they struggle. The use of substances is on the increase because they just don’t know what else to do with the pain and distress that they are experiencing. The parents are often in denial and compare their difficulties with those of their children and think the children have nothing to stress over.
OS: Very sad! I believe this conversation will be helpful to both parents and children.
MNN: Absolutely.
OS: We have heard of addiction. What is addiction and how do you help children and youths addicted to drugs?
MNN: The concept of addiction is a very complex one; we often think of addiction in terms of drugs and alcohol, but addiction goes much wider and deeper than this. People can be addicted to different things, from substances (to include energy drinks to this list), to activities, like gym, work, gambling, sex, the list is endless. I have known a guy who was addicted to cheese. So the better we understand addictions the better we can respond to this problem.
Addictions often affect people on 2 levels:
1) Physical dependency – this is when you are physically dependent on something, or someone.
2) Psychological Dependency, this is the thinking or beliefs behind the addiction.
So to treat one without treating the other is essentially a waste of time and resources. This is what usually happens whenever most people talk about “rehab”. At present we do not have rehabs in Zimbabwe, especially government ones.
We also make the mistake of thinking that awareness will help the youth stop taking drugs. The idea of awareness without the required services is actually more damaging. If you have a problem and you do not know it, you could live in bliss with your problem, but the moment someone comes and tells you that you have a problem without giving you a solution – that is the worst thing that we could do to each other.
We also cannot help the children without helping the parents who are partly contributing to the problem. What we need is a robust system of addressing mental health/psychological issues from the community, while they are still social problems, before it becomes medical or criminal problems.
OS: Thank you for the insights. Rehabilitation has been cited as one of the ways to bring the addicted people back to normal living. Is it an effective way and how can the government strengthen the capacity of rehabilitation facilities?
MNN: Rehabilitation is very effective if used properly, with a clear understanding of the stages required for someone to go through Rehabilitation. Firstly, rehabilitation is not a forced process. You can take a donkey to the river, but you cannot make it drink. the same concept applies here.
The mistake most parents make is that they wait till the problem becomes critical when the user is now aggressive and violent, essentially they wait till the crisis phase. What is done at crisis stage is not rehabilitation, but containment for safety, while in that containment, they are not really properly detoxed because they start to get treated with other drugs, so its simply swapping one drug with another. Once they become more settled on the other drug, we think they are cured and we discharge them. But we would not have done anything as far as the problem is concerned.
Rehabilitation only starts after a successful detoxification, not suppression with other drugs / medications. Essentially all medicines are drugs and they all have side effects. So, as I have mentioned earlier, the government needs to structure supportive mental health services in communities, and also build or commission specialist addiction rehabilitation centres, not piggyback off the back of mental health institutions. While they are all mental health issues, they require very different interventions and approaches.
At present, our government does not fully appreciate mental health issues for them to commission the required services. and this is our biggest hurdle. We rely too much on traditional beliefs and approaches, if not religious ones. These have failed, for the longest time.
Secondly, rehabilitation only starts when the individual realises that they need rehabilitation through structured support by psychologists. Drug workers can only provide supportive components of these processes, and not the core interventions. This process cannot be forced on anyone.
OS: Children have been also become part of people committing suicide. What does this reflect on your part as a psychotherapist?
MNN: This says children have gotten to the point of losing hope for any meaningful help. Most of the time, those referred to psychological services recover, but this also requires the family to become part of this journey. Often pushing blame onto one person, while we all contribute, is equally damaging. Many of those that commit suicide would not have been referred not had access to the right help, partly due to poor understanding and highly expressed emotions on the family’s part. So, they both give up on each other, without being conscious of it. This is what pushes the sufferer to the edge.
OS: Besides drug abuse, what else can contribute to mental health issues in young people, lets say in children?
MNN: There are what we call Adverse Childhood Experiences (ACEs). These are about 10 experiences that if these have been constant in a child’s life, they are at high risk of developing mental health problems. Things like abuse: physical and or sexual, losses of significant family members, not only parents, but also other significant supports like grandparents and aunts and uncles., chronic physical and or mental health problems of the parents or care givers, and Incarceration of a parent, etc.
We all experience adverse experiences, but also how we are supported through those can have a huge bearing on the development of a child.
OS: What advise can you offer to parents in terms of providing psycho support before approaching specialists?
MNN: Parents need to be present, both physically and emotionally. Mothers play a different role to fathers, and so both are critical. Growing up with one, without the other can contribute to unhealthy personalities and lifestyle habits. Parents also need to provide a wide range of exploit for their children, exposure to different environments can also help children establish a balanced sense of reality away from whatever their parents offer. Holidays away with other family members can provide a healthy and much needed respite for both, and can give you space to reflect on how you are both doing.
OS: How do you see a media house like The Besana Mail helping children and communities on the issues we have discussed today?
MNN: Media houses hold a very critical role in publishing helpful content as this to the wider members of society. As clinicians, we can only see very few people at a time, but media houses have a much wider reach, so let us work together to conscientise our people to the real problems and real solutions, not just slogans that don’t bring any solutions. Saying No to Drugs means nothing to someone who is struggling.
Also publicising such in public spaces, billboards, printed materials, audio/visual and social media platforms can help reach the masses.
OS: Well said! Your last words?
MNN: These problems affect us all, and we all contribute, so let us not turn a blind eye because its not in my backyard. It wont be long till it does. Even if you don’t have kids, those that get affected may come to rob you to fund their habit.
The only way out of these problems is if we work together and back to our UBUNTU where we looked out for each other. Let us reconnect as communities and restore the moral fabric of our society. If you are affected, please reach out, there is help out here. I thank you for this opportunity.
OS: Thank you Mr Nyamande for such an insightful session. It was an honour to have you
MNN: The honour is mine.
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