All views expressed are the writer’s own.
By Elsabé Brits
Every year the South African Child Gauge is published, probably one of the most thorough documents about the state of our children. And every year the review elicits a wide range of emotions in me – from anger to depression to nihilism and hope.
It is one of those reviews which every policymaker, politician, and person with an inch of power must read. When journalists like me report about the findings the reaction is mostly one of shock – but we should know this. Or do we just turn or heads away?
This 16th annual review of the situation of the country’s children is published by the Children’s Institute at the University of Cape Town, in partnership with UNICEF South Africa; the DSI-NRF Centre for Excellence in Human Development, University of the Witwatersrand; the Standard Bank Tutuwa Community Foundation and The LEGO Foundation.
The focus of the research this year is child and adolescent mental health.
Here are some of the facts: Two-thirds of South African children (63%) live below the upper-bound poverty line.
Nearly one in two children (42%) have experienced violence, including physical violence (35%) and sexual abuse (35%), and while the suburbs offer a measure of protection, violence in many areas is all pervasive, with 99% of children in Soweto having either experienced or witnessed violence in their home, school and/or community.
Children and adolescents are vulnerable to a range of mental disorders – from depression and anxiety disorders to post-traumatic stress disorder (PTSD), attention deficit hyperactivity disorder, and learning, conduct and substance abuse disorders.
Even with the best possible mental health promotion and prevention strategies, approximately 10% – 20% of children and adolescents will develop a mental disorder and/or a neurodevelopmental disability
Yet, the majority of young people with mental disorders remain untreated and in South Africa, only one in 10 children with a diagnosable and treatable mental disorder is able to access care.
Mental disorders in young people not only cause distress for children and their families, but they also impair children’s ability to function in everyday life in ways that can ripple out across the life course in an intergenerational cycle of poverty, violence and mental ill health. Half of all adult mental health problems have their origins prior to age 14 (and 75% by age 24).
Children and adolescents who do need treatment are likely to encounter a health sector ill equipped to give them the necessary care and support. South Africa’s Child and Adolescent Mental Health services are in crisis: child and adolescent psychiatrists and other mental health professionals are available in only a handful of urban centres; while limited services and human resources compromise care at district level.
As a result, only 1 in 10 children with diagnosable mental disorders are able to access treatment.
Children and adolescents with physical, intellectual or sensory impairments are at a higher risk of developing mental disorders, especially when they live in environments in which they and their families face daily discrimination and battle to access health care, education, transport and other services.
The Covid-19 pandemic has shed light on how external environmental events can grind down individuals’ mental health. Children and adolescents were not immune to the stress bought on by the pandemic. In fact, it has only compounded hardships already present and is a minor dress rehearsal for the shocks that climate breakdown will bring.
The authors wrote: We have a window of opportunity to act and put children at the centre of all that we do, to harness their energy, curiosity, and clarity of thought, and to build resilient communities better able to withstand the challenges to come. The secret to building resilience lies in the “ordinary magic” of “close relationships with competent caring adults, committed families, effective schools and communities, [and] opportunities to succeed, where belief in the self is nurtured by positive interactions in the world”.
By placing the mental health and well-being of children and adolescents at the centre of all policies and actions, and providing opportunities for them to learn, grow and participate in decision-making, we have the potential to heal the divisions of the past and enable our children to thrive.
Access the review here: http://www.ci.uct.ac.za/ci/cg2021-2022-child-and-adolescent-mental-health