A 'greatly troubling' picture: Children's minds are taking a beating with COVID
Experts are saying they're seeing a lot more requests for children to talk about anxiety. And government is worried the dangers this poses may become too big for us to handle.
JOHANNESBURG/CAPE TOWN - "What happens if my grandmother dies?"
"My auntie looks after me and she's on the taxi now and she can't get the vaccine. What happens then? Is she going to get it and die?"
"Who's going to look after me?"
These are some of the frightening questions children are asking Cape Town-based child psychiatrist, Anusha Lachman. Since the outbreak of the COVID-19 pandemic, she has received "a lot more" requests to see children with anxiety.
Experts working with children in South Africa say more of them are admitting they're experiencing suicidal thoughts. They have also noticed an emerging picture of a generation of mentally wounded children, some of whom are showing early signs of post-traumatic stress disorder.
Not all children have been affected by the pandemic in the same way. Some have lost their parents or caregivers to the pandemic, others have been plunged further down the poverty line, and more are confronted with the pre-existing inequality in the country when it comes to online learning.
READ: An open letter of healing to South Africans
"I think that we are going to struggle when we realise that, collectively, children are not doing well," Lachman told Eyewitness News.
Children have lost their sense of normalcy and there are confusing messages being sent to children constantly during the pandemic, she said.
"We are reinforcing that you need to wash your hands, you need to be clean, you need to sanitise, and so children become quite upset when things are not done in that order... things are clean but people are getting sick. And still, they are dying. It's very confusing messages for children."
Lachman said it was a tragedy that children's mental healthcare has never been prioritised in this country. She is one of only 35 child psychiatrists currently practicing in South Africa, both in the private and public sectors. There are some provinces, such as North West, where there is no child psychiatrist.
What will it take to change this?
"Political goodwill. And we need money."
She said the mental health of our youth was at a critical point.
"So we have the complexity of adversities that children have to face on a daily basis in South Africa [violence, child abuse, rape, absent parents, education]. Internationally, they say if you count the number of adversities you have from the age of two, we can almost predict higher rates of medical conditions later on in adulthood. So higher rates of comorbidities, diabetes and cancer. So, as an adult, you will function less effectively than what we expect."
WATCH: COVID-19 and the lockdown - How is it affecting children in SA?
Save The Children CEO Steve Miller agreed and said what COVID-19 was doing was amplifying all the pre-existing challenges children are facing.
"We can be guaranteed in this country of long term, toxic stress in many of our children going forward. So what we're seeing emerging now is a picture that is greatly troubling and should be for all of us in South Africa. Our good friends at ChildLine have seen rocketing numbers of calls received during this pandemic. Children have been reaching out because they don't always have people to speak to or people who understand what they are going through," said Miller.
Experts are concerned about the long term impact of the pandemic on children's mental health, saying it is at a point we could see early signs of post-traumatic stress disorder (PTSD) among this generation.
"It's a little too early to know for sure whether PTSD is going to really become a major issue. But the signs are all there, that there will be lasting implication from this pandemic for the mental health and well being of our children," said Miller.
"Children are like little sponges, especially the younger children. They are developing their neurological systems, everything is coming on stream. And they pick up on everything around them. And the tragedy of it all - they take it on themselves as well. All of us adults, the vast majority of us, have been going through really difficult times. Unemployment levels are at record highs. This uncertainty about the future, all of these anxieties that we're going through as adults, are now being imprinted on our children, the difference being that we sometimes develop coping strategies already that we can somehow deal with these things, whereas children don't always have that. They don't always have the ability to articulate what they're going through, communicate effectively with people how they're feeling," said Miller.
He's also a believer of more decisive "political commitment" to deal with mental health problems among the youth, especially nationally.
Deputy Minister in the Presidency for Women, Youth and People with Disabilities Hlengiwe Mkhize told Eyewitness News that if the issue remained unattended, we could sit with a generation with "childhood trauma".
"We need to find the language, the words to articulate what they've gone through, because they will say 'I'm fine, I'm okay', typical of a child."
She said with many children suddenly losing their caregivers or relatives to COVID-19, many have not been able to say goodbye.
"You know, one woman was sharing that she was surprised. The child started saying - it was after the schools were closed - and the child said, 'but when is daddy coming back, because he needs to take us to school, it's getting cold'. In most instances, the first thing families will do is to sit children down and take them through the mourning [process] of the funeral. [Now] you expect a child to process that on his or her own and understand the long term consequences?"
Mkhize wants parents to talk more openly about death and the pressures of COVID-19 with their children to help them deal with their emotions.
"Let's talk about them. Where are they [the deceased]? What has happened to them? How did they die? How did we bury them? What were the restrictions? There is some work that we need to do, to hold children in a very gentle manner so that you don't further traumatise them later."
The deputy minister also said that schools need to help children process the sudden pain caused by COVID-19 in recent months to avoid having a "generation of such wounded young people that they will do things that will shock you".
"Avenues of participating should be created. I do believe if we identify priority problems and we invite professionals, whether training institutions, to come forward and work with schools, some material can be developed and put online for young people to try and understand things we're talking about.
The Johannesburg Parent and Child Counselling Centre, which provides long and short term counselling for children and adolescents, has noticed heightened levels of anxiety, depression and stress among children since the start of the pandemic.
The organisation's director, Claudine Ribeiro, told Eyewitness News that being isolated from family and friends, not being able to partake in extramural activities, sport and also attending school in a vastly different set-up to what they're used to are some of the factors that have a role to play.
She said school closures for long periods of time had an impact on children's wellbeing, especially those living in difficult circumstances.
"School is sometimes a second home for many kids, it's a secure environment and provides a kind of sanctuary for a few hours... The school can also often provide resources the child may not have in their home environment, such as a school councillor."
Ribeiro agrees with Mkhize that parents need to talk to their children about how they are feeling about the changes they are seeing during the pandemic.
"Sometimes just being able to say it to their mom or their dad, so that they're not being interpreted as being naughty, that they're actually battling with some feelings. If parents can just help them express what they're going through, it would be an enormous help."