Even children can have suicidal tendencies - Experts

KUALA LUMPUR - About a year ago, a casual assessment of the mental health of pupils at a primary school here yielded a surprising finding - a Year Five pupil openly indicated his wish to commit suicide. The assessment was carried out as part of the Healthy Mind Programme implemented by the Ministry of Health in collaboration with the Ministry of Education.

Later, at a briefing for parents, the principal of the school concerned said the programme should not be underestimated as it helped them to detect the mental health levels of their pupils.

"Our investigations revealed the (suicidal) child has family problems and we took prompt action to address the situation," he informed the parents who were stunned at the realisation that a child as young as 11 could be grappling with thoughts of suicide.

Almost every day, police are recording cases classified as "sudden death” involving individuals from various age groups. The causes of death range from drowning after falling from a bridge to injuries from falling off tall buildings and hanging from a fan.

Although not explicitly stated, it is generally understood that most of these cases involved individuals who chose to end their own lives due to various factors, with the majority attributed to depression.

Although the issue of primary schoolchildren contemplating suicide is relatively rare in this country, experts advise parents and others not to take it lightly.

FACE MYRIAD CHALLENGES

Prof Dr Haslinda Abdullah, director of the Institute for Social Science Studies at Universiti Putra Malaysia (UPM), told Bernama primary school-aged children do not know how to manage their emotions, nor are they aware of the consequences and repercussions of actions such as suicide.

"(At their age), all they understand is if they do it (commit suicide) they will be released from the ‘pain’ they are feeling,” she said.

"Adults may shrug off the problems faced by children of that age as trivial but for these kids, it is not so.”

Psychiatrist Dr Ruziana Masiran concurred, saying at that age, children tend to understand complex concepts such as death and suicide but their understanding of related emotions and the implications of their self-harm behaviours on themselves and others is limited.

Parents, guardians and educators should, therefore, lend an ear to their children, support their emotions and take appropriate steps to ensure their safety and mental well-being, said the consultant psychiatrist at the Children and Adolescents’ Clinic at Hospital Sultan Abdul Aziz Shah UPM.

This has become all the more pertinent now considering today’s children face a myriad of challenges unlike their counterparts three decades ago who were primarily occupied with playing with their friends.

Dr Ruziana said children these days often find themselves burdened with higher academic expectations, and the pressure to excel in school can lead to stress, anxiety and feelings of inadequacy. Even the syllabus has become more rigorous compared to the past.

In addition to that, they also need to navigate the impact of social media and cyberbullying which also contribute to mental health issues.

"Through social media, children can be exposed to harmful content that can have negative effects on their mental health,” she said, adding the lack of social support due to changes in the family structure, increased mobility and dependence on technology for communication contributes to a decline in the social support network available to children, causing them to feel isolated or disconnected from the very people who should be providing them with moral support.

Sharing a case she had handled as a psychiatrist, Dr Ruziana said her patient was a 11-year-old girl who came to her clinic with cuts on her left and right arms. She suffered from depression following the breakdown of her parents’ marriage.

"The child’s friends in school ostracised her, exacerbating the pressure she faced. Often when negative emotions persist, a patient would contemplate or attempt self-harm,” she added.

Handling and treating such cases require time and patience.

"For young patients, we must observe their expressions because there will be times when they don’t know how to articulate what they are going through. Some of them have lost faith in the people around them, so we need to nurture their trust as best as we can,” she explained.

She added when a child or adolescent exhibits a tendency to harm themselves or take their own lives, it is actually a signal that they are "seeking help”.

"This is when we have to intervene to rescue them from the emotional turmoil they are going through.”

WORRYING

Pointing to the findings of the 2022 National Health and Morbidity Survey, Dr Ruziana said there has been an increase in suicidal ideation and suicide attempt rates among Malaysian adolescents aged between 13 and 17.

The suicidal ideation rate rose to 13.1 per cent in 2022 from 10 per cent in 2017, while the suicide attempt rate went up to 9.5 per cent in 2022 from 6.9 per cent in 2017.

A study carried out by the Institute for Health Behavioural Research, Ministry of Health, in collaboration with the United Nations Children’s Fund in 2022 also revealed shocking statistics pertaining to children’s mental health.

The study, carried out to evaluate the mental health levels of adolescents and children residing in 37 People’s Housing Project (PPR) schemes in the Klang Valley, showed more than 12.3 per cent of the respondents aged between 10 and 17 experienced mental health issues and had suicidal tendencies.

Said Dr Ruziana: "The statistics are alarming, underscoring the critical need to provide timely interventions and mental health support for children before they enter adolescence.”

To nip mental health issues in the bud, she urged parents to monitor their children’s behaviour and look out for changes in their moods as well as sleeping and eating patterns.

"If they look sad or anxious, ask them how they are. Tell them to openly express how they feel. If something is indeed bothering them, hear them out and validate their emotions,” she advised.

UPM’s Haslinda said early detection of mental health problems and timely intervention can prevent a child from engaging in harmful behaviours.

STIGMA

Meanwhile, acknowledging that the preventive approach is the best way to address depression among children, Dr Ruziana said societal stigma towards mental health issues, however, hinders individuals from seeking help.

She also stressed the need to improve access to mental health services to enable the public to seek treatment early.

"Access to mental health services including counselling and therapy is still limited in Malaysia, especially in rural areas.

"Apart from that, addressing the mental health needs of school students is also crucial, given the increasing prevalence of this issue among Malaysian youth. Schools and community organisations play a vital role in promoting mental health awareness," she said.

She suggested that authorities intensify efforts to prevent suicides through the implementation of more comprehensive policies. These include funding for mental health services, suicide prevention programmes and research initiatives.

"Collaborative efforts involving government agencies, NGOs (non-governmental organisations) and the community are crucial for effective suicide prevention,” she added. - BERNAMA