Trần Thị Hồng Thu, Deputy Director of Hà Nội-based Mai Huong Daycare Psychiatric Hospital. Photo Courtesy of Trần Thị Hồng Thu

Trần Thị Hồng Thu, Deputy Director of Hà Nội-based Mai Huong Daycare Psychiatric Hospital, told online newspaper Chinhphu.vn her views on child mental health and child suicide cases due to depression.

Depression has been blamed for many heartbreaking cases, even suicide among children. What are your thoughts on this?

We often think that depression usually appears in adulthood or adolescence, but in fact, children can have depression too.

Many factors contribute to depression, including genetics, environment and circumstances. Children and adolescents with family members with a history of depression are at greater risk of developing depression.

Depression can also be a response to certain stressors, such as a change of school, the death of a loved one, moving, the birth of a sibling or any other event.

Other factors can also contribute to the development of depression, such as family conflict, bullying (in person or online), physical illness (diabetes, epilepsy, migraines), living away from parents, learning difficulties, and conflicts with teachers and friends.

How can we identify a child with depression?

Signs of depression in a child or a student are not easy to recognise, but if adults pay attention, it's possible.

Typical symptoms of depression are sadness and loneliness. Sadness is an important aspect of depression, but sadness is not enough. Depression includes many symptoms.

Depression has different manifestations in each person and varies from day to day, depending on the context and circumstances. Depression has many levels, from mild to severe, lasting anything from a few weeks and months to years.

Children with depression lose interest in activities they used to enjoy. Children cry boredom, sleep or lie down a lot.

When children are forced to participate in activities, they used to love, they are no longer happy and excited. Children with depression have difficulty making and maintaining friendships, may be socially isolated, have difficulty expressing how they feel, and even want to run away from home.

They also cry easily, become irritable, sometimes even aggressive, have low self-esteem, low energy, and feelings of hopelessness. They feel life cannot get better.

They are extremely sensitive to rejection or failure, whether real or imagined. Depression often causes children to focus on negative qualities, detracting from the positive aspects of their lives.

Children with depression often complain of physical symptoms, such as headaches and abdominal pain, for which no cause can be found.

Depression often interferes with a child's ability to concentrate or maintain focus, leading to poor grades and long absences from school. Children can change their sleeping and eating habits, indicating a fear of death.

A significant concern related to depression is suicide. If the warning signs are recognised, suicide is an interventional behaviour that can be prevented. Signs of suicide include more worries about violence and weapons, and they may speak, write about or suggest suicide.

Children may take things away from others, especially things they love. They may become increasingly withdrawn, lethargic, depressed, angry, or resentful. They also may have marked changes in their learning and appearance, with little concern for personal hygiene and appearance.

There are many warning factors for suicide, such as previous suicide attempts, substance abuse, previous or ongoing abuse (physical, sexual or emotional), learning difficulties, recent loss, relocation, impulsivity, poor judgment, untreated mental health problems abuse, aggression/fight/bullying, past or present self-injury, family history of suicide, or sexual orientation.

Cultural factors also contribute to an increased risk of suicide, such as a change in gender roles and expectations, feelings of isolation or victimisation, and rational response to shame.

What can we do to prevent depression in children? 

Health practitioners, policymakers and researchers increasingly recognise mental health as an important factor for children to develop healthily. Parents can promote children's health by ensuring that children have the skills to manage their thoughts and feelings, build positive social relationships and participate actively in society.

Feeling sad is also a part of life, and it is essential to avoid these unpleasant feelings and know how to prevent sadness from turning to depression.

Positive relationships with parents are important. Do as much as possible to maintain strong relationships between your child and family and friends so that they will always be happy.

To limit self-harm behaviour, even suicide, in children and adolescents, the role of family, school and the whole society is critical. Do you have some suggestions for families and schools?

Parents must not forget to talk regularly with their children. Parents may be in constant contact with other adults in their child's life, such as teachers, school counsellors/social workers, coaches, and music instructors. 

Limit screen time and encourage them to join social interactions.

If your child is contemplating suicide, always treat this as an emergency. Remove or lock up weapons - guns, knives, ropes, long cables - and keep all medications in proper places.

Parents and children can list healthy activities, such as dancing, writing, drawing, colouring, exercising, playing with pets, blowing bubbles, reading, and listening to music, and create a list of people you can contact in difficult times, such as grandparents, relatives, friends, and teachers. It is advisable to speak with a mental health professional for timely advice and treatment.

When teachers notice that a student is showing signs of a change in behaviour or is performing poorly in school, they should talk to their school doctor or social worker. Teachers should discuss their concerns with parents. Finally, keep a safe space for children in the classroom. — VNS