January 25, 2008
Look out for warning signs of mental illness in adolescents


On average, one adolescent girl in St. Vincent and the Grenadines tries to kill herself every two weeks and up three adolescents are seen each week at the Mental Health Centre for serious mental illness.{{more}}

Dr. Amrie Morris (photo below), Senior Registrar based at the Mental Health Centre, told Searchlight that although surprising, these statistics follow the trend in the rest of the Caribbean and the world.

She quoted from a 2000 World Health Organization / Pan American Health Organization report – “Portrait of Adolescent Health in the Caribbean”, which states that while 80 per cent of adolescents (children between 10 and 18 years) are healthy and feel generally happy, the other 20 per cent are not coping and display symptoms of mental disorders.

And, according to Dr Morris, close attention needs to be paid to the ones who are not coping. “When you have these emotional and mental disturbances at a young age, it affects the formation of your personality and it leads to marked impairment in your adult life. When you leave it untreated, messed up children become messed up adults,” she said.

Last week Saturday, the attention of dozens of people in the Tyrell Street area of Kingstown was drawn to the sight of a young female perched on a ledge of the Milton Cato Memorial Hospital. She reportedly stood there for approximately 20 minutes, during which time firemen were called in to try to retrieve her. An eyewitness told Searchlight that nurses placed mattresses on the grass below where the girl was standing to cushion her in case she fell or jumped. She was finally pulled in, off the ledge, by a civilian who was assisting the police.

While declining to comment on this or any other specific case, Dr. Morris told Searchlight that many factors put children at risk for mental illness, but in this country, the main one is abuse, whether sexual, physical or emotional.

Also high on the list of contributing factors she said, is inconsistent care giving. “The mother has probably gone off to Canouan or somewhere, and leaves the child with somebody. In those cases, you find that there is not a lot of discipline or structure in the family.”

“Even if the mother has to migrate to provide, ensure that the child is left in the care of somebody who is responsible and stable…. Going from home to home without a sense of stability and belonging really messes up children,” she advised.

Conflict or disruption, such as divorce in the family, is another risk factor she said.

Especially worrying to Morris, who did postgraduate training in Psychiatry, is the upsurge in violence in our society. “This is something we have to look at in St. Vincent … exposure to violence, whether in the home or the community, even if they themselves are not directly involved, predisposes them to developing mental illness.”

Dr Morris said the family and school system need to provide structure and discipline, which would encourage resilience in the child. “We find a lot of young people are getting easily frustrated for things that we would have brushed off. There is not this sense of, ‘I can overcome adversity’.”

The young doctor advised: “We need to give our young people opportunities for positive involvement, where they get positive reinforcement either from their achievement in school, their contribution to the family circle, or their community.”

Children who have learning disabilities are not achieving in the regular school system, and those who do not feel a sense of belonging are also at risk, Dr. Morris said. She feels that the school system needs to provide avenues for children who are not academically inclined to exhibit their strengths.

While mental illness tends to manifest itself differently in girls compared with boys, a change in personality or behaviour is the main clue that something might be wrong. Dr. Morris said girls tend to harm themselves to draw attention to the fact that something is wrong, while boys act out violently or begin abusing substances. She said in the two years since she has been at the Mental Health Centre, approximately 50 girls have taken pills in an attempt to kill themselves, while she has only seen one such case in a boy.

Dr. Morris advised parents, teachers and caregivers to look out for slipping grades, the child becoming disruptive or irritable or not wanting to interact with family or friends. She said that parents should pay attention to a child who is sleeping more or less than usual or threatens suicide when frustrated.

If a parent observes worrying symptoms in their child, Dr Morris advises them to seek help immediately. “The sooner the child gets help, the better, because it might be possible to reverse or prevent the progression of symptoms.” She said treatment ranged from counseling to the use of medication.

Parents should contact their district nurse, family doctor, the Mental Health Centre or Marion House who would be able to refer them appropriately. Dr Morris, however, lamented that there is a need to increase the scope of services offered and gave as an example the absence of a clinical psychologist in the system.