Kids attending classes but with anxiety, depression

The anxiety, depression and loneliness that children had gone through during the pandemic-caused long school closure is now welling over into classrooms, leading to disruptive behaviour, such as a lack of attention to study and engagement in bullying and violence, in many kids.  

The pandemic has subsided, but it will take a long time to heal its effects on children's mental health, say health experts.

To shed light on the change in children's behaviour, take a recent incident at Rajshahi Collegiate School and College: On 10 August, 12 students were punished for aggressive behaviour. They hurled abuses at their classmates and hit some on the school premises.

"We never saw students behaving like this before Covid-19. Their behaviour has changed a lot. Maybe this is because of depression and loneliness with no socialising during the long-term school closure in the pandemic," Nur Jahan Begum, principal of Rajshahi Collegiate School and College, told The Business Standard.

They are now being motivated in different ways before the beginning of every class. "We are getting positive results," she said.

Many children across the country are still suffering from physical and mental illness because they could not socialise with one another for a long time – when they had been kept at home. Thus they missed a normal childhood that can never come back. 

During the school closure, the government kept virtual teaching accessible to students, but many could not take advantage of it in the absence of digital devices and Internet connections. Moreover, many had not found it engaging either.

Mainly in city areas, a good number of kids spent time at home playing on smartphones or watching TV or engaging in indoor activities, which eventually caused physical and physiological stress on them.

Now, they are back in classes and are struggling with mental health issues. Many schools are now trying to deal with such problems, using their own techniques in the process. 

Health experts say only psychiatrists can support children's mental health properly. 

Md Sohel, headmaster of Ganda Girls High School in Bhola, told TBS, "We have basically no knowledge about mental health. So, most of the time we cannot identify such problems."

The education ministry has failed to provide students with mental health support even though it has taken initiatives. In these circumstances, World Mental Health Day 2022 will be observed across the country on 10 October with the theme, "Make mental health for all a global priority".

Prof Dr Mohammad Ahsanul Habib, former director of Mental Hospital, Pabna, told TBS that there has been a rise in different mental health issues among children of different ages. 

The pandemic effects on mental health will actually be felt five to seven years later, he noted.

Dr Mohammad Ahsanul Habib, who is currently Head of the Department of Psychiatry at Anwer Khan Modern Medical College and Hospital, said children are more addicted to the Internet because of their exposure to online classes for a long time.

 They now show a lack of attention to studies, but rather prefer spending time on smartphones, he also said.

Aachol Foundation conducted research between 1-15 June last year and found that 61% of young people in the country are suffering from depression.

The respondents reported they are dealing with excessive stress, loneliness, pressure to get married, uncertain future, session jams in universities, financial instability, and cell phone addiction.

University students are also suffering from mental disorders caused by pandemic-led closures.

A research article titled "Psychological responses during the Covid-19 outbreak among university students in Bangladesh" – which was published last year in PLOS ONE, a US-based research journal – has shown that 76% of students are in depression, 71% in anxiety and 70% in stress. 

The researchers conducted the Internet-based survey during the month of April 2020, involving 3,122 Bangladeshi university students aged 18 to 29 years. 

A study conducted by five researchers, headed by Nahid Salma, an assistant professor at Jahangirnagar University, and published in the "Journal of Public Health", a British-German based journal, last year, showed that 10.41% university students of Bangladesh are suffering from mental disturbances due to the coronavirus pandemic.

Government initiatives 

The education ministry in its own observation has found problems in students' thinking, emotions and behaviour. 

The Directorate of Secondary and Higher Education is providing online training to 2 lakh teachers on mental health so they can identify and provide primary treatment to students, its director general Professor Nehal Ahmed told TBS. 

"I hope that such training will bring about a positive result in dealing with the mental problems of students," he said.

Education Minister Dipu Moni, however, told the media in 2021 that the authorities will appoint 64 psychologists – one at each district. But there has been no visible progress so far. The higher educational institutions have formed psychological centres but the manpower to identify problems and provide services to students is not sufficient.  

The education minister has now said the ministry has a plan to train at least two teachers for taking in-person training in first aid across the country. 

Professor Md Amir Hossain, director of the Monitoring and Evaluation Wing of Directorate of Secondary and Higher Education, told TBS that the wing had found that about 30-40% of students aged between 12 and 18 are now suffering from depression because of loneliness in pandemic times. 

"We are working for students to recover from mental illness. We have asked head teachers to take extra care if they find any such symptoms."

There are about 1.50 crore students of secondary and higher secondary levels at 50,000 institutions across the country.

Crisis of psychologists 

According to the National Mental Health Policy, the number of mental health professionals in the country is very low compared to mental health problems. 

There are only 1.17 mental health workers per 1,00,000 people in Bangladesh. Of them, 0.13 are psychiatrists, 0.01 are other specialist physicians, 0.87 are mental health nurses and 0.12 are psychologists and other professional mental health workers. 

Prof Dr Mohammad Ahsanul Habib told TBS, "There are 350 psychiatrists and fewer than 100 psychotherapists for the 16 crore people of our country. These doctors live in Dhaka, Rajshahi and various divisional cities. At the district and upazila levels, medical care is absolutely inadequate."

Prof Dr Mehtab Khanam, a noted psychologist, said people are becoming poorer and losing their capital and jobs due to the Covid-19 pandemic. It directly impacts the lives of students, pushing them into depression.

What Unicef suggests

Unicef says teachers can support students' mental health in eight ways during Covid-19 school returns. 

These include listening to children's concerns, checking how children are doing, providing children with accurate information around COVID-19, seeking suggestions from children on how to create a welcoming, ensuring safe and comfortable classroom and watching out for any warning signs of child behaviour that interferes with their ability to explore, play and learn. 

The other ways are encouraging games and sports to promote interaction between students and modelling good coping behaviour for students – be calm, honest, and caring, take care of yourself and know your limits. 

How other countries provide mental health support to children 

Almost 96% of schools in the USA provide at least some school-based mental health services, most commonly by a school counsellor or licensed mental health provider employed by the school system.

Some schools have made changes to their daily or yearly academic calendars in hopes of mitigating mental health issues. In some places, that was a controversial move because it meant cancelling classes on certain days, which caused families already exhausted by campus closures to scramble for care.

In the UK, mental health support teams work in a variety of ways, including enabling children to text their local mental health support team, with a health professional responding within an hour during the school day offering them advice.

The teams also help staff within schools and colleges to provide a 'whole school approach' to mental health and wellbeing through training sessions for parents or workshops for teachers.

India also has taken up many programmes to provide mental health support to students.