“No more a child, not yet an adult”. Adolescence; a unique stage of life, ranging from 10 to 19 years of age. We have always considered them a ‘healthy group’ and may not gauge this period important especially in their mental health development. With the Covid-19 pandemic affecting everyone globally, we have yet to defeat the long-standing mental health crisis.
The prevalence of mental health disorders among adolescence is 15% globally (1) and 50% of this disorder begins as early as 14 years old (2). What’s worse, 72% of mental health services to children and adolescents have been disrupted due to COVID-19. It is sad to acknowledge that in Malaysia, 424, 000 children suffer from this hidden epidemic. Malaysia’s 2019 National Health and Morbidity Survey reported that 1 in 5 adolescents suffered from depression (highly treatable but often undiagnosed and untreated), 2 in 5 adolescences were anxious and about 1 in 10 of them were stressed (3). If left untreated, the consequences can have huge impact on their academic a performance and physical health.
Negative stigmas towards mental health services and professionals are the main obstacle stated by most adolescents in seeking help (4). This factor persists to be prevalent making mental health illness among the adolescents continue to exist in oblivion. In addition, the government clinic setting does not provide a conducive environment for adolescents to talk about their problems due to the limited space in the consultation room. Shyness and fear are the other two barriers preventing our adolescent to seek help. How can we help them overcome these barriers? Could telehealth be a good option? Research has shown that tele-healthcare has promising potential to fill the gaps between current and future needs (5). Telehealth that is being practiced till date guided by Malaysia’s Telemedicine Act 1997 is mainly to trace results or for home delivery of medicine. As telehealth is gaining ground internationally, perhaps this is the right time for our government to revise this act to cover the scope of ‘true’ telemedicine which should involve consultation and drug prescription. New regulations and policiesare needed to guide our healthcare providers to address the ethical, legal issues, consents and consultation when planning tele counselling for our adolescents. Getting the Ministry of Health and Ministry of Education to be actively involved, we can introduce tele-counselling and tele-health services to every school.
Every government clinic has a designated school health team, and a link can be created between the school health team and the counsellors/teachers. Teachers recognize students that might need help through their classroom participations, school work or disciplinary records. Selecting a leader among students to advocate this service will make it more acceptable as peers have more influence. Students who wish to seek help but are fearful or embarrassed of visiting the clinic can utilize the tele-counselling service at the comfort of their respective environments and get help. This may also encourage a higher rate of compliance for further appointments. Adolescents who are IT savvy maybe more engaged with tele-counselling.
Tele-counselling platform holds a great potential to address mental health among adolescents. A physically and mentally healthy adolescent brings hope to the nation. Mental health care is a right, not a privilege.
The article was written by Dr Kalashini Ramachandran (Doctor of Public Health candidate), Professor Dr Noran Naqiah Hairi and Professor Dr Moy Foong Ming. It was first published on 4 May 2021 on Sin Chew website.