The need for school-based mental health services in Nigeria: A must, not an option

HEALTHDIGEST– Recently, a 10-year-old student was allegedly raped while on a school excursion. A few months ago, a 12-year-old Sylvester Oromoni died, allegedly tortured by school bullies. Sexual abuse, bullying and the death of classmates are just a few of the numerous emotional challenges children face in school.

Schools must do better to help children who are often ill-equipped to understand or properly deal with the crises they encounter.

Globally, 1 in 6 people are aged 10-19 years and according to the World Health Organisation, half of all mental health disorders in adulthood start before age 14, and two-thirds before 24. It is estimated that 1 in 7 (14%), 10-19 year-olds experience mental health conditions, yet these remain largely unrecognised and untreated.

Mental health conditions account for 16% of the global burden of disease and injury in people aged 10–19 years with suicide being the fourth leading cause of death in older adolescents (15-19 years). Since the onset of COVID-19, there is a 25% increase in the prevalence of anxiety and depression worldwide and young people are disproportionally at risk of suicidal and self-harming behaviours – In Nigeria, UNICEF in 2021 stated that 1 in 6 young Nigerians is depressed.

Adolescents with mental health conditions are particularly vulnerable to social exclusion, discrimination, stigma, educational difficulties, risk-taking behaviours, and physical ill-health and human rights violations. The consequences of not addressing adolescents’ mental health challenges extend to adulthood, impairing both their physical and mental health and limiting their opportunities to lead fulfilling lives as adults.

I address these issues and see them firsthand as a Psychiatrist. In the past three months, I have given eight seminars at various schools on topics such as bullying, and depression in children to the Parents and Teachers forums. Likewise, I have facilitated workshops for 20 teachers on how to elicit the signs of common mental health challenges among children and adolescents as mental health first aiders.

Adolescence is a period in which young people go through to get a good start in life. As a result, schools play a vital role in children’s development, from social and peer relationships to academic accomplishment and cognitive advancement, emotional control, and behavioural expectations. All of these characteristics, particularly their physical and moral growth, are influenced by mental health. Adolescence must develop a healthy mental state in order to cope with adolescent challenges and learn good social skills. Children and adolescents are often unaware of how to recognize mental illnesses such as behavioural disorders, anxiety, or depression.

Indeed, as much as we know parents are the primary caregivers, half of the children’s waking hours are spent within the school environment. Because children and youth spend the majority of their time in school, this environment plays an increasingly critical role in supporting these students and providing a safe, non-stigmatizing, and supportive natural environment in which children, youth, and families have access to prevention, early intervention, and treatment through school-based mental health programs.

Mentally healthy students are more likely to go to school ready to learn, actively engage in school activities, have supportive and caring connections with adults and young people, use appropriate problem-solving skills, have nonaggressive behaviours, and add to positive school culture.

School owners should be guided to institute these services for the students and get the teachers trained on how to support these students. Studies show the value of developing comprehensive school mental health programs in helping students achieve academically and have access to experiences that build social skills, leadership, self-awareness, and caring connections to adults in their school and community.

After the death of Sylvester Oromoni, the school shut down for a few months but has reopened. They have not yet set up school-based mental health services for students who were traumatized.

Government and other MDAs should implement policies in ensuring these services are made available with the right professionals in our schools. These services may involve the school hiring qualified and certified school-based therapists. These professionals can provide access to prevention programming, early identification of mental health challenges, and treatment options. Another option is for schools to partner with mental health organizations and agencies to develop an integrated, comprehensive program of support and services.

Some studies have indicated that adolescents are more comfortable accessing health care services through school-based clinics and like the idea of accessing a range of health and social services in a single location.4

Further, schools provide a natural setting in which students can receive needed support and services and where families are comfortable and trusting in accessing these supports and services. School-based mental health is a vital part of student support systems and this shouldn’t be an option.

Dr. Maymunah Kadiri is the MD/CEO of Pinnacle Medical Services and Author of Deep Expression, Aspen New Voices Senior Fellow, 2021. She is Africa’s leading voice for mental health in normalising mental health conversations. Follow her on Twitter and Instagram @iamdrmay