Schools: the key to better mental health for children and young people

Written by Dr Muftau Mohammed
MSc Global Mental Health Alumnus of King's College London

Laraba, 15, from Nigeria suffers symptoms suggestive of a severe depressive disorder. She frequently feels deep sadness, cries often and, as her depression has deepened, she’s experienced auditory hallucinations – hearing voices that aren’t there. She also has multiple physical injuries, suggesting ongoing physical abuse.

Her depressive symptoms – and the fact she has dyslexia – have severely impeded her performance at secondary school. As a result, Laraba has been subjected to corporal punishment from her teachers and teasing from her classmates. She’s also had to repeat classes. The way Laraba has been treated at school has compounded her depression. 

Her symptoms were dismissed as a demonic affliction. Laraba’s parents consulted spiritual healers to rid her of the ‘demons’ they believed were physically torturing her. 

Now, at least, Laraba is starting to get the support she needs at the child and adolescent mental health (CAMH) service run by the Nigerian Health Service in Kaduna, in the country’s north-west. She’s happier and more confident, and has finally started to feel comfortable at school.

Even so, Laraba suffered needlessly for years.

She is very far from an isolated case. Even before the pandemic, one in every five children and adolescents across the world had a diagnosable mental health problem. Covid-19, unsurprisingly, has made the global situation for young people even worse. A recent study of 600 school-going Nigerian adolescents, conducted after a lockdown, revealed that one in every three students had thought of ending their own lives, and around 14% had a major depressive disorder. 

These kids are often unidentified and so receive no mental health support. 

As with Laraba, the low mood, loss of interest and poor concentration associated with their depression is likely to severely impair their school performance. It may be one of the factors contributing to the abysmal numeracy and literacy scores we see for so many children in countries around the world.

Schools as a solution

It could be so very different – and it is schools that offer perhaps the greatest hope of a real change. 

Schools can provide a potentially safe and structured environment for children. They are a place where – as well as completing their education – children can learn social and collaborative skills and build self-esteem, critical ingredients for positive mental health. Structured activities and social interaction can help kids recover from episodes of depression, for example.

Conversely, as in Laraba’s case, adverse school circumstances can exacerbate or cause mental health problems in children – resulting in them doing less well in school. And so, ironically, the institution that should be helping children succeed in life can actually become a massive barrier to them realising their full potential and making a meaningful contribution to society.

To tap the full potential of schools to make a positive difference to the mental health of children and young people, the education sector needs to explore and develop innovative and scientific solutions. Mental health should be part of every school curriculum – emphasising empathy and reducing stigma. And teacher training should be based on the latest scientific understanding of neuroscience and developmental psychology.

This is especially crucial in many low-income countries where, for example, corporal punishment is the primary behaviour-management strategy, despite evidence for its detrimental impact on child mental health.

A concerted multisectoral approach

Other sectors aside from education have a crucial role to play. The policies and practices of health, economic, environmental and law-enforcement sectors, for example, could help address critical factors influencing mental health – such as poverty, food shortages, crime, trauma and climate-change-related anxiety.

The theme of World Mental Health Day 2022 was ‘Make Mental Health and Well-being a Global Priority for All.’ To realise this aspiration, we first need to recognise children and young people are a unique group, with their own particular psychological make-up and mental health needs. Then we need nothing short of concerted multisectoral action. Our future economic development and the lives of children like Laraba depend on it. 

If Laraba’s teacher had received mental health training; if her parents had known about the social, biological and psychological basis of mental health conditions and the scientific and evidence-based treatment options; and if her school’s curriculum had promoted empathy and de-stigmatisation, it could have made all the difference to Laraba – both to her mental health and her success at school and in later life.