The current economic recession and its attendant consequences such as retrenchment of staff leading to unemployment, and worry over inability to meet daily expenses and scarcity of essential items has raised the level of stress and depression on the Lankan public as a whole.
Health officials have thus raised concerns that this could lead to a surge in both physical and mental health problems country wide. They have also noted that those most vulnerable to the negative impact of the current economic recession are children who due to schools being closed for most days of the week and deprived of their routine classroom learning and social interactions with their peers , are now compelled to study on line.
The Sunday Observer spoke to Senior Lecturer, Dept. of Psychiatry, University of Sri Jayewardenpura andConsultant Child and Adolescent Psychiatrist Colombo South Teaching Hospital Dr Yasodha Rohanachandra to find out how the decision to use Distance Education as the main tool for teaching school children impacts on our teen population who are facing various fears and uncertainties on the brink of adulthood.
Excerpts
Q: We are now in the midst of a severe economic crisis that has negatively impacted Sri Lankan people of all ages. How has it affected the adult population?
A: Mentally it has raised the levels of stress and depression in adults who have lost their jobs with no other income for daily expenses, with some (males in particular) resorting to substance use and experiencing suicidal thoughts. Physically this stress has also led to the risk of more cardio vascular disease and non communicable diseases (NCDs) like hypertension, diabetes and strokes.
Q: In what way has the current economic crunch and its fallout affected the physical health and development of children ?
A: Early child development depends on responsive caregiving, adequate nutrition, good health, security, safety and opportunities for early learning. Economic downturns lead to increased parental stress and longer working hours. This makes parents less capable to provide opportunities for play, exploration and cognitive stimulation, all of which can hinder child development. Research done in other countries during previous economic recessions have shown that such periods can be associated with poor birth outcomes such as higher rates of low birth weight and preterm delivery. Increased infant mortality rates have also been reported. Increased prevalence of malnutrition, stunting and nutritional deficiencies among children is also likely, as food prices soar sky high. Children from low-income families are especially vulnerable to develop such physical adversities.
Q: How has it affected their education?
A: Firstly, reduced parental income makes it difficult for parents to cover the basic costs of education, which may lead to reduced school enrollment and higher school drop-out rates. Drop in school enrollment is likely to affect children from poorer families the most and children from families where a parent suffered job loss are more likely drop out of school. In addition, parents may have to work for longer hours to meet the higher financial demands, resulting in reduction in the time they can assist children in their schoolwork.
This may lead to poorer academic achievement in children and adolescents. Economic recession can also reduce the quality of education due to the restrictions imposed on funding for schools. Higher rates of teacher absenteeism have also noted during past economic crises, as teachers engaged in other part-time employment to meet their financial needs.
Parental unemployment during an economic recession and rising cost of living may force parents to turn towards child labour. The age of the child, family income, parents’ educational level and family size and make up all play a role in determining whether a child will be pushed to engage in labour during a financial crisis. For example, children in secondary school are at a higher risk of leaving school to engage in child labour than primary school children.
It has been charged that the tendency to focus on on line classes has resulted in sidelining an important health problem in students, namely their mental health. Do you agree?
Students have just begun to get back into track after schools were closed for prolonged periods due to COVID. And now their education seems to have become disrupted once again. This may cause them to lose their motivation for studies, and they may also get the impression that school is not important.
Q: Studies have shown that lack of in-person interaction in online courses has led to a sense of isolation and disconnectedness from a learning community among students . Your comments?
A: Age-appropriate social interactions are an essential requirement for the development of social skills in children and adolescents. It is through interaction with peers at school the children learn sharing, working as a team, how to solve problems and to accept winning and losing. All these skills are vital for healthy interpersonal and professional relationships in adulthood. By depriving our children of the opportunity to develop these essential skills, we will be creating adults who are incompetent in social relationships.
Having to constantly be on the computer to meet deadlines given by on line teachers has resulted in the home environment no longer being a peaceful place for students to study, live and relax. Recent studies have found that relaxing at home and being able to find time to talk with the family and enjoy some family games goes a long way in relieving such adverse mental impact. Do you agree?
Yes, definitely. We have seen an increase in conflicts between parents and children and conflicts between siblings during the period of online teaching in the pandemic. Home does not have an ideal environment for learning and parents are not trained to be teachers. Thus, online teaching can be stressful to both children and their parents.
Q: Students studying on line often complain it is more stressful than face to face classroom teaching. What is your opinion on this?
A: Online learning can definitely be more stressful, especially to younger children and children who find schoolwork difficult. Young children learn best with activity-based learning and tend to lose attention easily in online learning. During online learning, teachers are not able to see whether the children are paying attention and are not able to see their facial expressions. The teachers also don’t get the opportunity to check the students’ books. Thus, the teachers will have difficulty in identifying students who are lagging behind. In addition, in online learning, the class size is usually large and sometimes the lessons are not conducted by the child’s usual teachers..
Q: New research on the increased use of computers or devices for online learning has revealed some disturbing physical health outcomes, such as negative physical impacts on the users, including spine and back problems, eye strain and dry eyes. It also reveals that computer-related physical stress is likely to be exacerbated with prolonged screen time. What’s your take on this?
A: Yes. Spending too much time on screens is known to be associated with increased risk of eye fatigue, blurring of vision, dryness of eyes, eye discomfort, problems with distant vision, transient double vision and eyelid tics. In addition, I must add that excessive screen time robs children of outdoor time and physical activity. This sedentary lifestyle associated with excessive screen time can lead to obesity and increased risk of diabetes, hyperlipidaemia, high blood pressure and cardiovascular problems in later life. Screen time is associated with musculoskeletal pain and discomfort via its effect on posture and could have an effect on their growing bodies .
Q: In retrospect, if you were asked to summarise the impact of the economic recession on the mental health of children and adolescents, what are the key factors to bear in mind?
A: Economic adversity can cause increased stress and higher risk of behavioural problems in children and adolescents. These negative outcomes are mediated through increased parental stress and the changes quality of parenting..
Parental stress is likely to affect their interactions with their children. Parents are known to resort to harsh, inconsistent parenting methods and are known to be less supportive and sensitive to their child’s needs due to their own stress. These changes ultimately lead to elevated emotional and behavioural problems in their children. In addition, financial difficulties itself, can cause additional stress to children and adolescents, as they may also worry about their family finances. There is also evidence that the negative mental health effects of economic adversity may persist for several years, with higher rates of violent crimes, substance abuse and chronic health problems in affected children and adolescents in later life. Moreover, the cumulative stresses associated with economic hardships can increase the risk of child maltreatment. Parents having to work for longer hours to meet financial needs, may leave children unsupervised for longer periods and may be a risk factor for child abuse.
Q: As a leading authority on Child and Adolescent Health have you any suggestions on what can be done to reduce these negative psychosocial impacts of the economic recession and how would you fill the gaps to this end?
A: Measures should be designed to identify families that are likely to be most affected by the recession. Such families should receive extra financial and social support to prevent adverse physical and psychological consequences. Maintenance of funding for health and education is important to minimise the adverse impact on health and education. Continuation of uninterrupted schooling is vital to reduce the impact on mental health and education on children.
Increased substance use during periods of recession contributes to increased family conflicts, increased mental health problems and suicide. Therefore, regulation of the marketing of alcoholic beverages, restrictions on their availability, and taxation have been suggested as useful interventions to reduce substance use disorders during an economic recession.
Q: Have you a message to parents on minimising the mental stress of on-line teaching on their children?
A: Parents should realise that home environment is not optimal for learning and that children may not have the same motivation for online learning as in person schooling.
Parents should create a quiet place for online learning with minimal distractions. The devices used for online learning should be kept in an open area, where it can be supervised by an adult, to make sure that children do not engage in other online activities while doing online classes. Parents should install appropriate child safety measures in their devices to prevent children from accessing inappropriate material. Parents should make sure that the child has plenty of opportunities for outdoor play and in-person social interactions while engaging in online learning.
Q: Any contact line which a teen can reach when faced with a psychological problem ?
A: Talk to your friends and family. If you feel that they cannot help, seek help from a mental health professional. You can easily reach a mental health professional through the mental health helpline of the National Institute of Mental Health, at 1926. Mental health support is also available at Mithuru Piyasa and Yowun Piyasa centers at government hospitals.
All base, district and teaching hospitals also have psychiatry clinics where you can get help from a consultant psychiatrist.