The health crisis caused by the pandemic has pushed many families to the limit. The latest data indicates an increase in self-harm and suicide in minors due to uncertainty and social isolation.
The Spanish Association of Pediatrics has created a multidisciplinary Mental Health in Childhood Working Group made up of pediatric professionals from the Society of Child Psychiatry (SPI), the Spanish Society of Pediatric Emergencies (SEUP) and the Spanish Association of Primary Care Pediatrics (AEPAP) that ask to care for children at risk and their families.
In a statement, pediatricians have warned of the increase in some psychological sequelae such as an increase in suicidal ideation (+244.1%), anxiety (+280.6%) and low self-esteem (+212.3%) during confinement .
During 2020, the ANAR Foundation (Foundation for the Care of Children and Adolescents at Risk) answered 145% more calls from minors with suicidal thoughts and 180% more self-harm compared to the previous two years. Castilla y León and Madrid were the regions with the most cases.
Likewise, that year 14 children under 15 years of age (7 boys and 7 girls) committed suicide in Spain, twice as many as the previous year.
Confinement, socioeconomic pressure from families, fear of the pandemic and mourning for loved ones, and the increase in sedentary activities have been determining factors in the increase in self-harm and suicide attempts in minors.
Absence of a national prevention plan
Pediatric associations denounce the absence of a national plan for the prevention of suicide. Although some Autonomous Communities such as Madrid have their own plan, others do not, which makes it difficult to follow a strategy.
Azucena Díez, member of the Mental Health in Childhood working group of the Spanish Association of Pediatrics (AEP) and president of the AEP Child Psychiatry Society (SPI-AEP), explains to EFEsalud that “a good prevention plan It must include all health professionals who care for minors such as paediatricians, socio-health services and professionals from the world of education”.
The health clarifies that “primary care doctors and paediatricians, together with nursing staff, are a fundamental group to prevent suicidal behavior, since they are in contact with children and their families.”
“Ideally, everyone has basic knowledge, not at the level of a clinical psychiatrist, but they do know how to distinguish whether these self-harms have suicidal intent and determine their severity,” the expert clarifies.
The importance of schools
Schools and other educational centers should be other keys to this strategy. In Spain, schooling is compulsory until the age of 16. Therefore, they can act as “regulators of children’s behavior,” says Azucena Díez.
Díez affirms that “schools must have emotional education subjects, where children are taught to express their feelings, tools to resolve conflicts and, above all, prevention in situations of possible harassment.”
“There is some controversy about whether talking about suicide directly to adolescents can be useful or can give ideas by generating a certain contagious effect. The interesting thing would be to do a more global prevention, ”she explains.
Pediatric organizations establish the following basic priorities:
- Implement training plans for teachers, counselors and management team.
- Detect risk factors and establish care and follow-up measures after suicidal behaviour.
- Know useful strategies to avoid the worsening of the behavior or a possible imitation effect.
- Communicate with families quickly, smoothly and sensitively.
- Train support students to detect cases in the school and social networks.
- Improve and increase material and human resources for mental health care aimed at children and adolescents.
How can families take care of children’s mental health?
Azucena Díez emphasizes that “the most important thing is communication, although in the adolescent stage it can be complicated.”
“We have all been teenagers and it seems that our parents become rivals. Many complain that their parents are too busy, they don’t want to worry them, or that expressing their feelings could invalidate them,” says the expert.
Consequently, many children resort to posts on social networks or to people their age to ask for help in this type of situation. However, Díez recalls that “sooner or later they will have to talk to their parents.”
“The first message for parents is to try to create a climate with open and fluid communication to make the adolescent feel comfortable. This seems very easy, but it is really complicated, although you have to try, ”she expresses.
Approaching their subjects of interest, not peppering them with questions and not addressing them in a tone of order or blame are some of the keys to maintaining good communication, according to the pediatrician.
“When a teenager feels sad, depressed or hopeless and they themselves have the ability to tell their parents, it says a lot about the family dynamics”, he values.
How should one act in a case of self-harm or attempted suicide in minors?
Faced with a warning signal, Díez states: “In a case of self-harm or attempted suicide, the ideal would be to speak with the pediatrician first so that he can assess whether the case should be referred to mental health urgently.”
However, the health company warns that other problems arise here, such as the lack of training of professionals. “Oftentimes, primary care physicians and pediatricians don’t feel trained to do a basic exam,” she says.
Additionally, waiting lists, overcrowded programs, and a lack of mental health professions make it difficult to treat cases.
The pediatrician adds that “the social gap is another problem that particularly worries them, since access for many families is very limited.”
“Families that are aware and have financial means will be able to go to a private specialist to speed up this process, and then they have better prognosis. This is very sad and I consider it an injustice,” she notes.
Suicide, the leading cause of unnatural death among young people
The pandemic has exposed the psychological suffering of thousands of people. Young people and children are a particularly affected group, as reported by the Spanish Association of Pediatrics.
Currently, suicide is the first cause of unnatural death in Spain in young people, according to data from the National Institute of Statistics.
The Youth Institute (INJUVE) reports global prevalence rates of emotional disorders between 6.5% for anxiety disorders and 2.6% for depressive disorders in the child and adolescent population (between 6 and 18 years).
a message of hope
Azucena Díez affirms that “all these children should be given a message of hope and that they are not alone because everything has a solution, even if it doesn’t seem like it”.
Also, remember that they can contact an adult such as the school principal, social services or emergency telephone numbers such as 112.
In Spain, there are many ways to ask for help in case of suicide. On the one hand, the hope phone (717 00 37 17), attended by an NGO.
The ANAR Foundationspecifically for children and adolescents, also deals with cases of self-harm and suicide in childhood.
Likewise, the Government approved last December the start-up of 024, a suicide hotline that will be available in May for the entire State.
Social networks such as Instagram, Tik Tok or Facebook have protocols to provide help in case of suicide risk with specific phones for each country.
