Mending teens' mental health in an online world

12 Mar 2020

Straits Times, 12 Mar 2020, Mending teens' mental health in an online world
The age-old pressure to do well in school is not the only thing that bothers students these days.

A growing number of children and youth aged between seven and 18 are being admitted into public hospitals for mental health conditions - from 569 in 2016, to 640 in 2017. In 2018, the number fell to 607, but that is still a fair bit higher than in 2016.

A nationwide effort has begun, with a new network being formed across ministries studying how to improve young people's mental well-being.

Just what is bothering young people these days?

It's hard to sum it up simply, but experts say a large part of the struggles of youth often comes from social pressures, as they are of an age when peer influence is important.

The digital age has created additional stress points for young people to feel these pressures, for example when their constant use of social media means they end up comparing themselves and their lives frequently, and adversely, with the curated images of others.

This is not unique to Singapore, and the Organisation for Economic Cooperation and Development (OECD) had last year raised concerns over how "the digital world is becoming a sizeable part of the real world" for young people, even as they spend more time online.

As Education Minister Ong Ye Kung said last week in Parliament, cyber wellness is closely linked to mental health. Acknowledging these trends, secondary school students will learn about mental health issues in the new character and citizenship education (CCE) curriculum that starts next year.

By 2022, all schools will have peer support programmes and train suitable students to look out for their friends and know how to spot signs of distress. The Education Ministry also outlined last week its plans to guide students to use technology responsibly and wisely, alongside a plan for all secondary school students to have their own digital device, like a tablet, by 2028.

Minister for Social and Family Development Desmond Lee also announced last week a Youth Mental Well-being Network, which has since drawn the interest of more than 700 individuals and groups. The network aims to bring together perspectives and suggestions from different people with the intention to improve youth mental health.

A hub with coordinated mental health and social support services will be set up in Woodlands later this year in a community space in Care Corner, a non-profit organisation, to better support at-risk youth. The Institute of Mental Health, the Health Ministry and the Agency for Integrated Care are also involved in the new programme.

Reporting on education keeps me in touch with school communities and I interact often with teachers, principals and students.

Last month, a Secondary 4 student told me that many of her friends feared being judged or made fun of, especially by popular students online and offline. Sometimes they also receive unkind comments on anonymous messaging platform Tellonym, which is popular among teenagers here.

Another Secondary 2 student said she is on Instagram every day, scrolling through pictures and videos. It is mostly "fun" to see what her friends are doing, but sometimes she regrets posting photographs of herself.

"The more you look at yourself, you ask yourself, 'When did I become uglier?' " she lamented, admitting that she tends to overthink at times.

These are not uncommon sentiments among students. In 2015, the OECD's Programme for International Student Assessment reported that 15-year-olds who used the Internet more than six hours a day were most likely to have lower life satisfaction and well-being.

Community organisations have reported more young people seeking help to cope with cyber bullying, or calling because of suicidal thoughts.

Cyberspace has contributed to changes in young people's psyche because of the heightened public profile they maintain online, unlike previous generations. To get ahead in the endless race for likes, clicks and views, any projection of self posted online is typically biased towards positive experiences, leaving out the negative.

As Nominated MP Lim Sun Sun pointed out: "How youth feel about themselves can be contingent on the feedback they get based on how they portray themselves."

"Instagram is a very visual platform that favours pictures of glamorous, attractive and appealing settings. Young people view each other going to cool places, dining in the right spots, wearing the right clothes, in with the right people," added Professor Lim, who heads the humanities, arts and social sciences department at the Singapore University of Technology and Design.

This can spark comparison and envy and make young people feel discontented with their daily lives.

Mr Delane Lim, executive director of the Character and Leadership Academy, which helps young people understand stress and depression, observed that young people are more likely to seek support online.

"In the past, without social media, we talked to people around us. But now, we Google how to solve a problem and seek advice from strangers online," he said. "Our youth are so well connected online, but in terms of authentic relationship building, they are disconnected."

Yet not everything can be blamed on social media alone. Nominated MP Anthea Ong pointed to research showing that "passive use" of Facebook, or merely scrolling through posts, was associated with lower well-being and life satisfaction. But "active use", where Facebook was used as a means to communicate with others or create content, may have a slight positive impact on well-being over time.

"This may suggest that how children interact with media, as well as the type of media they use, and how long they use it for may all influence mental health and well-being in different ways," she said.

The concerted push to understand the struggles that affect youth underscores the need for society to treat it seriously.

Including mental health in the CCE curriculum will help students know how to identify signs that a person needs help.

As Mr Cho Ming Xiu, founder of Campus PSY, a mental health peer support group, said: "In the past, only peer support leaders would know these things, but now every student will have access to such information, so they can identify early signs of mental health conditions among their friends and even themselves. Early intervention is always better than cure."

Peer support is a useful first line of defence, but schools must ensure that students are adequately trained and do not end up bearing the emotional burdens of their peers.

But more preventive work is needed to help students learn to be resilient, so that they do not buckle under the multitude of pressures.

A lot of work has gone into raising awareness of mental health in recent years, but Mr Lim said an awareness of self and individual coping mechanisms is still lacking.

For example, he says: "Everyone has 'automatic negative thoughts'. When something bad happens, your mind automatically goes into a negative mode."

Students can be trained to identify negative thinking habits, and learn techniques to stop them and adopt better mental habits.

In that sense, helping students combat negativity early in life must be a top priority, rather than waiting till such habits manifest in mental or behavioural problems.

Parents, too, must play a part in redefining happiness and fulfilment for their children, even as society opens up about mental health.

First and foremost, children need unconditional love and affirmation from their parents so that they do not look for them elsewhere, online or offline.

Granted, parenting in the digital era has also got more complex, and the teenage years are often the hardest for parents to reach their children, who may shut them out.

But the first step for parents is to empathise with their children's experience and to keep the channel of communication open, so they know they are not alone.

Prof Lim recommends that parents use the digital platforms their children are on, so they can see how they work and create shared spaces with them.

"Of course you won't be 100 per cent privy to your child's life... but it's also not that different from previous generations. We, too, had our own lives that we didn't want our parents to fully know about."

What matters most, however, is values.

Young people surf the Internet for information. They join online platforms where they post photographs of themselves and share their milestones. They play online games with faceless teammates or opponents.

These are not harmful activities, but as Minister Ong highlighted last week, "technology presents children with influences, choices and decisions that previous generations never had to contend with".

"With a powerful device in each of our children's hands, they can decide - do I use it to acquire knowledge for learning, or access undesirable materials? Do I use it to keep in touch with family and friends, or get addicted to digital entertainment? Do I use it to record meaningful memories, take pictures with my friends, or intrude into the privacy of others, or worse, commit a sexual offence?"

In 2017, about 230 voyeurism cases involving hidden cameras were reported to the police, up from some 150 cases in 2013.

That is why spending more time on cyber wellness and positioning mental health as part of values education are right moves, because there are certain fundamentals in life - like respecting others and having empathy - that we should hold fast to, regardless of what technology allows us to do.

These changes build on the existing syllabus, which aim to develop in students a strong sense of identity, navigate relationships with others and make the right choices.

Mental health is a delicate issue and there are no textbook answers, because not every young person is struggling with the same pressures.

The hope is that the new efforts will provide schools with a clearer framework for cyberhealth programmes. Beyond schools, in the wider public arena, parents and the community also need to shed light on the battles young people are facing and spark public conversations on how best to help them.