An idealised view of childhood is one of the stumbling blocks to overcomewhen it dealing with depression among children. Alison Healy reports
Most people would find it hard to believe that a five-year-old child could be depressed or suicidal but child psychiatrists have urged parents to be on the alert for the warning signs in their children.
In 2002, 203 children under 14 years were treated in hospital for attempted suicide or deliberate self-harm. As these figures do not include children treated by GPs, or children not treated at all, the number of children making such attempts could be much higher.
"A certain percentage do want to die but, for quite a number, it's like they don't care if they live or die," says Dr Kate Ganter, child psychiatrist and chairwoman of the Irish College of Psychiatrists.
Some of these children engage in self-harm activities because they are unable to cope with the intense psychological pain they are experiencing. In the past 10 years for which records are available, 31 suicides have been recorded in children under 14.
"It's a myth that children don't get depressed," says Prof Michael Fitzgerald, child and adolescent psychiatrist and chairman of the Irish Association of Suicidology.
"It's a myth that children don't feel hopeless. It's a myth that they don't get involved in parasuicide." But what does a five-year-old have to be depressed about?
"An enormous amount," he says. Children could get depressed if they suffer from a behavioural problem such as Attention Deficit Disorder and experience constant criticism.
"They could be depressed if they are living in a family with domestic violence, or if they are being bullied or teased. Children have plenty of reasons to feel hopeless.
"It is very important that parents look out for depression and hopelessness in children."
While children may have experienced these issues in the past, suicide was not such an obvious part of culture then, he says. That has changed and we are now living in an increasingly aggressive, violent, fragmented and less child-centred society.
Prof Fitzgerald points to a study of primary school children which found 15 per cent of boys felt that life was not worth living "most of the time" while a further 18 per cent felt life was not worth living "sometimes". "I would think that rate is even higher now since that study was carried out a few years ago," he says.
People have an idealised view of childhood, says Dr John Connolly, psychiatrist and chairman of the Irish Association of Suicidology. "They have the view that children are very, very happy all the time but they can be depressed or have disturbed relationships with their parents or peers."
The increase in alcohol consumption by young people is also a key factor in suicides or attempted suicides, according to Dr Connolly. "We know from our casualty departments that they are dealing with more and more 12 and 13 year-olds who have fallen down drunk in the streets."
Inadequate facilities for children needing psychiatric help is adding to the distress of families in this situation, according to Dr Ganter.
Just 20 beds are designated for child or adolescent psychiatric patients in the State.
"It's a huge problem and a number of children have been inappropriately admitted to adult psychiatric hospitals because of this," she says. "People only do that out of desperation if the child is at high risk but it shouldn't have to happen," she says. Children may also be admitted to paediatric wards but that is also inappropriate.
Dr Connolly says parents should encourage children to talk about their feelings. "There's a myth that talking about suicide puts the idea in people's heads but that's really quite wrong.
- The latest figures are in the 2nd Annual Report of the National Parasuicide Registry. It was launched in Cork yesterday by the Minister for Health, Mr Martin, who said he shared public concern about the rising levels about parasuicide.
His department is working with the National Suicide Review Group and the Health Boards Executive on the preparation of a new "national action-oriented strategy" for suicide prevention," he said.