Officials fear looming crisis in adolescent health

Government to examine mental health, violence at home and at school, and physical activity as children become more sedentary

ABU DHABI // The Ministry of Health is trying to come to grips with what appears to be a looming crisis in adolescent health. In a bid to address what the World Health Organisation (WHO) calls a "neglected" area, it has begun a follow-up survey to a 2005 study to better isolate the problem areas and formulate remedial action.

Dr Mariam al Matroushi, director of the ministry's central department of school health, said the survey would focus on mental health, violence at home and at school, and physical activity as children become ever more sedentary. The previous study found that one third of problems faced by adolescents in the UAE were psychological, Dr al Matroushi said. Up to 3,000 pupils aged 13 to 15 at 52 schools - 26 government and 26 private - will be questioned in the latest study, which began last month. The UAE was among the first group of Arab countries to carry out the WHO's school-health survey in 2005, which involved 194 schools.

"The survey opened our eyes to many different issues we need to target," Dr al Matroushi said, "and mental health is certainly one of these which we need to focus on." She is now campaigning to have a counsellor in each school to care for those with medical conditions, to prevent problems and to identify any behavioural issues. "They should be with the children when a situation arises that could lead to stress or psychological problems," she said.

Worldwide, approximately 20 per cent of children and adolescents suffer from a "disabling mental illness", according to the WHO, including anxiety, depression and behavioural disorders. In the Global School-Based Student Health Survey, it found that 13 per cent of the 15,790 questioned had seriously considered attempting suicide during the 12 months prior to the survey and that 9.8 per cent actually considered how they would do it.

Since suicide is strictly prohibited under Islam, there are few regional statistics available on the subject. Worldwide, however, suicide is the third leading cause of death among adolescents, with about four million trying to kill themselves each year, according to the WHO. More than 35 per cent reported feeling "so sad or hopeless every day for two weeks or more in a row that they stopped doing their usual activities during the past 12 months" and more than 15 per cent said they felt lonely "most of the time or always", the global survey showed.

Mental health is still a stigma in the UAE, Dr al Matroushi said, although it has improved as society becomes more open to discussing the subject. "We are progressing in removing its stigma," she said. "We need to address it; this research has shown us this." One of the most surprising finds of the research - which also looked into drug and alcohol abuse and awareness of sexually transmitted diseases - was the prevalence of violence in and out of school, Dr Matroushi said.

The ministry's first study showed that almost a third of students had been attacked at school by bullies during the previous 12 months and that two out of five had been involved in a physical fight one or more times. Dr al Matroushi said this finding had been unexpected. "It puts an obligation on us to teach our children how to resolve our conflicts reasonably," she said. "We should deliver it to them routinely, how to resolve their problems. In our community we feel in general that the UAE is safer than many other countries.

"You rarely hear about people being attacked at night, for example, but when you hear they have been involved in fighting or been the victim of abuse, you feel frustrated." Dr al Matroushi emphasised that this was not limited to school. "It includes everywhere," she said. She said the ministry was trying to raise children's physical activity levels and nutrition after research showed the extent of sedentary behaviour. But she cautioned that positive results would take time to achieve.

"You have to work for years to see results in reducing these levels of obesity and diabetes," she said. "Everybody here is doing something, the ministry, the Red Crescent. Change needs to come through these combined initiatives." Dr al Matroushi said the ministry sought a "comprehensive plan" to change the environment for children. "It's not a healthy country," she said. "In the malls you don't find healthy food. Even in the health institutions you find unhealthy junk food. Our children see us eating badly, so how can we be role models?"

In a conference on adolescent health this week, Dr Suzanne Farhoud, the regional adviser for child and adolescent health at the WHO, said children's health was a "neglected area" that needed to be better understood. "The Ministry of Health can't do it alone," she said. All sectors, including "schools, families, health care providers, teachers, social workers, religious advocates, leaders and the adolescents themselves" must be involved.

@Email:[e-mail] * With additional reporting from Nadia el Dasher