A RECORD number of children and adolescents aged 19 and below have been seeking help at the Institute of Mental Health (IMH).

However, this does not necessarily mean that there has been a spike in mental illnesses among the young, the IMH said.

Instead, this could be due to an increased awareness of such illnesses and the greater number of outreach programmes.

Last year, the IMH's Child Guidance Clinic, which provides psychological and psychiatric services for those aged 19 and below, saw nearly 3,000 referrals.

By contrast, from 2000 to 2006, the IMH had between 2,000 and 2,500 annual referrals, mostly from schools or polyclinics.

It said that most of the new cases were children with attention deficit hyperactivity disorder (ADHD), learning disorders or emotional disorders such as excessive worry, fear and sadness.

The increase in the number of referrals did not necessarily indicate a higher incidence of mental illness among students, said Dr Ong Say How, the IMH's deputy chief of the department of child and adolescent psychiatry.

He pointed to better public knowledge of the IMH's services and programmes and more school counsellors who were 'more vigilant and ready to refer students to the IMH's clinics' as other possible reasons behind the rise.

The number of full-time school counsellors has risen from 270 last year to 360 now, in line with the Ministry of Education's plan to have a counsellor in every school by this year.

Just as importantly, the stigma of having a child referred to counsellors or psychiatrists has diminished, said one primary school counsellor.

'In the past, people thought it was a bad reflection of their parenting skills if they needed to bring in their child for help,' he said.

'But now, if you don't bring in your child to seek help, that is seen as bad parenting.'

There are also new initiatives such as the Response, Early Intervention and Assessment in Community Mental Health (Reach) scheme.

Launched in August last year, it aims to train some 50 general practitioners and 350 counsellors over the next five years in the early detection of childhood conditions such as ADHD, anxiety and depression.

Eight out of the 10 counsellors and psychiatrists interviewed also noticed an increase in the number of young people seeking help.

They partly agreed with Dr Ong, but felt that greater awareness may not be the only reason behind the higher numbers being treated.

These experts were concerned that, besides the higher stress faced by young people today, there seemed to be a greater lack of parent-child interaction.

Longer hours in school and at work meant that family members were spending less time together.

During interactions, parents inevitably asked about schoolwork and test scores rather than about their children's well-being, noted Ms Koh Wah Khoon, the director of family services at the Singapore Children's Society.

She has noticed a trend of children equating their self-worth with how far they had met their parents' expectations.

Today's children also have another thing vying for their attention: the Internet.

Ms Jessica Leong, a counsellor in private practice, said that more parents had problems getting their children to bed as their kids stayed online till early in the morning.

While the problem used to be limited to university or polytechnic students, she now has children as young as 11 brought to her.

When parents do not spend time to impart necessary life skills, their children may not be able to cope with crises when these happen, said Dr Ong.

Compounded with the fact that most children had fewer opportunities to experience major life events or adversity today, this generation may not be as resilient when coping with stress, he noted.

But doctors assured parents that there was no need to be alarmed by the new figures.

Said Dr Alex Su, the IMH's head of emergency services: 'They're seeking help rather than suffering in silence. That is a good sign.'

This article was first published in The Sunday Times on Mar 16, 2008.