Health AreasNon-communicable Diseases

The impact of trauma on children’s mental health

Mummy, ona moto!! (Mummy, there’s a fire. Come and see!)

Bahati called out to his mother who was in the kitchen preparing that evening’s meal. Bahati is only seven years old. He had been playing in their sitting room as the images of a car on fire aired on television. It was in the background until the screams of a lady being rescued attracted this young mind to the screen.

The ambulance sirens grew closer and louder.

Mummy! Mummy! Come and see!

He beckoned further! His mother came and assured him that they would all be rescued then she returned to the kitchen.

That evening, Bahati couldn’t sleep. The images from the burning cars replayed in his mind. The screams from the lady sounded like they had come from under his bed. Bahati’s sisters and his parents stayed awake and assured him that the event had been contained and everyone rescued. But Bahati held onto his mother’s shirt all evening and in the morning he refused to attend school.

Child and adolescent psychiatrist Dr Josephine Omondi explains that children are not immune to traumatic events; even when they are exposed to them by proxy, like Bahati had.

Dr. Josephine Omondi, Child & Adolescent Psychiatrist, Kenyatta National Hospital

Dr Omondi defines mental trauma as the experience of an event by a child that is emotionally painful or distressful resulting in lasting mental and physical effects. Whereas most of the awareness on trauma has centered on adults, Dr Omondi notes that children also get traumatised affecting their daily lives.

“The exposure to trauma on children is often unappreciated and in most cases is untreated. The child suffers silently hence can affect the child’s social interactions,” Dr Omondi added.

“Adults can help kids recover from traumatic experiences by understanding the effects of a child who has been exposed to trauma,” Dr Omondi said. She further noted that psychological trauma causes horror, terror, or helplessness in children.

Some of the common causes of psychological trauma in children include:

  • Family conflicts/ domestic violence
  • Sexual abuse
  • Physical abuse
  • Natural disasters like floods
  • Accidents
  • Separation from parent or care-giver
  • Bullying

Whereas the effects of the events above vary from one child to another, Dr Omondi notes that there is a need for a keen family member, guardian or even teacher to investigate the reasons behind a change in the child’s routine.

These include:

  • Irritability
  • Poor sleep pattern
  • Sadness
  • Withdrawal from peers & play
  • Clinginess
  • Development of new fears
  • Fear
  • Depression
  • Anxiety
  • Anger and aggression
  • Self-destructive behavior
  • Feelings of isolation
  • Poor self-esteem
  • Difficulty trusting others

If unaddressed, child trauma survivors are at a higher risk of having long-term health problems and difficulty in maintaining relationships or even keeping jobs. Dr Omondi further explained that whenever a child is exposed to a disturbing event, they do not always develop traumatic stress.

Some of the factors that determine the impact of the psychological trauma include:

  • Severity of the event
  • Proximity to the event
  • History of trauma
  • Family and community factors

What kind of help is available?

Dr Omondi notes that one of the key principles of seeking help from the medical experts is accepting that there has been a change in the child’s behaviour and routines hence an intervention is needed. However the paediatric mental health specialist is keen to observe that there are medical and non-medical options of treatment that are arrived at after a consultation with the doctors and a discussion held with the child’s parents or guardians.

“The non-medical options include talk therapy where we encourage the child to explain what they saw, felt or heard. We are keen to listen to their descriptions and watch their expressions,” Dr Omondi noted. In other instances, we explore play therapy where we ask the child to draw imaged from the experience or request them to enact the scene, Dr Omondi added.

Dr Omondi noted that in some fewer cases, medicines are given however this is after a series of assessments are done and the young patient followed through to ensure that this form of treatment is given alongside the non-medical options like talk and play therapy.

Whichever mode of treatment is chosen, Dr Omondi cited the need to re-assure the child that harm will not happen anymore and also have social support in place from the family and community. Their questions should also be honestly responded to and establishing a daily routine is part of the recovery.

While the treatment is ongoing Dr Omondi advises that the child should be surrounded by love and also praise the child if they are coping well.

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