Nurse Nhlanhla Mofokeng raises awareness about early childhood mental health, and tells us it affects how we think, feel and behave.

“When we speak about health, we often think about the physical body and eating well, exercising and treating illnesses. But mental health is just as important, and it begins much earlier than many people realise.

“Children’s mental health is the building block for their overall well-being, future relationships and success in life,” she explained.

She said early mental health matters because it is a critical period when children develop cognitive and emotional coping skills. She highlighted that emotional well-being influences how children handle stress, learn in school, and connect with others.

“Early experiences, positive and negative, shape the brain and affect lifelong mental health,” she said.

Types of mental illnesses in children:
• Anxiety disorders: Excessive worry, restlessness, avoidance of school and social settings;
• Depression: Prolonged sadness, withdrawal, poor sleep, loss of interest in activities;
• Attention-Deficit/Hyperactivity Disorder: Difficulty focusing, impulsivity, hyperactivity;
• Conduct Disorder: Aggressive or destructive behaviour, lying, stealing, truancy;
• Oppositional Defiant Disorder: Frequent anger, defiance toward authority;
• Autism Spectrum Disorder: Challenges in communication, social interaction, repetitive behaviours;
• Eating disorders: Unhealthy focus on food and body image, sudden weight changes;

She explained that there could be several causes and risk factors, which may include family issues like neglect, abuse or unstable home environments.

Other issues may include:
• Poverty and lack of access to basic needs;
• Genetics and family history of mental illness;
• Exposure to violence, trauma or substance abuse in the home;
• Bullying at school or in the community. Being bullied can cause deep emotional scars, low self-esteem, anxiety, depression and suicidal thoughts.

“Children who bully others also face long-term behavioural challenges,” stated Mfokeng.

The impact of bullying:
• Victims often struggle with low confidence and isolation;
• It can lead to school refusal, poor academic performance or dropping out;
• It increases the risk of depression, anxiety and self-harm.
• The bullied and the bully are at higher risk of future mental health and behavioural problems.

“We must never ignore bullying. It should be taken seriously, reported to teachers, parents and community leaders, and promptly handled. A zero-tolerance approach ensures children feel safe, supported and respected.

“It is important to recognise the warning signs that a child may be struggling and needs help. Persistent sadness or irritability can indicate emotional distress, especially if it continues over an extended period,” she cited.

“Withdrawal from friends, family, or school activities may signal that the child is feeling overwhelmed or disconnected. Sudden changes in eating or sleeping habits and a noticeable decline in school performance are also red flags.”

Mofokeng said one of the most serious indicators is when a child talks about feeling worthless or expresses thoughts of wanting to die.

“This should always be treated as an immediate emergency. Additionally, frequent physical complaints like headaches or stomach aches without a medical cause can be signs of emotional pain.

“Aggressive or destructive behaviour may also reflect deeper struggles the child cannot articulate. Recognising these signs early can be crucial in getting the child the support they need,” she said.

How the community can support children:
• Early awareness: Recognise that children can experience real emotional struggles, not just bad behaviour;
• Safe spaces: Schools, churches, and community centres should be supportive, non-judgmental environments;
• Open conversations: Encourage children to talk about their feelings without fear of being dismissed;
• Parental guidance: Parents should learn positive parenting, patience and the importance of listening;
• Address bullying: Teachers, parents and peers should immediately report bullying and provide counselling to victims and perpetrators;
• Access to services: Advocate for child-friendly mental health services in clinics, schools and communities;
• Reduce stigma: Mental health is not a sign of weakness; it’s a part of overall health.

She concluded by saying, “If we want a healthier and stronger society, we must invest in our children’s mental health. By recognising early signs, addressing bullying and creating safe environments, we can help children grow into resilient, confident adults,” she concluded.