It's a sobering fact, it was reported recently that suicide remains the leading cause of death for people aged 10 to 29, with 94 cases in 2019, the same figure as in 2018.

The numbers are stark: Ten females aged 10 to 19 took their own lives last year compared with three in 2018, while 13 boys in the same age group committed suicide last year, compared with 19 the year before.

It’s not “nice” to think about it but in our high-stress world, stress is inevitably filtering through to our children. This could be emotional or psychological pain ­— whether it’s caused by societal pressures, family, peers or even by our children putting undue pressure on themselves.

The COVID-19 pandemic ­— an uncertain situation, job loss worries, ­at-home conflict — has only deepened an at-risk individual's anxiety, insecurity and fears. In response, the Samaritans of Singapore (SOS) launched a text-based service in July called SOS Care Text for people in distress or contemplating suicide. This text messaging option is an alternative form of emotional support to its phone hotline.

So how do we know when a child is so badly affected? We put the question to psychologist Daniel Koh of Insights Mind Centre.

So, are parents usually aware that their child is dealing with emotional or mental health issues?

Parents may not be aware of the children having depression, may not notice or believe that their children can be depressed. Then also, children may not be aware that they are having depression — and that would prevent them telling others about it or seeking help!

What are the reasons for depression? School stress or possibly bullying?

There are so many! Triggers can be like feeling trapped in a situation, feeling hopeless/helpless, being unable to cope, suffering from a change of environment, not performing as expected (at school or otherwise), family issues trickling down to the child, social issues — perhaps the child is too self-critical? — pressure, feeling guilty, feeling that they have disappointed/failed others. There are many reasons.

Are there obvious signs that a child is depressed?

Emotionally, you’d probably see prolonged sadness that the child seems unable to recover from; crying; mood swings; displaying unusual sensitivity; suddenly turning quiet; expressing loneliness, anger or aggression; unusual anxiety or stress, or just manic behaviour — these are all signs that something is off.

Behaviourally, well, you might want to talk to your child if they start to be isolated and withdrawn, if they seem to have lost pleasure in favourite things and activities, if they seem to be avoiding people or specific places, if your child seems to be distracted with poor concentration and constantly restless and fidgeting.

And of course, the biggest sign is when they talk about or attempt self-harm or self-punishment or suicide.

What can a parent or friend of the family do? It’s awfully difficult to get a child to articulate what’s wrong…

There isn’t an easy answer: One has to give the child comfort, security and safety. Comfort, that you love the child no matter what happens, to show that you know the child and not just who you want the child to be.

Security means you have to protect your child and not betray their trust when they speak out. You need to keep your word, and be fair and non-biased. Most of all, you must never compare your child with other children — comparing them “tells” your child they are not only a failure but not liked.

Children take time to think out what to say or how to express themselves — especially younger children — so give them the chance and be patient. This sends them the cue that you are open to them at any time. Do not give them a deadline as it will push them away.

Is there anything else that parents need to know?

Be aware of transference (redirection of feelings from yourself to your kid). Be aware of your own behaviour and comments. When a child is depressed, they are lost, do not take away what remaining comfort they have because this may push them over the edge. Even if you are angry, anxious, stressed, do not show it in front of the child and remember that depression is beyond a person’s control, they are not trying to make you angry but are crying out for help.

How to help a distressed child

If you know a child showing signs as described above, what can you do? Two major, free resources are the Tinkle Friends web chats/phone lines by the Singapore Children’s Society, as well as the Samaritans of Singapore (SOS) helpline.

* Tinkle Friend Helpline: 1800-2744-788

* Tinkle Friend Online Chat: www.tinklefriend.com

* SOS helpline: 1800-221 4444

* SOS e-mail: pat@sos.org.sg

* National Addictions Management Service: 6732-6837

Photo: iStock

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