In South Africa, little research has been done on depression and anxiety among younger adolescents, those between the ages of 10 and 14. Existing studies have primarily targeted older adolescents and those living with HIV.
The age range of 10- to 14-year-olds has been neglected. This age group is important because half of all mental health problems develop before the age of 14.
As mental health researchers we conducted a study focusing on these young adolescents in 10 schools in under-resourced areas within Cape Town and the Cape Winelands.
How we conducted the study
Working with community-based organisations offering psychological and social support and counselling, we recruited 621 adolescents aged 10 to 14 in 10 primary schools.
The criteria included adolescents who: (1) were enrolled in the selected schools in the Western Cape province; (2) were aged 10 to 14 years; (3) provided assent; and (4) had caregivers who provided consent for their child to participate.
Using a tablet-based survey, we gathered information on sociodemographic factors, mental health symptoms, substance use, bullying, punishment, witnessing violence at home and self-esteem.
Mental health symptoms were measured with internationally accepted screening tools, namely the Patient Health Questionnaire for Adolescents for depression symptoms and the Generalised Anxiety Disorder Scale 7 for symptoms of anxiety.
The majority of the adolescents were female (61%) and the average age was 12 years. More than half (58.6%) lived with a single parent and 15.3% did not live with either of their parents.
More than two-thirds of the participants reported speaking two languages at home, with 402 (64.7%) speaking English, 321 (51.2%) speaking isiXhosa, 112 (18.0%) speaking Afrikaans, and 60 (9.7%) speaking another language.
What we found
We found that a high percentage of adolescents reported experiencing bullying at school (80.5%), witnessing violence at home (78.6%), and being exposed to punishment by caregivers (56.4%).
A significant portion of the adolescents had tried alcohol at least once (23.8%).
Depression: 33% experienced symptoms of depression such as feeling sad or down, irritability, hopelessness, trouble sleeping, appetite changes and difficulty concentrating. Depressive symptoms were linked with being in a higher grade in school, alcohol consumption, the use of other drugs, and witnessing violence among adults at home.
Anxiety: 21% reported symptoms of anxiety. These included difficulty controlling worry, feeling afraid or scared, feeling irritable, trouble concentrating and feeling restless. Significant associations were found with being in a higher school grade, poor emotional regulation skills, and cannabis use.
Going forward
Although the high levels of depression and anxiety symptoms do not indicate a definite diagnosis for each of the young adolescents, these figures are very concerning for this age group. They highlight the urgent need for comprehensive mental health support in schools.
To address this gap, the researchers are piloting the World Health Organization’s Early Adolescent Skills for Emotions (EASE) programme at some of the schools in the Western Cape.
EASE is a group psychological intervention for 10- to 14-year-olds and their caregivers which can be delivered by non-specialist providers to improve their mental health.
Claire van der Westhuizen has received funding from Fogarty International and the Wellcome Trust.
Katherine Sorsdahl has received funding from Wellcome Trust and the UK Medical Research Council.
Mirriam Mkhize does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
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