Depressive-related distress in Mauritian and South African

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Depressive-related distress in Mauritian and South African
Adolescent Girls
Paper Presenter: Harshalini yashita Bundhoo, University of Mauritius
Author(s):
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Anthony L Pillay, Univeristy of Kwazulu-Natal, South Africa
Harshalini Yashita Bundhoo, University of Mauritius
Uma Bhowon, University of Mauritius
Over the last two to three decades depressive illness in adolescent girls has become a
significant concern among mental health specialists, and society in general. This is despite
the finding of a comprehensive review confirming that there is no epidemic of depression
in young people (Costello, Erklani & Angold, 2006). Of course, the related features of
suicidal ideation and behaviour make this problem one of the more pressing mental health
emergencies. It is also a critical area that demands national attention and investment in
terms of prevention approaches and mental health service delivery systems.
Depressive illness is known to affect adult females at about twice the rate found in males
(American Psychiatric Association, 2000). Research with younger people have also
highlighted increased vulnerability among girls, with longitudinal research showing that
girls are at higher risk than boys, for depressive symptoms by the 12th grade due to their
experiencing more challenges in early adolescence (Petersen, Sarigiani & Kennedy, 1991).
Moreover recent research has revealed that girls report more depressive symptoms in
interpersonal contexts like peer events, and tend to respond to stressors more strongly
than boys, more often in the form of depression (Hankin, Mermelstein & Roesch, 2007).
There is also evidence suggesting that the vulnerability to depressive symptoms may be
related to earlier variables such as low birth weight which has been found to predict
depression in adolescent girls, but not boys, when life adversities are present (Costello,
Worthman, Erkanli & Angold, 2007).
Internationally self-harm behaviours constitute a high risk problem for adolescent girls
(Evans, Hawton, Rodham & Deeks, 2005), with girls in the 15-19 year age group most
vulnerable (Rodham, Hawton & Evans, 2005). In many instances adverse life situations
and stressors play a role in the development of depressive and self-harm intentions in this
age group. How adolescents cope with adverse experiences, and the extent to which they
access (or have access to) health care resources, will obviously mediate the effects of
those life experiences.
Recent research on adolescent coping has found that one of the reasons that girls suffer
more depression than boys relates to their greater tendency to cope with problems by
ruminating (Li, DiGiuseppe & Froh, 2006). Research has also indicated the need for
interventions to disrupt the continuity of stressful conditions across adolescents as a way
of reducing the likelihood of earlier adversities precipitating depressive responses (Hazel,
Hammen, Brennan, & Najman, 2008).
Against this background the authors were interested in the levels of depressive and related
symptoms in adolescent girls in their respective countries (i.e. South Africa and Mauritius),
and especially those in lower socioeconomic communities. To this end they designed a
programme to (i) briefly assess such symptoms and (ii) provide mental health promotion
information within a secondary school context. It is the former that is the focus of this
paper.
The samples were drawn from high schools in Mauritius and South Africa. Since the study
was a preliminary cross-national investigation of self-reports of depressive and stressrelated symptoms in adolescent girls, the authors focused on one secondary school in each
of the countries. All girls in the respective schools between the ages of 14 and 17 years
were identified as possible participants.
The authors constructed a short questionnaire comprising of 6 questions, in addition to the
age and gender information. These focused on thoughts about and attempts at suicidal
behaviours; sadness/tearfulness everyday for over two weeks during the past year; having
a friend to talk to when feeling sad; feeling that the problems are too much to cope with
alone; availability of resources to access in times of distress. The questions required a ‘yes’
or ‘no’ response. The questionnaires were distributed and participants were requested to
complete them by checking the relevant ‘yes’ or ‘no’ box, but not to write their names on
the form. They were also informed that they were free to participate or not to participate.
There were 198 participants in the Mauritian sample (mean age = 15.02 years, s.d. =
0.79) and 275 in the South African sample (mean age = 15.67 years, s.d. = 1.03). Around
one-quarter of the girls in both samples had thought about self harm during the past five
years, while between 14.6% and 16.7% had made self-harm attempts. Around one-third
reported being sad and tearful everyday for more than two weeks over the past year. Over
half the Mauritian girls and almost one-third of the South African felt their problems were
too much to cope. One-fifth of the South African girls and twice that proportion of the
Mauritians knew of no places to go for help when feeling sad or depressed.
The present finding is clearly suggestive of significant psychological distress, for which
professional help is evidently indicated. Moreover, in the absence of intervention the
likelihood of suicidal behaviour is a serious concern. Around one out of six girls had a
history of self-harm attempts is worrying considering that individuals with such a history
are known to be at significant risk for further self-destructive behaviours (Pfeffer, 2003).
Also of concern is the extent to which these individuals are able to access mental health
care services. There is evidence to show that only around one-quarter of individuals
engaging in suicidal behaviours access health care facilities (World Health Organisation,
2002).
The present findings reflect significant areas of concern regarding self-harm ideation and
behaviour, as well as depressive symptoms, in Mauritian and South African adolescent
girls. In addition, large proportions of girls in both samples reported not being able to cope
with their problems, and not knowing where to go for help. The findings point to the need
for programmes aimed at increasing awareness of mental health issues and resources in
young people, in an effort to enhance psychological well-being. Even in contexts where
mental health services are available, it is vital that young people are made aware of them,
their uses, and modes of access.
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