Young patients' depression a challenge for doctors

School connections

In January, Fudan University Children's Hospital established a club - the first of its kind in China - to offer psychological support to children with chronic diseases and help their parents handle the pressure.

The hospital used to have 22 clubs, each dedicated to children diagnosed with specific diseases, but they have been integrated to offer a more comprehensive service.

The new club began its work with children with attention deficit hyperactivity disorder, or ADHD, said Xu Hong, the head of the hospital.

Attention and behavioral training as well as baduanjin, a Chinese stretching exercise with a history of 800 years that has been shown to improve the body functions of children with ADHD, were introduced at the club once a week and warmly welcomed by young patients.

"We're considering setting up a choir in August," Xu said. "Art therapy and psychological support are beneficial for the children's all-around development."

Zhu, who is a doctor with the hospital's psychology department, explained that children diagnosed with ADHD tend to feel much more pressure than their peers.

"It's mainly because teachers and even parents don't relate their behaviors to sickness, but believe it's owing to their bad attitude," she said. "But in fact it's a disease related to the imperfect development of the nervous system."

The hospital also plans to forge connections with nearby primary and middle schools so it can carry out early assessment, diagnosis and follow-up treatment for children with psychological issues.

"Without due communication between schools and hospitals, which are on different ends of offering psychological health education and medical services to children, it often happens that the school may treat a child's psychological problem as a moral deficiency, and the hospital's treatment plan lacks advice from teachers familiar with the child's situation," said Gao Hongyun, the hospital's head of psychology.

Such cooperation will allow doctors to enter schools to screen children for potential psychological problems through surveys and other approaches, facilitating early detection, she said. For children with chronic diseases, teachers and doctors can work together to form plans to ensure minimum disruption to medical treatment or their studies.

Kang Min, principal of Minhang District Experimental Primary School, said such screening has been conducted in schools for years, but most parents dodged the fact their children have psychological issues.

"Screening conducted by professional hospital doctors may be more authoritative," she said.

Gao added that lectures will also be held on ways to eliminate a sick child's feeling of shame.

At Shanghai Children's Hospital, since spring 2016, patients with leukemia have been provided with regular classes that are synchronized with the school curriculum and taught by teachers.

Niu Jun, head of the hospital's social work department, said a survey three years ago found nearly two-thirds of young patients experienced serious emotional changes after falling ill, and their top concern was about schooling. Such children usually have to be hospitalized for weeks at a time over a period of two or three years.

"Such emotional change is more obvious with older children, especially those who performed well in school before entering the hospital," Niu said. "Many would become depressed and reserved, which puts extra pressure on their parents.

"We established a platform for children to interact with peers and have access to school education, to boost the confidence of children and their families."

Cao Jing, the mother of an 11-year-old boy who is a patient at Shanghai Children's Hospital, said he looked forward to the classes every week. "He'd even like to attend the classes for younger children," she said.