The Malta Independent 8 December 2021, Wednesday

Young people exhibiting increase in externalising behaviours – MAP

Shona Berger Sunday, 5 September 2021, 09:00 Last update: about 4 months ago

Children and adolescents are exhibiting an increase in externalising behaviours at home with family members following the peak of the Covid-19 pandemic, according to the President of the Maltese Association of Psychiatry (MAP), Nigel Camilleri.

From their academic success to their social skills and mental health, the Covid-19 pandemic has negatively impacted today’s children. Although the public health authorities and government have done everything to care for people’s physical health, the mental health of the nation needs to be thoroughly considered and looked into following the impact of the pandemic, Camilleri said.


The Malta Independent on Sunday spoke with the MAP President Nigel Camilleri as well as counselling psychologist Franica Cassar. This was done in order to identify whether aggressive behaviour among the public has increased due to the pandemic, what might be the root causes of aggression and whether they’ve noticed a striking change in pattern with regard to conditions amongst clients.

Camilleri, who generally deals with children and adolescents, highlighted a number of factors, which when combined together lead to a better understanding as to why aggressive behaviour might be on the rise. Consequently, saying that he would not be surprised to see youngsters presenting acting-out behaviour more than usual.

Apart from an increase in externalising behaviours at home, Camilleri also noted an increase in this kind of behaviour when it comes to outside violence as well.


Stress factor

“The pandemic has been a stress factor across all ages, thus leading to a surge in a range of mental illnesses from anxiety, depression through to psychosis. The pandemic has also led to a significant surge in the number of referrals made. When looking at the registered statistics within services for children and young people, one can note that both within the state and private sector, referrals have not stopped,” Camilleri said.

He emphasised that two of the potential reasons for increased aggressive behaviour were the closure of schools and sport facilities. Throughout the pandemic, students have experienced an unexpected and unpredictable change in their educational experience, from schools being closed and re-opened to receiving their education through online means. Students were also restricted to their homes as they could not participate in any curriculum activities outside of school as a preventive measure against the virus.

At this stage, statistics on whether aggressive behaviour has increased due to the pandemic, whether there is a relationship between the two factors, whether there are any other reasons behind this increase or whether this is just a stand-alone phase, have not yet been gathered. 

However, “a striking difference we’ve noticed, is the number of parents who decided to enrol their children in summer schools this year. When compared to previous years, this number has decreased due to the pandemic, at the result of children spending their time more at home or playing outside in the street,” Camilleri said.


Boredom and limited movement

Consequently, spending more time at home usually leads to boredom, due also to the significant increase in screen time, thus causing trouble. Boredom does not lead to trouble in all cases, but it cannot be denied that in others it does.” 

The very limited physical movement during the pandemic negatively affected a substantial number of children. Camilleri explained that many parents shed light on the fact that since the first and last closure of schools in Malta, children with conditions such as anxiety have struggled to get back into school or get back into routine.

“We believe that we need to focus on reducing the risk of Covid-19 cases but not to the extent of closing schools and sports facilities. All educational institutions, including University as well as Higher Education, need to reopen as young people have been deprived from that social interaction for a very long time,” Camilleri said.


Mental health strategy

With regard to the measures being taken in a bid to help the nation deal with mental health issues caused by the experience of the pandemic, Camilleri explained that “so far, the government has taken the initiative to involve the MAP in order to identify what is needed to deal with the aftermath and ‘tsunami’ of mental health illnesses that we will start seeing post-Covid. As an association, together with the Chair of Psychiatry, we have presented a number of proposals on what could be done.”

In line with the Mental Health Strategy, Camilleri remarked that “we’ve also seen an increase in psychiatrists as well as a doubling in the number of trainees who have been chosen to enter the field of psychiatry. This shows that the demand has increased, thus the government is looking into increasing its manpower, as without it, we will not be able to address peoples’ needs.”

Moreover, Camilleri also highlighted that Malta lacks forensic services for adolescents, in terms of offering facility and community service, both before and after the pandemic. This means that when young people offend, they are treated at the Corradino Correctional Facility, which does not have a therapeutic community setting.

“There is a need for these facilities to be implemented as well as a need for age-appropriate youth groups (not related to religion) which can be local district based, led by youth workers, motivators, amongst others. We also need trained staff who offer Dialectical Behavioural therapy as well as ABA therapy (Applied Behaviour Analysis) in order to address behavioural problems in young people,” Camilleri said.


Fear and anxiety

Meanwhile, counselling psychologist Franica Cassar said that the Covid-19 pandemic created fears and high levels of anxiety amongst many people due to the lack of control over their own lives.

“Despite this, although an increase in anger amongst clients is evident, I do not believe that this is due to the pandemic but the increase in violence is due to our individualistic society,” Cassar said.

“We are living in a world that is disconnecting us from social communities and making us more individualistic, more self-centred and more narcissistic. We are growing in a society in which we focus on ourselves and our close family members, making us less empathic towards others.”

“We are living in a society that pressures us to reach a certain social class due to what we are exposed through the media. Thus, we are constantly pressured to work harder in order to achieve more. Little do we notice that this comes at a price,” Cassar said.


Short temper, loss of control

She explained that in order to sustain a particular kind of lifestyle, people spend more time working, leading to more frustration and irritability. This also leads people to be more short-tempered and have less control of their emotions.

Therefore, due to this individualistic sense of self and narcissistic traits, people may start feeling entitled to certain needs and oblige others to follow them. When something or someone threatens this entitlement of control, they will fight for it either to gain it back or to stop themselves from feeling insecure, Cassar said.

She remarked that unfortunately, this violence will continue to increase in the future, unless people work on themselves, recognising their strengths while accepting their limitations and insecurities.



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