Strong Minds, Safer Future: What Children Are Really Telling Us in the Clinic
This is the first of a two-part article on children and mental health, the focus of Child Month. This was written by family physician Dr Rochelle Bailey, exclusively for the North Coast Times — The Editor
By Dr. Rochelle A. Bailey
The theme for Child Month 2026, “Prioritise Our Children’s Mental Health: Strong Minds, Safer Future,” is not merely aspirational. It is deeply rooted in what we encounter daily in clinical practice across Jamaica and the wider Caribbean.
As a family physician, I have learned that children rarely present with mental health concerns in ways that are immediately recognisable. Instead, they present with patterns, with repetition, and quite often, with physical symptoms that quietly point to emotional distress.
Globally, approximately 1 in 5 children and adolescents live with a mental health condition, and nearly 50 per cent of all lifetime mental disorders begin before age 14. Regionally, Caribbean data indicate that more than half of adolescents report persistent feelings of worry, sadness, or hopelessness.
These are not distant figures. They reflect the lived reality of children sitting in our waiting rooms.
How mental health presents across age groups
To recognise distress in children, we must first understand that it evolves with development. The presentation is rarely static and almost never identical to that of adults.
EARLY CHILDHOOD, AGES 0 TO 5 YEARS
At this stage, emotional distress is often expressed through behaviour and physiology rather than words. Common signs include:
* excessive crying or irritability
* sleep disturbances or frequent night waking
* regression in milestones such as toileting or speech
* heightened separation anxiety beyond what is developmentally expected
* clinginess or difficulty settling in familiar environments
At this age, the child’s emotional world is closely tied to attachment and caregiver presence.
SCHOOL AGED CHILDREN, AGES 6 TO 12 YEARS
This is the period where somatisation becomes especially prominent. Children may not say they are anxious, but their bodies often reveal it. Presentations may include:
* recurrent abdominal pain or headaches without medical explanation
* urinary frequency or urgency in the absence of infection
* decline in academic performance
* irritability, behavioural outbursts, or social withdrawal
* difficulty concentrating or restlessness
This is often the stage where patterns begin to repeat, prompting multiple visits to primary care.
ADOLESCENTS, AGES 13 TO 18 YEARS
In adolescence, symptoms become more internalised or risk-oriented. Common features include:
* persistent low mood or irritability
* withdrawal from family or peers
* changes in sleep and appetite
* risk-taking behaviours or substance use
* declining academic engagement
* expressions of hopelessness or low self-worth
Among all age groups, anxiety disorders remain the most prevalent, frequently coexisting with depression and behavioural challenges.
A MOMENT IN PRACTICE
A child once presented to my clinic with a persistent sensation of needing to urinate. There was no infection, no anatomical abnormality, and no identifiable physiological cause.
Yet the symptom persisted.
With time and careful exploration, it became evident that the child’s mother did not live with her and was unable to see her as often as the child wished. The relationship was present, loving even, but limited by a lack of consistent physical contact.
The child expressed a simple longing to spend more time with her mother. What she could not fully articulate emotionally, her body expressed physically.
Dr Bailey is in private practice in St Mary.
(Part 2 — The role of Primary care and healing beyond the clinic will be published on Wednesday, May 13, 2026)
