A few days ago a pianist said during a live stream broadcast of his recital that he felt suicidal from numerous stressful life events. People in the comment section were ruthless toward the pianist. Not only did they not support this person in a moment of fragility, but these commentators also coldly taunted and mocked him. In the end, tragedy struck.
As a psychiatrist, I was deeply distraught by this turn of events. This saga not only reminds us of the brutality of the online world, but also serves as a bitter reminder that society must rightly recognize the psychological trauma that cyberbullying can cause. In the Internet “e-era,” unprecedented freedoms allow people to disregard the limits of time and space. Borders are blurred and it is difficult to halt unbridled attacks, leading to unrestricted harm — or much worse — caused by bullying.
Schoolyard bullying from back in the day, when bullies relied on physical strength to torment those weaker than themselves, has morphed into today’s virtual world of keyboard thugs and malcontents who hide behind a screen, engaging in cruel dogpiling where several anonymous users could attack a single person in a coordinated instant. Cyberbullying has become a major factor impacting one’s mental health.
A survey showed that cyberbullying victims tend to be younger people whose personality and identity are still developing. Being bullied could lead to depression, post-traumatic stress disorders, and in extreme instances, could be the last straw — the final blow before they decide to take their own life.
Suicide is a leading cause of death in younger people. The prevalence of psychiatric disorders among adolescents is about 30 percent of the age group. These illnesses and disorders have long prognoses, impact learning and create self-loathing. They lead to impulsive comorbidities, severe mental illness, criminal behavior and even self-destruction. There is inadequate health insurance system support for pediatric psychiatric care, which leads to a dearth of specialists. This situation makes it impossible to provide acute care to adolescents coping with psychiatric disorders or illnesses in a manner that respects autonomy, privacy and safety.
President William Lai (賴清德) is enthusiastically rooting for his “Healthy Taiwan” healthcare reform policy, which would elevate mental health to a national-level policy issue. We should stand behind this new policy and encourage all sectors of society to put greater focus on the problem of cyberbullying. In particular, we should incorporate comprehensive mental health education into elementary and junior-high-school curriculums.
In Europe and the US, psychology and social and emotional learning (SEL) classes have long been required courses, holding the same weight as languages, mathematics and science courses. SEL courses place an emphasis on cultivating five key qualities: introspection, self-control, social awareness, interpersonal relationships and responsible decisionmaking. Cultivation of these qualities not only enhances a student’s self-efficacy and self-worth, but could also increase emotional regulation capabilities and mental resilience, playing key roles in preventing cyberbullying.
Many educators and parents have been misled into believing that psychiatric conditions, such as attention deficit hyperactivity disorder or clinical depression, do not exist. They have been misled into opposing medication and therapy, and have unwitting bias against and are dismissive of psychiatric conditions. As adolescents develop and as they join society, their long-term knowledge of and biases against psychiatric conditions and neurological science create compounding effects. There is no time to waste when it comes to improving health curriculums for elementary and junior-high-school students, enhancing lessons on psychological conditions.
As a professional psychiatrist, each day I see the devastating impacts of misunderstanding of psychiatric and brain disorders on patients and their families. If I could take science and medicine — common-sense psychology in particular — and bring that to an SEL curriculum, it would have far-reaching implications for not only psychiatric treatment, but also on society’s overall mental health.
Psychotherapy in Taiwan has long been plagued by a lack of personnel, funding and resources, especially when it concerns population groups who cannot afford treatments and therapy. We ought to be heavily promoting a transition toward digitalized mental health treatment, putting efforts into telehealth diagnostics and digital treatment.
Treatment guidelines in Europe and the US are clear on their recommendations: There are guidelines to not prescribe medication when treating light to moderate anxiety disorders and depression. Treatment providers must discuss with patients the option of not using medication as treatment, while also recommending the use of multiple digital and online treatment applications.
Health is not just a matter of treatments or health insurance. A nation’s goals ought to be to “empower all of its people.” A government should be concerned with the transition from just the treatment of illnesses to preventive healthcare. It should be concerned with evolving from medication treatment services to the promotion of comprehensive, holistic health.
Su Kuan-pin is a professor of psychiatry at China Medical University’s College of Medicine, deputy director of Tainan Municipal An-nan Hospital and a member of the Presidential Office’s Healthy Taiwan Promotion Committee.
Translated by Tim Smith
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