ChildLine report reveals extent of children's health fears

BMJ 1998; 316 doi: (Published 13 June 1998) Cite this as: BMJ 1998;316:1766
  1. Zosia Kmietowicz
  1. London

    Children with a chronic illness, who are going through puberty, who wet the bed, or who have a sick parent feel depressed, miserable, worried, ashamed, and even suicidal, according to a review of callers to the free national telephone helpline, ChildLine.

    The extent of the embarrassment, distress, and anxiety that children feel about their own or their parents' health problems came as a surprise to the report's author, Dr Sheila Cross, a former paediatrician at North Middlesex Hospital and a ChildLine counsellor for seven years. In the report, I know you're not a doctor, but…, Dr Cross studied around 800 of the almost 2000 children who rang ChildLine in 1994-5 and 1996-7 about their health problems.

    She found that children suffering from asthma, diabetes, and other chronic illness sometimes fail to take their medicines because they do not want to be different from other children. “I know it's dangerous but I go out without my inhaler because then I feel normal,” is how one caller put it. Another commented: “I vary my tablets because I want to feel in control.”

    “Non-compliance takes a very different picture when you hear a child talking about it,” said Dr Cross. “As a paediatrician I do not think I understood that sometimes it was the need to be in control of their own bodies that led young people to experiment with their treatment. Many may share the feelings of the caller who said,'I feel like a freak.“

    Overall the child callers did not complain about the way doctors treated them, although some children were reluctant to visit the doctors for fear that their parents would find out. One girl was furious because her general practitioner told her school she had been to his surgery, while another heard the receptionist describing her over the phone as “a well known mental case.” However, in 1996-7 no child expressed fears that their doctors would breach their confidence or would not see them alone—an encouraging step forward, said Dr Cross.

    Children who wet the bed were among the most distressed callers. Many were ridiculed by their parents, who saw the enuresis as an act of aggression by the child, while others pretended it was not happening. Some children told ChildLine how they had to buy their own incontinence pads out of their pocket money. One child had been forced to spend the day in the bath—“to wash away what I've done.” She had been told by her parents: “I'm bad and it's my fault I'm incontinent.” A boy said: “Mum tells everyone; I feel low. I tried to kill myself once.”

    Concerns about puberty led to 2111 calls in 1994-5, many from children who were maturing physically. A study of 200 of these calls showed that children suffer from a lack of information and support from their parents as well as from embarrassment. One young girl asked: “I thought I had got a period but my mum said it can't be, so what is it?“ Altogether 15 girls under 10 were menstruating; one 8 year old had coped with her periods for several months without telling her mother.

    Other callers asked about contraception or wanted advice about “saying no” to sex. Analysis of the calls showed the need for primary rather than secondary schools to provide sex education so that children can cope better with their physical maturity, commented Dr Cross.

    Calls from children with a sick parent were perhaps the most heart rending and showed the true impact on family life. Many wanted to protect sick parents from their own problems, or wanted to look after them. Others were physically abused by the sick parent, or sexually abused by the parent's partner while the sick parent was in hospital, but kept quiet for fear of upsetting their ill parent. “The shock could kill her,” said one girl whose mother had cancer and who was being forced to have sex by her mother's boyfriend. “My dad hits me, but I know he gets headaches,”said another caller.

    “I hadn't appreciated the depth of misery and isolation among these children—even though I realise they are self selected,” said Dr Cross. “I think now I would try to help them with their concerns about their parents—perhaps by asking help from another professional or therapist who could be open with these children. Doctors can be more aware of anxieties children have about themselves and their parents' health and to be aware of their need for information.”

    I know you're not a doctor, but … is available, price £5, from ChildLine (health) 2nd Floor, Royal Mail Building, London N1 OQW.

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    Some children feel anxious about their health problems


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