Teenager’s health – insight from a GP

By: Dr Neil Forrest

Star Vista clinic
Posted on: 12 Jan 2024

In partnership with BESSA education consultancy, we asked Dr Neil Forrest to provide an overview on teen health, especially for those planning on attending boarding school abroad.

There can be few greater challenges in life than being a parent of teenagers. Although my children are younger, I see the pressures of this period manifest in various ways in my consult room. Watching your children develop from kids into adults can be both rewarding and terrifying in equal measure. Teen health can be viewed through three lenses – physical, sexual and mental. Different personalities may have challenges in one or all (or none!) of these areas. Boys and girls can present in different ways and are exposed to different kinds of pressures, so parents may need to take a different approach with each of their kids.

If you are planning on sending your child abroad to boarding school, you may have increased anxieties in these areas. Boarding schools tend to have excellent pastoral care, and most have a medical team on site. If you would like continuity of care, the Osler Health team offer telemedicine consultations and can dispense medications in Singapore.

Physical health

In my opinion this should be one of the easier elements for parents as it is most aligned with the things we should be doing for our own well-being. Eating a healthy balanced diet, taking regular exercise, not smoking or drinking to excess. There are of course some physical issues which are specific to teenagers. I see lots of young people struggling with acne and the onset of periods in girls can sometimes be challenging. Sometimes teenagers need reassurance that a physical change they’ve noticed is completely normal! If you would like a doctor to support your child on some of these issues before they leave for the start of term, we can certainly help.

Drugs and alcohol are a particular concern for parents. Schools have very strict policies on smoking, vaping, drinking and drugs and my advice would be to trust the school authorities to manage this area. If, however, you are concerned that your child may be taking recreational drugs, smoking or drinking to excess, have an open conversation with them and if this does not allay your concerns, have a chat to your GP.

 

Sexual health

Surely one of the most difficult topics to discuss with your children! Taking the lead on this and talking openly and frankly with your kids is key. Remember, if they don’t learn this stuff from you, they’ll be learning it from the internet or their friends. Teenagers these days aren’t having any more sex (on average), any younger than previous generations, but they are being exposed to it in different ways, often online.

Young people who are starting to become sexually active need to be aware of their contraceptive options, as well as how to reduce their risk of STDs. Teenagers can see a doctor for these issues in Singapore without their parental consent, if the doctor deems them to be competent and mature enough to make an informed decision. It is important to note that the legal age of sexual consent in Singapore, Switzerland and the UK is 16, however clearly in all boarding schools it would be a serious breach of the rules. At Osler Health we can undertake comprehensive STD testing and provide a wide range of contraception options and can talk openly and honestly with your child. Sexual health services and contraception for people under 16 is generally more accessible in the UK and Europe compared with Singapore.

Mental health

Adolescence is a period where people often experience mental health problems for the first time. Depression, anxiety, eating disorders and even psychotic illnesses can all present during the teenage years. The mental wellness of your child can be the hardest area to navigate, particularly when your child is living overseas.

It’s often difficult to know whether your child is experiencing worrying mental health issues or just going through the normal stages of teen development. This is where speaking to a doctor or school counsellor may be helpful. I try to see teenagers both alone AND with their parents to allow me to get a more complete picture. Sometimes parents come to see me without their kids just to see if their concerns warrant further assessment.

What are the common flags for identifying a problem? The below can give you some guidance, but I urge you as parents to seek help if you are concerned.

Anxiety/Depression

  • Social withdrawal
  • Change in appetite
  • Change in sleep
  • Change in behaviour
  • Low mood. Inability to take pleasure in things.
  • Physical signs of self-harm/injury

Eating disorders

  • Rapid or excessive weight loss
  • Refusing to eat with others
  • Tooth decay in bulimia
  • Obsession with weight/appearance/exercise

Psychosis

  • Erratic behaviour
  • Paranoia
  • Delusional beliefs
  • Hallucinations

I would advise people to have two main goals for their teenage parenting. Firstly, be a role model – treat yourself and others with respect and kindness. Secondly, be there for them, be the person they can talk to – openly, nod-judgmental and understanding. You don’t have to have all the answers, and they don’t expect you to.

If you feel your teen would benefit from discussing something with a GP please encourage them to see the GP without you and assure them that it is confidential. This may be easier for them than a ‘school doctor’. It is important to note that confidentiality can be broken if the teenager is at risk of harm, for example suffering abuse or expressing suicidal intent.

Dr Neil Forrest is a UK trained GP based at Osler Health International. Dr Neil has been caring for teens (and parents of teens!) in Singapore for over 8 years, and is known for his down-to-earth, kind approach. He practices from the Osler Health Star Vista clinic
www.osler-health.com

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