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Overview of Child & Adolescent Mental Health in Sri Lanka

Written by Senuri Kodithuwakku

Understanding Child and Adolescent Mental Health

Childhood and adolescence are periods of rapid biological, cognitive, and social change, making young people especially vulnerable to mental health difficulties such as anxiety, depression, and behavioral problems. Good mental health during these years is crucial for healthy development, learning, relationships, and a successful transition into adulthood. Research shows that around 50% of adult psychiatric disorders begin during adolescence (1), highlighting the importance of early identification, prevention, and access to appropriate mental health support as a major public health priority.

Mental Health Challenges Among Sri Lankan Children and Adolescents

Overall population data from Sri Lankan hospitals providing mental health services in 2019 show that depressive disorders, psychotic substance-related disorders, and schizophrenia are the main reasons for seeking treatment. However, comprehensive data on youth mental health remain limited, as the country lacks systematic surveillance for this population (2). Below are a few available studies that provide some insight into the mental health challenges faced by children and adolescents in Sri Lanka.

A 2022 study found that mental health problems among Sri Lankan adolescents are significantly higher than the global average of 14.3% (3), with an overall prevalence of 40.3%. Common issues included loneliness (30.8%), anxiety (20.2%), and suicidal thoughts (3.7%), with mental health problems more frequent in females than males(4).

Some other studies reported that 13.8% of children aged 7 to 11 years and 18.9% of adolescents aged 13 to 18 had emotional or behavioral problems. Among the older group, 12.6% said these difficulties significantly impacted their daily lives. In the same study, 28% of adolescents aged 14 to 18 screened positive for severe anxiety, while 36% were diagnosed with depression (5).

Key Risk Factors for Children’s and Adolescents’ Mental Health in Sri Lanka

Several social and environmental factors contribute to these challenges. Sri Lanka as a developing country, has been severely affected by COVID-19, the consequent economic crisis, and the 2019 Easter Sunday attacks. School closures and the shift to online learning, coupled with the digital divide, disrupted education and increased screen time, contributing to migraines, anxiety, poor sleep, and aggression(6,7,8). A survey in Eastern Sri Lanka found that 75% of students reported increased stress and anxiety due to school closures, physical isolation, and unexpected changes (9). Children born during the pandemic also found to show lower verbal, motor, and cognitive skill development, particularly in lower socio-economic families (10).

Additional factors affecting mental health in children and adolescents in Sri Lanka  include bullying, alcohol and narcotic substance misuse, financial difficulties, educational dissatisfaction, and relationship problems (11). Additionally, about 75% of women migrating for work were married and many had children, and mental health problems were reported to be significantly higher among these children (12).

Between 27th and 29th of November 2025,  Cyclone Ditwah caused widespread flooding and landslides across Sri Lanka, affecting approximately 2.2 million people in all 25 districts. Over 100,000 houses were fully or partially damaged, and more than 230,000 people were displaced at the peak of the emergency. As of 14th December 2025, the cyclone had resulted in 643 fatalities, with 183 people still missing (13). Such large-scale disasters are likely to lead to mental health issues among children and adolescents, including increased anxiety, stress, trauma, and other psychosocial challenges that Sri Lanka will have to face in the coming years. 

Key Protective Factors for Children’s and Adolescents’ Mental Health in Sri Lanka

Engagement with parents and close friends, adequate nutrition, and a physically active lifestyle appear to protect many Sri Lankan children and adolescents from common mental health problems (4). This can be explained as strong social connections providing emotional support and a sense of security, proper nutrition supporting brain development and mood regulation, and regular physical activity reducing stress, improving sleep, and boosting self-esteem. Together these factors act as protective buffers, helping young people maintain better mental health even in the face of social, economic, or environmental challenges.

Available Resources for Child and Adolescent Mental Health in Sri Lanka

In Sri Lanka mental health services for children and adolescents are primarily hospital-based, and schools generally lack structured and standardized counseling services. This is due to negative perceptions of mental health and limited investment in services among other challenges (14). Providing proper mental health support to young people is crucial, as it can prevent these problems from continuing into adulthood and support the development of important skills such as emotional regulation, memory, learning, and interpersonal relationships (5).

Children and adolescents have unique developmental needs. They experience mental health disorders differently from adults, respond differently to interventions, and require environments tailored to their age (5). They also have distinct relationships with healthcare professionals. However in Sri Lanka, there are only 0.03 child and adolescent psychiatrists per 10,000 people, meaning most young patients are treated by adult psychiatrists (5).

As of 2020, Sri Lanka had only two inpatient centers for children under 12; one in Colombo and one in Kandy (5). The first center providing adolescent psychiatric support was established in 2016 at the National Institute of Mental Health (NIMH). Due to these limited resources, many children and adolescents are treated in adult clinics, where adult psychiatrists also may not have the specialized knowledge or experience required to meet their needs effectively (5).

While awareness and support for child and adolescent mental health are growing, there is still a significant shortage of human and physical resources, highlighting the urgent need to expand services across the country (5).

Suggestions to Improve Child and Adolescent Mental Health in Sri Lanka

The first step is to conduct island-wide surveys to identify psychological morbidity among children and adolescents, using validated tools such as the Strengths and Difficulties Questionnaire (SDQ).(15,16,17) These surveys can help detect common emotional and behavioral problems early, identify high-risk populations, and provide evidence to guide policies and allocate resources effectively.

Next, easy access to mental health support should be ensured for young people. This can be achieved by strengthening school health programs, appointing trained child and adolescent mental health professionals, and setting specific mental health goals within schools. The national Mental Health Helpline (1926) can also be expanded to better cater to children and adolescents. Awareness of available services should be raised through social and public media, using youth-friendly informative posts, videos, and online campaigns focused on psychological well-being, reconciliation, social responsibility, and leadership. Simultaneously, monitoring media for false information and content promoting violence or cruelty is crucial to prevent youth unrest and mob violence (15).

Future policy decisions should adopt an integrated approach, involving individuals, families, and communities, to promote positive home and school environments. Encouraging physically active lifestyles, social engagement, and healthy coping strategies can further support mental well-being and resilience among Sri Lankan children and adolescents (4).

Conclusion

Child and adolescent mental health in Sri Lanka faces significant challenges, including high prevalence of emotional and behavioral problems, limited access to specialized care, and the impact of social, economic, and environmental stressors. While awareness and support are gradually increasing, there remains a critical shortage of trained professionals, structured services, and community-based interventions. Addressing these gaps through early identification, accessible mental health support, school and community programs, and integrated policy approaches is essential to promote the well-being, resilience, and healthy development of Sri Lanka’s young population.

References 

  1. Belfer M. L. (2008). Child and adolescent mental disorders: the magnitude of the problem across the globe. Journal of child psychology and psychiatry, and allied disciplines, 49(3), 226–236. https://doi.org/10.1111/j.1469-7610.2007.01855.x
  2. Directorate of Mental Health. Mental Health Disorders. Directorate of Mental Health, 2019 http://mentalhealth.health.gov.lk/index.php?option=com_content&view=article&id=22&Itemid=159&lang=en#mental-health-disorders Google Scholar 
  3. World Health Organization. (2025, September 1). Mental health of adolescents. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
  4. Rasalingam G, Rajalingam A, Chandradasa M, Nath M. Assessment of mental health problems among adolescents in Sri Lanka: findings from the cross-sectional Global School-based Health Survey. Health Sci Rep. 2022; 5:e886. doi:10.1002/hsr2.886 
  5. Yassin, F. (2024, January 23). Child and adolescent psychiatry in Sri Lanka: What’s missing and what can The Wave offer? The Wave Clinic. https://thewaveclinic.com/blog/child-adolescent-psychiatry-in-sri-lanka-whats-missing-what-can-the-wave-offer/
  6. Liyanagunawardena T, Distance SW-AJ of, 2021 undefined. Emergency remote education: experience from Sri Lanka during covid-19. asianjde.comhttp://www.asianjde.com/ojs/index.php/Asian JDE/article/view/554. Accessed 5 April 2022.
  7. Rajapakse A, Wijenayake D. Effects of Exposure to Digital Screens in Children andAdolescence. 13th International Research Conference General Sir John KotelawalaDefence University Allied Health Sciences Sessions. 10.1542/peds.2016-1758j. [DOI]
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