Protecting our children’s mental health

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To the lay person the term ‘infant mental health’ may conjure up a number of strange images, but it is one of the biggest areas of concern for health professionals working within the Western Trust who say that if we do not protect the health of our youngest children today we may well adversely affect their health throughout the rest of their lives.

“The evidence is overwhelming,” Kieran Downey, Assistant Director of Children’s Mental Health and Disability, said. “We can no longer ignore it. What we are seeing now, in our homes and in our schools, we have to tackle that.”

Mr Downey said that while he firmly believes 99.9% of parents want to be the very best parent they can be, there has been some breakdown in traditional parenting skills.

“An increasing number of children are starting P1 without being school ready,” he said. “The two biggest areas of concern are speech and language, and behaviour. When I say speech and language, I don’t mean there is some organic speech and language issue. What we are seeing is a lack of vocabulary because children are simply not being conversed with.

“Behavioural issues include not having learned basic skills - turn taking, knowing when to talk, how to behave socially - and we are seeing children enter Primary 1 who are not fully toilet trained.

“Undoubtedly this has an effect in the classroom.”

The blame he said lies in a number of factors. “There is no doubt life is a lot busier now,” he said. “It is hard for parents to juggle their responsibilities - and the demands that are placed on them but I think also the dawning of the IT age has made a huge difference.

“It has dramatically reduced the amount of one-on-one communication a child has with others. Children spend a lot of time in front of the TV, or on the XBox or DS. They don’t spend the same amount of time talking with their parents - and learning those basic conversational skills as they once did.”

“When we see children who lack those basic skills it is essentially because they have not learned to converse - the social skills of holding a conversation, asking questions and answering them.”

While these key issues show themselves in early life, Mr Downey said the concept of infant mental health is about giving children the very best emotional start in life - so that they have good mental and physical health as adults.

“Research has shown that 80% of key brain development - the hardwiring if you will - is complete by the time a child reaches four years of age. What a child experiences from the womb to that age is critical in forming the person they will become.

“Our aim is to promote five key messages on infant mental health that need to be heard. These are: no smoking in pregnancy; no alcohol in pregnancy; promoting breastfeeding; parents reading to their children and developing secure attachments through communicating love and affection. At the end of the day it is these that can make a difference.”

Mr Downey is keen to clarify each of these points. When it comes to no smoking in pregnancy - he says this does not only relate to the mother. A pregnant woman should not be exposed to secondary smoke either.

“Many of these messages have been out there for some time it is still not getting through sufficiently.

“People know the issues surrounding alcohol use in pregnancy. They know the benefits of breast feeding but our rates are still quite poor. It is about educating and supporting parents in the best way we can.”

The strategy will focus heavily on ensuring children form secure attachments in their early years - in essence sharing lots of hugs and kisses with their parents and carers and having continuity of care.

There will also be a significant emphasis on encouraging a return to reading in the home - with plans afoot to tie in with the City of Culture year in 2013.

“I cannot emphasize enough the positive role of reading in the home to your child. Not only does it give you quality time with your child but that interaction is priceless.

“Schools, parents, local libraries - they all have their role to play in encouraging this. We are hoping to tie in with the City of Culture to donate books to local children.”

Mr Downey said these changes are “absolutely necessary” - and high on the agenda for the Western Trust. “There are many organisations, the likes of Lifestart and Surestart who are working in this area and who have been putting this message across for years.

“We are now making it a priorty. We must use the resources we have to begin making these positive changes now.”

Mr Downey said these changes must come at all levels - agreeing that with increased emphasis on getting parents into work, the role of parent has been devalued and the importance of a parent’s input in their child’s early years has been disregarded.

“Is there room for change with current maternity or paternity laws? Of course there is - mums are working right up until their babies are born to try and get more time off with them after the birth when research has shown the benefits of having a mother who has had some time to rest, relax and prepare for the birth before her due date.”

He added that there is still a very real issue with helping parents who may have had negative experiences in their own childhood and may not have the necessary skills to parent.

“There has to be an integrated approach to breaking cycles of abuse and violence so that they don’t carry on into the next generation. A person has to learn how to parent - and most of us learn this from our own childhood experiences.

“We are seeing generational problems - so it is important the support is put in place to help those who are vulnerable.”

The Trust’s ‘Infant Mental Health Strategy - Supporting Infant Mental Health for Every Child in the Western Trust’, forms a blueprint for infant mental health services in the Western Trust area both now and into the future.

It is available to download from the ‘publications’ area of the Trust website: www.westerntrust.hscni.net.