More mental health help needed for under-5s, report says

The first years of a child’s life are crucial for brain and psychological development, and early intervention can prevent a child from developing mental health problems, a new report says

26th October 2023 about a 4 minute read
“Parents, carers and society as a whole have a critical role to play. This includes securing positive relationships and a nurturing environment that supports the building blocks of a child's social, emotional and cognitive development.” Dr Trudi Seneviratne, Royal College of Psychiatrists

Children need more psychological support to help prevent them from developing mental health problems later in life, according to a new report from the Royal College of Psychiatrists.

The report, entitled Infant and early childhood mental health: the case for action, says there is growing evidence that early intervention before age of five may help stop mental health conditions arising or worsening. It suggests that half of mental health conditions arise by the age of 14, and many start to develop in the first years of life.

According to NHS data, about 5% of two to four-year-olds experience anxiety or have behavioural disorders or neurodevelopmental conditions such as ADHD. The report notes that “pre-conception to 5 years is an important time in a child’s life and critical for brain and psychological development, the formation of enduring relationship patterns, and emotional, social and cognitive functioning – all of which are foundations for healthy development, but which can also confer protection against mental health conditions.”

It says, however, that “most babies, under 5s and their parents do not receive the support they need.” It adds: “This results in preventable suffering across the whole population, with negative impacts that can last throughout a person’s lifetime. Many economic costs come along with this too, as children can fail to achieve their potential or may not become the productive, functioning adults they otherwise would have been.”

Provide support for women during pregnancy

Dr Trudi Seneviratne, from the Royal College of Psychiatrists, said the majority of under-fives with mental health conditions were not receiving the level of support needed “to help them become productive, functioning adults and reach their full potential”.

She added: “The period from conception to five is essential in securing the healthy development of children into adulthood.

“Unfortunately, these years are often not given the importance they should be, and many people are unaware of what signs they should be looking out for.

“Parents, carers and society as a whole have a critical role to play. This includes securing positive relationships and a nurturing environment that supports the building blocks of a child’s social, emotional and cognitive development.”

The report recommended a number of ways to prevent children from developing mental health problems. These included providing support for the mother in pregnancy, working with parents to promote attachment to their child and recommending parenting programmes in the early stages of a child’s life.

Factors that increase the risk of problems developing in childhood, the report said, include alcohol or substance misuse during pregnancy and adverse experiences such as domestic violence, physical and emotional neglect and abuse.

New specialist services required

The report makes nine recommendations, including:

  • New specialist services across the UK for under-fives, their parents and carers, with timely access to a team of people including speech and language therapy, psychologists and social workers
  • More training for healthcare workers on how to spot and support under-fives with mental health problems
  • More research on the best ways to help young children
  • Better data collection on young children experiencing problems
  • Support to help the wider population gain a greater understanding about the mental health of under-fives

The report also says that failing to address the issue of children’s mental health “could breach statutory legislation and the under fives’ right to mental health under Article 24 of the United Nations Convention on the Rights of the Child.”

Joanna Moody, from Unicef UK, said: “Mental health in infancy and early childhood is often overlooked, yet it lays the foundations for a child’s future.”

She said the report provided a “strong evidence base for action to prioritise mental health right from the start of children’s lives,” adding that many services play a “vital role” in supporting children’s mental health, including early education, social services, maternity, health visiting and primary care.

FCC Insight

The Royal College of Psychiatrists is right that early childhood experiences have a crucial role to play in a person’s development. We know that adverse experiences such as trauma and neglect can lead to mental health problems as the child grows older. Conversely, making sure that young children and their parents have appropriate support from birth – and even before birth – can help children develop into mentally well adults. There is a strong case to be made for providing those families in need of support with access to psychologists, speech and language therapists and social workers.