Infant Mental Health Week: More than Mummies and Babies

This week is Infant Mental Health Week. It’s an important opportunity to raise awareness of the impact of babies’ first 1001 days on their subsequent developmental outcomes, and their life chances. Babies who have good, nurturing, responsive care in their earliest days have a much better chance of growing up to be happy, well-adjusted people, able to contribute to our society and perhaps care well for children of their own.

This is an important issue. It’s important that we invest in and look after future generations. It’s important that we ensure that babies have the very best start in life.

However, it is also important to note that the case of early infant support has in recent years been hijacked to support a particular political agenda. Early infant development is increasingly re-written in policy initiatives as support for mothers and infants (perhaps with a bit of extra support thrown in for dads). These policies argue that the best way to improve the outcomes of babies is to ensure that they receive responsive, synchronous caring from their mothers. The best way to support babies is to ‘fix’ bad mothering and ensure better attachments between mothers and babies. Consider this statement from the 1001 Critical Days Manifesto:

“Our goal is for every baby to receive sensitive, appropriate and responsive care from their main caregivers in the first years of life. Parents need to feel confident that they are raising their children in a loving and supportive environment.”

How could one quibble with that? It is obviously the case that babies need responsive care, and that parents equally need to benefit from knowing that they are good parents. But how, according to the Manifesto, is such a parenting environment to be provided? Good mental health services, access to antenatal classes, training for professionals in infant mental health, access to birth registration in children’s centres. These are, of course, important initiatives that must be supported.

But the elephant in the room for Infant Mental Health initiatives, the issue nobody seems to want to speak about anymore, is poverty. The largest predictor of poor mental health outcomes for babies is not, in fact, bad parenting. It is the environmental degradation, the stress, and the multiple vulnerabilities associated with poverty (Reiss, 2013). What makes our children vulnerable is not bad mothering. It is bad economies.

The poverty gap in the UK is widening. 3.7 million children in the UK live in poverty, with 1.7 million in severe poverty (Shale, Blachin, Rahman, Reeve, & Rolin, 2015). These numbers have steadily increased in the last ten years, as more and more families struggle to make ends meet. Raising children in poverty increases children’s chances of experiencing a range of negative mental health consequences, educational difficulties and future employment difficulties. Poverty blights children’s lives. It is therefore suprising that mental health policy increasingly ignores economic conditions, focusing instead on individuals and families (Callaghan, Fellin, & Warner-Gale, 2016)

Parenting is a kind of emotional labour. The main job of parenting a baby is to be emotionally available and responsive to our infant. This emotion work that parents do with their children is very vulnerable to stress. Conger, Conger, & Martin (2010) suggest that when families experience long term poverty, parents are more likely to become depressed and irritable, and family relationships become strained. It is the experience of long term poverty that places families under stress, and that is most strongly associated with problematic parenting and poorer children’s outcomes. The emotional work of parenting needs to be supported by better living conditions for families, by strong socioeconomic support, not (just) by parenting classes.

It is not my intention, in this blog, to put down the work of the All Parliamentary Group, or the 1001 Critical Days Manifesto. On the contrary, I believe their work is incredibly important. Rather, my intention is to draw attention to the blindspot that is developing in Early Years policy to the conditions that produce difficulties in family life. Fobbing off poverty reduction to ‘volunteers and outreach programmes’ entirely misses the point. Parents are not ‘bad’ because they lack skills. Rather they are struggling because the conditions that they live in — or let’s be truthful, that they just about survive in — are hostile to parenting.

Parents cannot parent effectively when they are worried about how they will feed themselves and their families, or when they are stressed about tenuous and insecure employment. No amount of parenting skills training can ameliorate that. Parents can’t parent effectively when they are anaesthetising themselves to the struggle of daily life with drugs and alcohol. They can’t parent effectively when they live in degraded housing stock, in communities that are struggling, in spaces that are not child friendly or healthy. Because of course, contrary to the view of Mrs Thatcher, there is such a thing as society. It is not ‘just individual men and women, and families’ (Keay, 1987).

If we want to improve the life chances of our babies, if we really want to improve infant mental health, we must provide better support for families. Families cannot be allowed to live in poverty.

Dr Jane Callaghan, Professor, Psychology

References

Callaghan, J. E. M., Fellin, L. C., & Warner-Gale, F. (2016). A critical analysis of Child and Adolescent Mental Health Services policy in England (Online Ahead of Publication). Clinical Child Psychology and Psychiatry.

Conger, R. D., Conger, K. J., & Martin, M. J. (2010). Socioeconomic status, family processes,and individual development. Journal of Marriage and Family, 72(3), 685–704. http://doi.org/10.1111/j.1741-3737.2010.00725.x

Keay, D. (1987). Aids, education and the year 2000! (An Interview With Margaret Thatcher). Women’s Own, 8–10.

Reiss, F. (2013). Socioeconomic inequalities and mental health problems in children and adolescents : A systematic review. Social Science & Medicine, 90, 24–31. http://doi.org/10.1016/j.socscimed.2013.04.026

Shale, J., Blachin, K., Rahman, J., Reeve, R., & Rolin, M. (2015). Households Below Average Income 1994/5–2008/9 (Vol. 2015). London: Department of Work and Pensions.