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In January, the Prime Minister focused her first major health speech on mental health, calling it ‘a hidden injustice’. She talked of a ‘comprehensive package of reforms to improve mental health support at every stage of a person’s life – with an emphasis on early intervention for children and young people’. Some of the planned £1.4 billion spend on children includes a review of often hard-to-access CAMHS services for children and adolescents, while every secondary school is to be offered ‘mental first aid’ training. But it should be a priority that this programme extends to early years providers.
The idea that under-fives have mental health problems can be difficult for adults to comprehend, but when we consider that over half of mental health problems are identified by age 14, early childhood clearly plays a part.
Many theories of human development have rooted mental illness in the early years, with those of Sigmund Freud, the founder of psychoanalysis, one of the most well known. It’s important not to be too simplistic: both nature and nurture may play a part. But humans exist in a relational world. The concept of attachment identifies the powerful expectation that young children have for a loving and secure relationship with an adult who comes to be identified as a parent. These experiences directly lead to the child developing a subjective sense of what may be going on in their own mind and the minds of others. When this works, we develop a positive sense of who we are and of our trust in others – the fundamental building blocks of mental health. When this goes wrong, we may feel alone, feel nobody understands, feel anxious and be suspicious about other people’s motives.
Trying to make sense of what is going on in a child’s mind could not be more important when it comes to children’s mental health. It could not be more important that the Prime Minister ensures attachment is directly addressed in her programme.
An exhibition on attachment pioneer John Bowlby is running at the Royal Society of Medicine until 29 April.
John Simmonds is director of policy, research and development at the British Association for Adoption and Fostering (CoramBAAF).