Parents review roles to better the stage they set for their children

The country’s first mental health service for toddlers may be on its way, but it’s long overdue writes Claire O’Sullivan.

GROUNDBREAKING steps are being taken by two Southern Health Board clinical psychologists towards the development of the country’s first mental health service for toddlers.

International statistics show one in five children will develop social and emotional difficulties before the age of 18 and, according to psychologists, many of these difficulties become apparent before the child reaches the age of three.

Infant mental health services have been in place for years in the US, Australia, New Zealand and most parts of Europe and it is the ambition of Catherine Maguire and Rochelle Matacz that such facilities be developed in Ireland.

They even self-financed a trip to New Zealand earlier this year to attend the World Congress of Infant Mental Health in Melbourne where they were the only two delegates from Ireland at the event, attended by up to 500 people.

With the support of the SHB, they have since set up two pilot projects - one with parents whose children are already displaying emotional problems and the second with healthcare professionals.

It is their hope these projects will help support their long-term goal of establishing a formal infant mental health service.

In the first pilot study, after several weeks of getting to know the families, the team will videotape the parents and their children as they interact together.

These children may have displayed emotional problems such as chronic crying, where they could cry incessantly for four or five hours, a sustained refusal to take food which can not be explained by physical illness, or even extreme forms of biting and head banging, which extends far beyond the normal behaviour of toddlers.

Often, according to the team, such behaviour can damage the parent/child relationship as the parents themselves are struggling to understand what is going on and so may not “be emotionally available to the children.”

Such behaviour can also potentially arise if the care-giver has been suffering from chronic post natal depression or another form of mental illness, which is affecting the child/care-giver bond.

The videotape project is based on a ‘Seeing Is Believing’ technique, aimed at giving parents more insight into their children’s social and emotional needs.

“We are not doing this to criticise parenting skills and will actively seek out the positive in the relationship.

“It is more to highlight to the parents the subtle cues that the family can pick up. It is aimed at giving the parent more insight into the babies’ needs,” said Catherine. According to Catherine and Rochelle, responding to a baby’s gaze, hand signals and the use of skin-to-skin contact is vital for a baby or toddler’s development.

“It doesn’t mean that a care-giver must constantly be holding a small child.

“We offer advice like putting a baby bouncer in an optimal position so when a mother is busy, the child can watch the care-giver as they move around.

“When the child/care-giver relationship is out of sync these things may not be happening.”

As part of the second pilot project, healthcare professionals such as public health nurses and physiotherapists have been trained in the importance of the social and emotional development of babies and how to notice any early signs of potential difficulties in the care-giver/child relationship.

“Public health nurses are very important as they can identify emotional and social distress days after the babies are born and so, with their help, early intervention can begin that will alleviate a lot of problems later on,” said Rochelle.

“Ideally, we would like to see other primary care professionals receiving similar training.

“In our work so far with the nurses and a physiotherapist, we highlight again the importance of teaching parents things as simple as how to hold a baby properly so it feels secure, playing with it, cuddling and other physical ways of ensuring a child feels secure.”

According to Catherine and Rochelle, in a dedicated mental health service, parents with emotional concerns during pregnancy will be followed up closely after birth.

“Then if emotional and social concerns were to develop, the appropriate support could be offered by the relevant healthcare professional,” said Catherine.

An infant mental health scheme has been in place in the US for years and studies have been completed on teenagers who benefited from such early care.

“The results have all been positive and highlight our case about how early intervention can stop these children having emotional problems before the age of 18, which can have enormous effects on their lives.

“The first three years of a baby’s life are vital to building the foundations of good mental health. From birth to age three, is a crucial period and the dance between parent and child sets the stage for the child’s future social and emotional development,” said Rochelle.

“A lot of emphasis is often placed on a child meeting its physical development milestones like rolling over or taking its first steps. Their emotional needs are much less understood and Ireland needs a service that helps early on.”