Right from the beginning: why early intervention is so important in parenting support
The research clearly shows that the first three years of life are critical to mental and emotional wellbeing for life. Professor Louise Newman AM discusses how critical early intervention can be in supporting both infants and parents.
Good mental health begins in infancy
The first three years of life shape our mental and emotional health for the rest of our lives. In particular, experiences with caregivers are vital to early development and shape infants’ neurological and psychological growth.
Right from the beginning, babies engage with their parents or caregivers – they are ‘hardwired’ to engage and communicate. The quality of early attachment relationships and emotional communication between caregivers and infants literally shapes brain development and the infants understanding of the social world. In this way, our earliest experiences are the foundations for positive mental health and resilience.
Early stress and disturbances in care can be caused by a range of factors, both in pregnancy and in the postpartum period. Common issues in parents, such as anxiety and depression, can also have a negative impact on transition to parenthood and attachment.
Evidence suggests that stress in the infant period of development can have long-term developmental effects, and that some infants are particularly vulnerable to the effects of stress-related hormones such as cortisol and noradrenaline.
Supporting mental health in new parents
Mentally healthy parents have a better chance at raising mentally healthy children, which is why it is so critical to support new parents with their mental health. Parents with limited extended family and social support and sole parents experience higher levels of stress than those with higher levels of support.
Unfortunately, isolation has become the norm during the COVID-19 pandemic, where necessary restrictions to face-to-face contact have limited access to services and social connection.
There are also particular groups in the community where early parenting and the experience of pregnancy are complex and who may require mental health support and social support.
Women with a history of depression and severe mental disorder and those with backgrounds of early trauma and abuse are vulnerable to both physical and emotional challenges of pregnancy and the postpartum period.
Engagement with coordinated care involving maternity and early childhood services, primary care and access to mental health specialists can all be part of the care required to support them.
What is needed to support good mental health in parents and infants?
In order to support parents in their mental health, allowing them to support their infants, several things are needed:
- A comprehensive early in life intervention and service model needs to start in pregnancy with better identification of vulnerable and stressed parents.
- A focus on women with mental health issues, those experiencing current risk including family violence, substance abuse issues and isolation is a central strategy.
- Marginalised groups such as asylum seekers and refugees and ATSI communities should be supported in partnership with specific services.
- Better screening and identification of depression, anxiety and distress in pregnancy allows coordination of support and monitoring.
While some programs for supporting transition to parenthood in vulnerable families are currently under evaluation, they are not widely available in maternity services.
The role of health practitioners
Health practitioners have a role in providing support for parents in learning to read and respond to infant cues and to develop positive emotional interaction. Parents with mental health needs should have access to timely assessment of depressive symptoms and evaluation of the need for medical intervention. Integration of parenting support, perinatal mental health treatment and psychosocial supports is ideal but remains a complex issue to organise as it crosses several service domains.
Local community-based hubs
Recent evidence to the Victorian Royal Commission on Mental Health spoke to the need for accessible local community-based hubs for early parenting and child health and better integration with primary care. Services in communities can better respond to local needs and coordinate additional care as needed. This type of approach also raises awareness across the community that the needs of parents and infants are central to health care and that the care and protection of infants is high social priority.
What are the challenges in supporting parent and infant mental health?
In many areas, mainstream mental health services have limited experience in working with women and families in pregnancy and few infant mental health and developmental programs.
Lack of access to early intervention when it is indicated is a major factor directly increasing the stress of both caregivers and infants and disrupts critical developmental pathways.
The early-in-life intervention approach is a core public health preventive approach aimed at reducing the community burden of mental health issues. Unfortunately, despite the evidence supporting this, it is not yet seen as a priority by most service models and government departments.
A major challenge remains the need to better orient mental health services around prevention and increasing awareness of the opportunity for impacting the burden of mental health problems in the community through early in life intervention.
Health systems in general are oriented around immediate needs and response with relative lack of investment in long term outcomes. Advocacy for early intervention approaches involves making clear arguments for the social benefits of getting in early to reduce risk and support development.
Developing programs and evaluating immediate and long-term impacts on parental mental health and infant development is a crucial component and supports the development of programs based on community need and the existing skills of those working in this important field.
Professor Louise Newman AM is a specialist in Perinatal and Infant Mental Health and early life Psychological Interventions at the Albert Road Clinic. Professor Newman focuses on Women’s Mental Health, support for early parenting and developmental difficulties of infants and young children. She is trained in Infant and Parent Psychodynamic Therapy.
Albert Road Clinic is a premier specialist private psychiatric facility located close to Melbourne CBD. The Clinic provides inpatient, patient and community based mental health services in a comfortable, discreet and supportive environment. The clinic’s mental health services cater to all ages, and is home to a number of child and adolescent psychiatrists who offer support with perinatal and family issues.
To seek further information about Albert Road Clinic’s mental health services please visit the Albert Road Clinic website, contact us or call us on 03 9279 3594 to have a confidential conversation with a member of our team.
Ramsay Health Care also offers specialised perinatal and postnatal mental health services across Melbourne at hospitals including Mitcham Private Hospital and Peninsula Private Hospital.