Health visiting is the public health profession of today, the profession that builds relationships with every child in the country to support their early relationships and ensure that every child matters. Dr Cheryll Adams, Executive Director for the Institute of Health Visiting which featured as a primary partner of the UKs first infant mental health awareness week last week shares her thoughts about health visitors and their public health role for babies life chances.
What do health visitors contribute to Infant Mental Health?
It's wonderful to see the level of public and professional interest that the first ever Infant Mental Health week stimulated last week. Events and activities happened right across the country, many of them led by health visitors who are members of the Institute of Health Visiting.
Why do health visitors take infant mental health so seriously? Health visitors are public health workers. Although they work with individual families, they also look at the big picture, and there is a very big picture in the case of infant mental health. We, as a profession, really understand that what happens to every child in the early period of their lives, both in the womb and in their first weeks and months, the so called '1001 Critical Days', which lay a blue print for their future life. Hence, society, as a whole, benefits from every baby having the best start possible.
If a baby's experience is a positive one, with nurturing parents and a calm, positive environment to grow up in, they will learn to form good relationships with others, have personal confidence, and, in turn, develop emotional resilience which helps them to manage the challenges that life will bring, whether from the school bully, a huge disappointment, the difficult partner or an unhelpful manager in the workplace much later on. They are also much more likely to manage the hormonal and social challenges of being a young adult and less likely to 'go off the rails' with all the associated costs of that to society as well as the individual!
However, becoming a family is a very challenging time for new parents, they are usually exhausted, they may have little external support, they could have financial problems brought on by the loss of an income and some mothers (and fathers) suffer from anxiety and depression. Health visitors have a key role in supporting parents in the early weeks and months of their child's life, helping them to cope with such challenges that may interfere with their ability to appropriately nurture their infants.
Health visitors help new parents to understand their babies, to become attuned to their simple communications from their first days of life. We all need someone we can trust in our lives, and it's crucial for a baby's future mental health that they build early trusting relationships with their principle caregivers, who will be the safe haven as they grow up, when needing to make sense of any negative experience faced.
Health visitors are very well connected to community support and, by working alongside parents, they can help them unpick what their greatest challenges may be, and who might be able to offer them help. At the simplest level this may involve linking them to other new mothers for companionship, or to local mums groups such as are run in children's centres, or by the NCT. It can also involve helping them to address their anxiety or depression, seeking help promptly.
Many years ago I visited a family unit where one of my more challenged families had gone to live for a month. A team of psychologists and child psychiatrists were helping them to unpick the negative emotional environment that had been created for their children. That day something was said to me which I have never forgotten - 'if health visitors only recognised postnatal depression earlier and we had better services to support new mothers' emotional wellbeing' this unit could close', think of the saving to the NHS that could bring?
Fortunately today, health visitors are increasingly well trained in recognising postnatal depression early, and in supporting families to manage it. They are also trained in recognising when the principle caregiver, usually the mum, but sometimes the dad, may be struggling to bond with their baby and to offer help. The challenge we face, apart from having sufficient resource to deliver this role fully, is that parents are often embarrassed if they feel they are not meeting the standard of parenthood that they see in magazines or on websites. They don't want to share any sense of failure. There is also a myth that if you admit to feeling depressed someone will take your baby away. Nothing is further from the truth, we are there to help, not to tell parents what to do, but to work alongside them offering advice and suggestions which we think could help them through a challenging period.
Someone once said to me as we both visited a new baby in hospital - 'that's a blank canvas, that little chap's future path is yet to be determined'. The most important factor in having a long, happy, productive and healthy life is our emotional and social health, physical health follows.
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