Centre for Community Child Health Early Years Seminar INTRODUCTION AND OUTLINE Infant and child mental health: Ensuring optimal wellbeing for all children This seminar is devoted to infant and child mental health – but • Parkville, 18 th March 2016 mental health is a problematic term when applied to this age group - no one wants to think of infants and young children Centre for Community Child Health having mental health problems, and there is a strong public backlash when anyone tries to do so WHAT DO ALL INFANTS AND CHILDREN NEED This appears to be partly because of the stigma attached to • FOR OPTIMAL WELL-BEING? mental health in general – we are afraid of it, and don’t talk about it easily – this is changing because of public campaigns such as Beyond Blue , but the atavistic fear still lurks in the Tim Moore background The reaction against applying mental health concepts to • Centre for Community Child Health young children also reflects a concern that this is pathologising children far too early – this is particularly the Murdoch Childrens Research Institute case when we try to apply adult mental health terminology The Royal Children’s Hospital such as depression or even mental health itself So we need to get a better understanding of what mental • health looks like in young children and how we should talk about it Centre for Community Child Health The scientific evidence is clear: Significant mental health • FOCUS OF PRESENTATION problems can and do occur in young children. Early mental health problems merit attention because they The focus of presentation is on normal development and the • • disrupt the typical patterns of developing brain architecture conditions that promote it rather than on mental health and impair emerging capacities for learning and relating to problems or issues others. This is to counterbalance the usual approach of focusing on • And regardless of the origin of mental health concerns, new and classifying the various forms of behavioural and • research clearly indicates that early intervention can have a developmental aberrations positive impact on the trajectory of common emotional or We are all on some spectrum or other at some stage of our • behavioral problems as well as outcomes for children with lives – if our classification systems continues to try and serious disorders. describe these variations, we will all find ourselves in the DSM eventually – the map will have become the territory National Scientific Council on the Developing Child (2008/2012). Establishing a Level Foundation for Life: Mental Health Begins in We need to understand how mental health problems develop • Early Childhood. NSCDC Working Paper No. 6. Cambridge, from the inside out, rather than treating them from the Massachusetts: Centre on the Developing Child at Harvard University . outside in Centre for Community Child Health OUTLINE The more we learn about the architecture of the mind, the more we see that conditions we recognise Defining our terms • as disorders are variations of the Understanding the relationships between mind and body • same biological and psychological What do we know about child development? systems that operate in all of us. • What are the conditions that infants and children need for • Normal and abnormal are like night their optimal wellbeing? and day: we recognise them as What are the conditions that families need to promote the different, but there is no sharp line • optimal well-being of their infants and children? between them. Implications • Readings and resources • Conclusions • Jordan Smoller (2012). The Other Side of Normal: How Biology Is Providing the Clues to Unlock the Secrets of Normal and Abnormal Behaviour. New York: William Morrow / HarperCollins Publishers. Centre for Community Child Health 1
Sound mental health provides an essential foundation of DEFINING OUR TERMS • stability that supports all other aspects of human What do we mean by the terms health, mental health and development—from the formation of friendships and the ability • well-being, and what is the relationship between them? Does to cope with adversity to the achievement of success in school, health underpin mental health and well-being? Or does work, and community life. mental health underpin the others? Understanding how emotional well-being can be strengthened • Each of the concepts can be defined as being broad enough • or disrupted in early childhood can help policymakers promote to include the other: the kinds of environments and experiences that prevent ─ On the one hand, health can be seen as the bedrock of problems and remediate early difficulties so they do not mental health and well-being; without a basic level of destabilize the developmental process. physical health, development is compromised, and their ability to develop the functional capabilities to participate reduced. National Scientific Council on the Developing Child (2008/2012). Establishing a Level Foundation for Life: Mental Health Begins in ─ On the other hand, mental health and well-being can be Early Childhood. NSCDC Working Paper No. 6. Cambridge, seen as synonymous with health in its broadest sense. Massachusetts: Centre on the Developing Child at Harvard University . Centre for Community Child Health THE NERVOUS SYSTEM MIND, BRAIN AND BODY The nervous system controls Thus, health and mental health / well-being can be and coordinates all bodily • understood as complementary concepts systems. This complementarity of the twin notions of health and It has two main parts: • wellbeing is consistent with what we are learning about the • The central nervous system , neurobiology of mind, brain and body: which consists of the brain ─ brain functioning is not purely cognitive, and the spinal cord • The peripheral nervous ─ ‘learning’ is not purely conscious, system , which forms a ─ learning is not exclusively neural, network through the body ─ the brain is not purely skull-based, and Properly understood, the brain ─ the brain is closely linked with other key bodily systems is not just skull-based but ‘embodied’, being shaped by messages from all over the body. Centre for Community Child Health MIND, BRAIN AND BODY (cont) THE MIND~BRAIN~BODY SYSTEM Psychological states (including mental health and • happiness), neurological functioning, and biological functioning (including health) are dynamic systems that interact with and affect each other continuously (Siegel, 2012; Davidson & Begley, 2012) This relationship between mind and body is bidirectional: • what is in the brain necessarily influences what is in the body, but what is in the body also influences what is in the brain (Davidson & Begley, 2012) The human brain and the rest of the body constitute an • indissociable organism, integrated by means of mutually interactive biochemical and neural regulatory circuits (including endocrine, immune, and autonomic neural components); the organism interacts with the environment as an ensemble: the interaction is neither of the body alone nor of the brain alone (Damasio, 1994) Centre for Community Child Health 2
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