4. Early Years - Universal
Context
4.1 Early years and childcare services can encompass pre-school education, day care, out of school care, childminding, fostering and adoption and other services such as family centres. By their nature, they cross traditional sector boundaries - education, social care, and health. Early years and childcare services may also be public, voluntary or private sector services. National Care Standards 56 help to ensure consistency in what is provided.
4.2 Good parenting is fundamental for the development of a child's mental health and wellbeing. As children's primary carers, all parents need to be supported and helped, but especially when they are parenting in difficult circumstances or facing uncertainty about the way they are bringing up their children. Interventions focussed during pregnancy and at the time around the birth are likely to be the most effective in preventing mental health problems of a child. These include interventions which improve and enhance the wellbeing of the mother and of the baby and promote the mother-infant bond, and which take into consideration the psychosocial aspects of pregnancy, promote good early parent-child interactions, attachment, support problem-solving skills of the parents, and underline the roles of fathers.
4.3 Early years and childcare services are a vital first "frontline" in establishing good mental health and wellbeing among the youngest children. Risk factors and vulnerabilities in infancy and early childhood are associated with mental health problems in children and young people. These in turn are associated with greatly heightened risk of mental illness in adult life. The ability to improve mental health and wellbeing in the early years is therefore a vital area for action. Positive and inclusive physical activity and the development of key motor skills have an important role in this, contributing to enhanced confidence and social skills.
Overarching philosophy and culture
4.4 The National Care Standards: Early Education and Childcare57 make clear reference to providing an environment in which children's emotional and social development is considered. They describe an environment in which children and young people:
- Will be welcomed, and will be valued as an individual
- Will be nurtured by staff who will promote his or her general wellbeing, health, nutrition and safety
- Will be supported by staff who interact effectively and enthusiastically with him or her
- Receive support from staff who respond to his or her individual needs (personal, emotional, educational and physical)
- Experience an environment of mutual respect, trust and open communication
- Can be confident that the service keeps up links and works effectively with partner organisations
Service elements and activities
* In the "Lead Partners" column, 2-3 partners are identified, with the suggested lead partner highlighted in bold. This is indicative only, and there is a much wider network of partners who should be consulted as appropriate. These are listed in Annex 1. The involvement of children, young people, parents and carers is assumed.
Service Elements |
Activity |
Outcomes |
lead Partners *see above |
Involvement of expectant parents, prospective adoptive parents, parents and children in developing information, resources and services to support their mental health and wellbeing |
- Development and implementation of a local strategy for the involvement and participation of expectant parents, parents and children.
- Development and implementation of the local strategy in partnership with expectant parents, parents and childcare support establishments.
- Occasional public local debates, e.g. via local press.
- Key workers seek the views of individual expectant parents, parents and children.
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- Expectant parents and parents feel that their views are valued.
- Service development and redesign is informed by the views of parents and expectant parents.
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- NHS midwifery services
- NHSCAMHS staff (inc. Primary Mental Health Workers)
- Social work services
|
Provision of training and consultation for midwives, public health nurses, allied health professionals and social workers, and awareness-raising input for staff working in adult mental health services and non-medical staff such as those working in the social services workforce and care staff, including those still in training |
- NHSCAMHS staff plan and provide multi-agency, multi-disciplinary training opportunities for midwives, public health nurses, allied health professionals, social services staff and care staff on mental health issues.
- Midwives, public health nurses, allied health professionals, social services staff and care staff are supported to participate in mental health training.
- NHSCAMHS staff provide ongoing consultation and advice to midwives, public health nurses, allied health professionals, social services staff and care staff on mental health issues.
- Obstetric mental health liaison services link with CAMHS.
- NHSCAMHS staff offer dedicated time in support of infant mental health through consultation to and/or direct work in perinatal services.
- Adult mental health and social work services link with CAMHS to consider and address the potential impact of a patient's mental health problems on any dependent children 58.
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- Midwives and public health nurses are able to support parents in developing a basic understanding of attachment issues, infant mental health and their role in supporting their child's mental and emotional development.
- Midwives, public health nurses, social services staff and care staff understand and are able to identify risk factors.
- Midwives, public health nurses, social services staff and care staff are able to ensure that parents' own mental health needs are recognised and addressed (particularly mothers with antenatal and postnatal depression).
- Adult mental health and social services staff are aware of the potential impact of their patient's/ client's condition on any dependants or young siblings.
- Midwives, public health nurses, social services staff and care staff are able to access specialist advice and support.
- Referral protocols for NHSCAMHS are agreed and transparent.
- Midwives, public health nurses, mental health officers and other agreed professionals are able to refer direct to specialist NHSCAMHS.
|
- NHSCAMHS staff (inc. Primary Mental Health Workers)
- NHS midwifery services
- Social work services
- CPD Co-ordinators
|
Provision of training and consultation for staff in pre-school and childcare settings |
- CAMHS staff link with pre-school and childcare settings, SureStart centres and local authority family centres.
- NHSCAMHS staff work with local authorities and with private and voluntary sector childcare providers to plan and provide training opportunities in mental health (including mental health promotion) for pre-school and childcare staff.
- NHSCAMHS staff provide ongoing consultation and advice to pre-school and childcare staff.
- Development and agreement of a referral protocol with pre-school and childcare staff.
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- Childcare staff have a basic understanding of mental and emotional health and development.
- Childcare staff recognise the importance of their contribution to children's mental and emotional wellbeing.
- Childcare staff have a basic understanding of protective factors and how these can be nurtured.
- Childcare staff have an understanding of the contribution that physical activity and development can make to emotional health.
- Childcare staff understand, and are able to identify, risk factors.
- Childcare staff know what specialist advice and support is available to them and how to access it.
- Referral protocols and pathways for CAMHS are agreed and transparent.
|
- NHSCAMHS staff (inc. Primary Mental Health Workers)
- Pre-school & childcare providers
- Childcare partnerships
- CPD Co-ordinators
|
Links with education authorities and with private and voluntary sector childcare providers to support the mental health and wellbeing of early years staff |
- Work with local authorities and with private and voluntary sector childcare providers to plan and provide a range of supports for staff to access before they become unwell, e.g. counselling/stress management, relaxation opportunities.
- Build on see me59 initiatives on mental health in the workplace.
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- Staff feel valued and supported, and are therefore more able to support others.
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- Health promotion staff
- Education authority
- Scotland's Health At Work 60
|
Contribute to development and delivery of universal parenting programmes |
- NHSCAMHS staff (and clinical psychologists) contribute to training for public health nurses and allied health professionals in the development and delivery of evidence-based parenting programmes and approaches.
- Provision of information locally for parents about parenting support and education groups that are available at a range of times and settings.
- Primary care staff encourage and support parents to participate in parenting programmes.
- Provision of accessible drop-in services and advice points for parents to discuss problems and access support.
- Access for primary care practitioners to clinical psychology consultation and advice on families in their care.
- Arrangements by CAMHS staff to ensure that young parents who are receiving care and treatment are enabled to engage in parenting programmes.
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- Parents have a basic understanding of mental and emotional health and development.
- Parents recognise their contribution to children's mental and emotional wellbeing.
- Parents have a basic understanding of protective factors and how these can be nurtured.
- Parents are supported by universal services and public messages to feel confident in dealing with their child's behaviour.
- Parents know how to access advice and support if they suspect there is a problem.
- Parents' coping skills are developed and affirmed.
- Parents receiving mental health care are enabled to engage in parenting programmes.
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- SureStart workers
- NHS Primary Care team
- Voluntary sector
- NHSCAMHS staff (inc. Primary Mental Health Workers)
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Involvement in provision of support for individual children and families, including targeted parent support |
- Primary care staff encourage and support parents to participate in tailored parenting programmes.
- NHSCAMHS staff input to training for key workers on mental health and parenting issues.
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- Key workers have a full understanding of attachment and are able to support this.
- Parents have a basic understanding of protective factors and how these can be nurtured.
- Parents feel confident in dealing with their child's behaviour.
- Parents' coping skills are developed and affirmed.
- Parents understand the importance of infant interaction and have the skills to put into practice.
- Parents know where they can access advice and support.
- Parents are supported to care for their child.
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- NHS Primary Care team
- Education authority
- Social work services
- Family centres
- NHSCAMHS staff (inc. Primary Mental Health Workers)
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