It was an absolute pleasure to be invited to deliver the opening address at last week’s annual conference during Infant Mental Health Awareness Week, kindly hosted by the Mercers’ Company in their beautiful Mercers’ Hall in central London. Organised by PIP UK, the Winston Churchill Memorial Trust, the Wave Trust, and the Dulverton Trust, the conference brought together some of the leading figures in the infant and maternal mental health space to discuss how we, as a society, can make more progress on this vital issue.
Infant mental health, or more specifically early intervention in the first 1001 critical days of life from conception to the age of 2, has been a passion of mine that predates my work in Parliament. Maternal depression is something that affects a great number of women each year and it can go on to have a lifelong impact on the opportunities and outcomes for the baby.
A secure and loving relationship with a key carer shapes the way a baby’s brain develops, with long-term consequences on that baby’s emotional health – the developing brain will literally learn that the world is a god place and that problems can be solved.
On the other hand, we know that a pregnant mother who suffers from stress produces more cortisol – a hormone which is easily transmitted via the placenta to the unborn child. The more stressed the mother, the more frequently the foetus is exposed to higher levels of cortisol. We know that exposure to high levels of cortisol can lead to modifications in gene expressions whilst the baby’s brain is still developing. So, even in the womb, the potential for lifelong emotional and physical health is being determined.
We also know about the critical role the prefrontal cortex plays in personality expression and guiding social behaviour, including our capacity for empathy and rationality. In the words of the wonderful Sue Gerhardt, the British psychotherapist and author of Why Love Matters, “affection shapes a baby’s brain”.
So affection – a secure early bond – is what we want for all babies! But it is far from what is happening today. We know that:
- 67 per cent of the UK population has experienced at least one Adverse Childhood Experience – a stressful or traumatic event, including abuse and neglect, in the earliest years – and that one in eight people have experienced four or more.
- These one in eight people are 3 times more likely to develop lung disease through smoking, 11 times more likely to use drugs intravenously, 14 times more likely to attempt suicide, and 4 and a half times more likely to develop depression.
- People who have experienced six or more ACEs can die as much as 20 years earlier than those who have experienced none.
- Conduct disorder in young children leads to adulthood antisocial personality disorder in about 50 per cent of cases, and is associated with a wide range of adverse long-term outcomes, particularly criminality.
However, I am in no way suggesting that insecure attachment always leads to disastrous outcomes. It is perfectly possible for an insecurely attached baby to grow up to lead a normal and happy life, but there is significant evidence that a troubled early life makes it so very much harder.
If we are to begin to reduce the number of ACEs our children experience, and ensure that more babies have a secure early bond, we need to tackle this problem at the beginning.
This is why I am delighted that the Government has been taking action. The recent Department of Health & Social Care Green Paper consultation on Transforming Children’s Mental Health is focused on tackling mental health in schools, and I was particularly pleased that it features sections on the importance of secure attachment and the provision of specialist perinatal services, with a focus on interventions centred around attachment relationships.
Our Better Births strategy and the Five Year Forward View for Mental Health demonstrate that perinatal mental health is becoming a higher priority for Government, and the Institute of Health Visitors has been funded to train almost 600 perinatal mental health visitor champions to identify and treat maternal mental health conditions.
We’re delivering £365 million of investment to ensure that, by 2020/21, up to 30,000 more women will be able to access high-quality mental health care in the community or in specialist Mother and Baby Units. Four new MBUs are opening in the next two years and we’re increasing capacity at the existing 15 units by around 50 per cent by the end of next year.
But the responsibility to break the cycle sits with more than just a midwife, or health visitor, or any one Government department. We’ve seen that the impact of insecure attachment touches every corner of society, from schools, to hospital admissions, to reoffending.
That is why a key ask of the 1001 Critical Days Manifesto – that I launched as a backbencher with cross-party support – has been to relaunch Sure Starts, and to bring together the myriad of different services available to support new babies and their parents under one roof. From birth registrations to antenatal support, relationship guidance to psychotherapeutic services, Children’s Centres could be reenergised. By making them a hub for families, health visitors, midwives, early years professionals and others, with a clear presumption of data sharing and a much-needed focus on Dads, we could better address the challenge of insecure early attachment and the hardship it inflicts in later life, giving all babies the best start.
Those 1001 critical days are truly where those cycles can be broken, and I am committed to doing everything I can, whether with PIP UK, in Cabinet or as an MP, to change our society for the better.
You can read my full speech here and the full programme for the conference here. Applications for Churchill Fellowships are open until the 18th September 2018 and offer a unique opportunity to expand your professional horizons by travelling abroad for up to two months, researching innovating ideas and best practice in a topic of your choice. Find out more information at www.wcmt.org.uk/apply.
Check speech against delivery. Photo credit: Clive Totman