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What is infant and child mental health (and why is it important)?

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People can be surprised to hear the term ‘mental health’ used in relation to infants and children. Often, when we think of mental health, we only think of problems and concerns, and conflate the idea (and stigma) of mental illness with the holistic concept of mental health and wellbeing (Frameworks Institute, 2009, 2019). You may be wondering what infant and child mental health even is, and why it’s important.

Child mental health can also be referred to as the child’s social and emotional wellbeing. Most infants and children experience good mental health, particularly if their parents, family, and community are responsive to their needs. They can meet challenges, express and regulate a range of emotions, explore their environment, and form secure relationships, all within the context of their age and developmental stage. And positive mental health means positive development, which helps kids grow to be healthy and well throughout their lives.

But not every family has the resources or support they need for their children’s positive development. When we start having conversations about mental health and wellbeing early in a child’s life, we can help create opportunities for every child to thrive.

Prevention and early intervention strategies are vital to improving infant and child mental health and helping to prevent the development of mental illness in adolescence and adulthood. Practitioners are in a unique position to provide support to parents and help plan for children’s social and emotional development and mental health at the earliest possible stage.

What is infant and child mental health?

Mental health is something everyone has. A child’s mental health is not fixed; it is experienced across a continuum ranging from positive mental health, to mental health vulnerabilities or difficulties, through to diagnosed mental health conditions.

This is the dynamic nature of child mental health. No child’s experience is static, and it is important to consider their ‘position’ on this continuum at different times.

Children do, and should, experience a range of emotions. This is a healthy part of childhood. But when a child is unable to regulate emotions causing them to continually miss out on opportunities or not engage in play it may be a sign of mental health vulnerabilities.

Many of the social determinants affecting mental health, such as education, social inclusion, housing and income, are unequally distributed through our communities, meaning that infants and children who experience disadvantage are more likely to have poorer mental health outcomes.

In the following podcast excerpt (1 minute, 3 seconds), Brad Morgan, Director of the Emerging Minds: National Workforce Centre for Child Mental Health shares how mental health is about more than just being ‘happy’.

What does positive mental health look like?

Infants and children need positive mental health for their physical and emotional development. Influences on mental health start before a child is born, continue in early childhood and go through to adolescence and adulthood.

Infants look to the trusted adults in their life to respond to their needs, engage, talk and play with them. Moments like these build supportive relationships, nurturing environments and provide opportunities to learn new things.

Positive mental health is foundational to emotional and physical development. It helps children learn to express and regulate a range of emotions, form other close and secure relationships, and confidently begin to explore the world around them.

Positive child mental health may look like a child who:

  • plays (alone and with others)
  • achieves developmental milestones
  • expresses their feelings
  • makes meaning of their world
  • is building their resilience; and
  • is curious and engaged with the people and places around them.

There is no one picture of what positive mental health looks like in a child. It should always be considered within the context of the child’s family circumstances, cultural and spiritual beliefs, environmental factors, and their personality and temperament.

Do infants and children experience mental health differently to adults?

Mental health is an integral part of overall health for children, just as it is for adults. But children’s mental health difficulties can present differently to adult mental health difficulties. Mental health vulnerabilities or difficulties in infants and children might include frequent or intense struggles with their emotions, thoughts, behaviours, learning or relationships.

They might have trouble calming down, struggle to control their moods, find it challenging to be separated from a parent, or have problems sleeping, eating or engaging at school.

Often these difficulties are not thought of or talked about in a way that considers the child’s mental health. They can be interpreted as behavioural issues, or misunderstood and dismissed as intentional actions (such as ‘they’re just being ‘naughty’, ‘defiant’, or a ‘worrier’’) instead of being considered as signs of mental health challenges.

These children might have trouble calming down after expressing a strong emotion or have trouble controlling their moods and behaviour. They might find it very challenging to be separated from their parent, or have problems with sleeping, eating, excessive crying or engaging with school and their community.

Looking out for influences on child mental health

Infants and children, more than any other age group, are shaped and influenced by a range of social, biological and environmental factors, all of which make up ‘the whole child’. Their mental health and wellbeing cannot be separated from the broader context of their lives. Considering a child’s behaviour, or changes in behaviour, alongside what is happening in their world is an important part of understanding child mental health.

Children’s health and development occurs within multiple contexts, including their own individual characteristics, their family, school, local neighbourhood, and community environments. This is called the child’s ecology and is similar to how we think about an ecosystem in nature.

Each of the parts at different levels of the ecological system interact with each other, influence each other, and support each other. Therefore, changes in one area of a child’s life can influence other areas (Bronfenbrenner, 1979; Zubrick, S. R., & Australia. Department of Families, Housing, Community Services and Indigenous Affairs & Growing Up in Australia, the Longitudinal Study of Australian Children, 2008; Zubrick et al., 2010)

It’s important to note that no one factor contributes to mental health in isolation. Throughout childhood, kids will have experiences that are nurturing, and those that are stressful; experiences that are positive and negative. These experiences can have a different impact on each child, depending on their ecology and the support people available to them.

The child’s family relationships (including extended family and carers) are considered the most influential factors in a child’s life. The quality and stability of these relationships has a lasting impact on the child’s mental health and wellbeing, self-confidence, learning, and how the child relates to others.

Children’s relationships with the people who are most consistently in their life influence the way their brain grows and functions (National Scientific Council on the Developing Child, 2004). Positive, steady relationships with educators, neighbours, friends and health service providers can also support a child’s healthy development and social and emotional wellbeing.

Some experiences throughout childhood can have more lasting impacts on mental health than others. Child, parent and family stressors can include:

  • experiencing trauma – the loss of a loved one, a natural disaster, or severe injury
  • having a parent with physical or mental illness
  • exposure to parental alcohol or substance use
  • experiences of poverty
  • exposure to family and domestic violence
  • periods of separation from a parent, or primary carer.

Infant and child mental health in Australia

The impact of any one factor can’t be predicted. For some kids, their experience of mental health is that of a diagnosable mental health condition, such as anxiety, depression and attention-deficit/hyperactivity disorder (ADHD).

Mental health conditions are not as common as positive mental health or mental health vulnerabilities, and many are temporary. But they are distinguishable by their intensity, duration and the extent of their impact on many areas of the child’s life.

In the following podcast excerpt (47 seconds), Brad Morgan, Director of the Emerging Minds: National Workforce Centre for Child Mental Health discusses some of the things to keep in mind when responding to child mental health vulnerabilities.

Who can help?

Children’s mental health is everyone’s responsibility. When we support every child, family and community, and understand what their needs and desires for positive health and wellbeing are, we can create a healthier and fairer foundation for all children.

Emerging Minds supports practitioners and health workers in both child and adult services to create opportunities for positive child mental health. Simple changes to your everyday practice can make a big impact to the mental health and lives of the children and parents you work with.

Practitioners are well placed to recognise influences, potential risk factors, positive opportunities and parenting skills and strengths that affect infant and child mental health. Whether you work in adult-focused services, with families, or with children, you can make simple changes to your everyday practice that can help promote positive mental health for kids now and into the future.

You can do this by:

  • asking clients who are parents about their children
  • taking a strengths-based approach to working with parents
  • working respectfully with parents to understand the impacts of parental adversity or circumstances on kids
  • working collaboratively with parents on prevention and early intervention opportunities in the life of the child
  • working collaboratively with parents on opportunities and skills that promote positive mental health and development
  • supporting children in ways that are sensitive to their experiences and enhance their social and emotional wellbeing.

It is not expected that you would diagnose mental health conditions, as this requires specialised training. When considering the severity and impact of a child’s mental health, it can be useful to ask ‘How pervasive is it?’, ‘How severe is it?’, and ‘How persistent is it?’. You can help by making referrals to specialists trained in diagnosing and treating mental health conditions.

In the following podcast excerpt (45 seconds), Dan Moss, Workforce Development Manager at Emerging Minds, talks about the significant role professionals can play in supporting children and families.

Ready to learn more?

You can make a difference in the lives of infants, children and families. Emerging Minds offers a range of free online training courses and resources that can help you learn more about infant and child mental health and how you can help.

Explore our online training:

Understanding Child Mental Health Foundation Course The Impact of Trauma on the Child Foundation Course Engaging with Children Working with First Nations Families and Children: A Framework for Understanding

References

Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. American Psychologist, 32, 513–531.

FrameWorks Institute. (2009). Child mental health: A review of the scientific discourse. Washington, DC: FrameWorks Institute.

FrameWorks Institute. (2019). Widening the lens on child mental health (internal report for AICAFMHA). Washington, DC: FrameWorks Institute.

*Lawrence, D., Johnson, S., Hafekost, J., Boterhoven De Haan, K., Sawyer, M., Ainley, J., & Zubrick, S. R. (2015). The mental health of children and adolescents. Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Canberra: Department of Health.

National Scientific Council on the Developing Child. (2004). Young children develop in an environment of relationships: Working paper no. 1. Cambridge: Centre on the Developing Child, Harvard University.

**von Klitzing, K., Dohnert, M., Kroll, M., & Grube, M. (2015). Mental disorders in early childhood. Deutsches Arzteblatt International, 112, 375–386.

Zubrick, S. R., & Australia. Department of Families, Housing, Community Services and Indigenous Affairs & Growing Up in Australia, the Longitudinal Study of Australian Children. (2008). Parenting and families in Australia. Canberra: Dept. of Families, Housing, Community Services and Indigenous Affairs.

Zubrick, S. R., Dudgeon, P., Gee, G., Glaskin, B., Kelly, K., Paradies, Y., … Walker, R. (2010). Social determinants of Aboriginal and Torres Strait islander social and emotional wellbeing. In N. Purdie, P. Dudgeon, & R. Walker (Eds), Working together: Aboriginal and Torres Strait islander mental health and wellbeing principles and practice (pp. 75–90). Canberra: Commonwealth of Australia.

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