A need to focus on mental health and two-generation solutions
By Nicole Letourneau
The federal government and First Nations of Canada have reached a landmark $40 billion agreement that will compensate people harmed by Canada’s on-reserve child welfare system. Not only will this help right a historic wrong, but the agreement sets aside half of the funding for long-term reform of the on-reserve child welfare system. This is a powerful opportunity to support the health and development of many children at risk. Indigenous Canadians represent one of the youngest populations in Canada, and they require a child welfare system that meets their communities’ needs.
Canada and First Nations cannot dither at getting this right—Indigenous children in the child welfare system must have evidence-informed services now to support their foundational brain and neurodevelopment. Early trauma experiences have lifelong impacts on developing biological systems and increase the risk for a host of physical, learning and mental heath problems over the lifespan. The need is most urgent for infants and young preschool children, who are undergoing the most rapid period of neuronal growth in their lifetimes. This is when the brain is exquisitely sensitive to both the negative impacts of trauma and positive impacts of healthy, nurturing relationships.
Our reformed child welfare system must not add to the trauma of children already affected by abuse and neglect.
Fortunately, burgeoning evidence at the intersections of public health, developmental neuroscience and economics offers ready solutions. In addition to meeting basic needs for housing, food and clothing, countless studies and reports repeatedly emphasize that supporting children’s success in the child welfare system requires a focus on mental health promotion for infants and young children. Failing to do so puts children at risk of dire lifelong consequences.
The concept of infant mental health may conjure visions of a baby on a Freudian-styled divan. Rather, infant mental health refers to how well a child develops socially and emotionally from birth to three years of age. Children who do not have optimal mental health often show signs early—displaying behavioural problems such as anxiety, aggression and hyperactivity that dramatically increase the risk for mental health disorders in adolescence.
Research also shows such problems in adolescence link to mental health, legal, financial and social problems in adulthood, and even increase the risk of intergenerational transmission of trauma to their offspring.
In our published review and intervention research, we demonstrate that infant and early childhood mental health is promoted when caregivers provide nurturing care that is sensitive and responsive to infants’ needs and their developmental level. Interventions that focus on helping caregivers reflect on their infants’ and young children’s thoughts, feelings, desires and intentions work to improve their sensitivity and responsiveness to children’s needs. Importantly, these skills can be taught to caregivers, whether biological parents, kinship or foster carers. The reformed child welfare system must make every effort to ensure that caregivers are supported to deliver this kind of essential care that promotes infant mental health, for the good of the child over the long-term.
Evidence also shows that a focus on two-generation solutions involving both the child and their caregivers in programming to support children’s mental health and development are paramount to success of traumatized children. Children exposed to trauma receive health and education services, such as home visiting and early intervention programs (e.g., Head-Start style programs) while their caregivers receive services tailored to their needs, such as parenting education focused on sensitivity and responsiveness along with positive discipline approaches, literacy education, supports for educational completion, job training, treatment for mental health problems, etc.
Two-generation solutions have been shown to increase caregivers’ employment and reduce their dependence on public assistance with a return on investment of $4 for every $1 invested; their children were shown to exceed developmental milestones compared to their same-age peers. Many examples exist for our reformed Canadian on-reserve welfare system to emulate and expand, for example, Aboriginal Head Start and Nurse-Family Partnership Programs are already realities in Canada.
Canada’s Indigenous children and their families are a growing and important part of the social fabric of this nation. Just as in any community, some families need more support than others. Together, let’s ensure we provide the best on-reserve child welfare system we can—one that focuses on infant and early childhood mental health and caregivers’ success so that we can stop the trauma that has affected too many generations.
Dr. Nicole Letourneau is a professor in the Faculty of Nursing and Cumming School of Medicine (Pediatrics, Psychiatry and Community Health Sciences) at the University of Calgary.