Mental Health in Early Years

When a child is mentally healthy, they'll reach emotional, physical, and developmental milestones. They can develop healthy social skills and acquire proper coping mechanisms when there are issues or problems. These children will thrive within their home environment, local community, and in school or early years centres. It's estimated that 1 in 10 children are affected by mental illness. Nearly 70% of children with a mental health issue have not had a professional intervention, stunting or negatively impacting growth and development. A child with mental disorders can cause significant changes to how they learn, handle emotions, behave, or interact. It's more likely to cause problems or disruptions during the day, particularly with fear, anxiety, or worry. 

The most common disorders associated with children include anxiety, behavioural disorders, and attention deficit or hyperactivity disorder. A child may also struggle with emotional development, behavioural skills, or difficulty with developmental disabilities. These can be exponentially larger with substance abuse, neglect, or abuse. 

It's important to remember that a lack of mental disorders is not a sign of mental health. A child can continue to suffer through weaknesses without developing proper coping skills down the road. Essentially, mental health in children is a sliding scale of overall health. 

Understanding How Mental Health Impacts Child Development

As a child continues to develop, their brain works rapidly to continue forming and growing too. Childhood experiences can have a significant impact on overall development. Children learn how to regulate emotions and physical responses as a child; delays can impact the causal effect of these milestones. For example, a child will be categorised on how they respond to stress and trauma throughout their lives. According to Harvard, toxic stress, including any experiences that can lay an unstable foundation, can physically damage the brain's architecture. This means a child facing significant toxicity at a young age is more likely to cause significant mental health problems (this can occur immediately or down the road). 

Why is mental health so challenging to understand with children?

Understanding mental health disorders in children can be challenging to comprehend for a multitude of reasons. Normal childhood development is an ongoing process that involves continuous and constant change. Young children lack emotional regulation, making triggers or responses seem over-the-top when they're considered normal range. Additionally, mental health disorders manifest differently in children, depending on the age of the child. These can alter traditional or common symptoms without the intellectual capacity to acknowledge a change in feelings. In simple terms, children may not be able to tell an adult through rational thought why they are thinking, responding, or reacting in a specific way. 

Despite mental health awareness improving, stigma and negative connotations are still attached to such conditions (especially in children). There are concerns with using medications, logistical challenges connected to treatment (centres are far away from residing city or town), or financial implications that may prevent a child from receiving counselling, treatment, or therapies to assist.    

What Causes Mental Illness in Children?

While the exact cause of mental illnesses is primarily unknown, research has strongly suggested influencing factors. These include biology, heredity, psychological trauma, and environmental (toxic) stress. 

What is Biology?

Some mental health disorders are connected to neurotransmitters. These help nerve cells in the brain communicate with the rest of the body and each other. If functioning correctly, these chemicals will communicate adequately. If they are not working properly, messages may not make it through, causing symptoms to develop. 

What is Heredity?

Heredity is the genetic influence that a child's parents have on mental illness. It is the likelihood that a child may develop or have a mental disorder passed on from their parents. One example includes schizophrenia (which has a strong genetic influence).  

What is Psychological Trauma?

These can often be included within the toxic stress category for childhood influence but include a psychological trauma that has impacted the child's overall functioning. These can consist of crucial early loss (such as a parent), severe abuse or neglect of a child, or other significant loss to the family dynamic.

What is toxic stress?

Anything that is considered a frequent, ongoing or prolonged activity that activates the stress response is categorised as toxic stress. Examples of such toxicity include chronic neglect, abuse (of any kind), death of a loved one, domestic violence, parental incarceration, or parental mental disorders/substance abuse. This response can be buffered through supportive and loving caregiver relationships but can impact virtually every aspect of a child' life. Mental health in the early years can be grossly connected to their development long-term. This can include brain development, academic achievement, and mental health conditions. 

How Can These Stressors Be Minimised?

Reducing the risk of mental health disorders can be categorised by healthy family functioning. This includes positive and nurturing interactions, supportive relationships, and trying to minimise conflict within the home. If a family is struggling to reduce the stress or overcome these lifestyle conditions, the intervention of a professional may be required. 

Identifying Key Warning Signs of Mental Health Conditions in Children

There are several maladaptive methods children learn to react to stressors in their life. Although the following list isn't exclusive, they do offer insight into warning signs to watch for when childminding.   

- Mood Changes: While every child will likely have a bad day, it's vital to identify intense, ongoing periods of sadness or withdrawal. These include large swings throughout the week that can consist of excessive periods of happiness too.

- Behaviour Changes: If you notice a child engaging in frequent fighting, weapons, self-harm (or harm to others), they may indicate a conduct disorder. 

- Intense Feelings: Fear or worries that interfere with daily activities, physical manifestations of such fear (including racing heart or fast breathing), can be a sign of anxiety disorders in children. 

- Physical Symptoms of Pain: Children with mental health conditions may feel physical (unexplained symptoms) when dealing with stressors. These might include headaches, tiredness, or stomach aches. 

- Missing Key Milestones: Autism spectrum disorder is a serious developmental disorder that often appears in early childhood. Symptoms can drastically vary but observing behaviour over time is paramount to diagnosis. Should a behaviour persist or worsen within two months, it may be cause for concern. 

Ways to promote mental health in children

Children want to feel heard, supported, and appreciated. With world mental health day marked on the 10^th of October every year (to raise awareness of mental health issues around the world), learning how to positively influence the children in your care is a small step in reducing the impact stressors play on a child's development. Always ask children how they're doing and encourage conversation in a safe and non-confrontational way. Get them used to talk about their feelings while being actively heard. Likewise, showing an interest in their life and hobbies (or interests) is another way to connect. Taking an interest in their lives will help them value themselves and also showcase any disruptions from "normal behaviour" when there are problems. 

A child should never feel discredited or dismissed when it comes to expressing their feelings. Try to remain non-judgmental when it comes to their emotions; stay open and understanding with their thoughts or concerns. Try to encourage a child to process their fears in a positive, constructive way. Try to monitor any emotional regulation and help them work through big emotions. Dealing with problematic behaviour can be difficult, but establishing boundaries, positive coping mechanisms, and ongoing support can help minimise disruptions in the future. 

Promoting mental health in early years staff/settings

With nearly 66% of staff suggesting that the pandemic had negatively impacted overall health and wellbeing, supporting and promoting mental health within the early years' team is critical for long-term success. Factor these statistics into the already problematic role of aiding children with complex backgrounds, emotional and behavioural demands, and ongoing support – you have a recipe for disaster. Supporting staff within an early years setting needs to start with open and constant communication. You need to have an open-door policy to discuss difficult or troubling behaviours (this can include stress on the worker. Nursery workers have extended periods of time with children, offering an essential role during the formative years. Improving training, education, and coursework for trauma-related behaviours is critical to overall stress reduction. 

Mental health services in the USA/UK

If you've noticed a change in your child's behaviour, or you're concerned about your child's mental health, contact your child's primary care physician. Make a note of any ongoing, chronic behavioural patterns, when they started, and how they have continued or are persisting overall. Reach out to any nursery teachers, friends, family members, or coaches for direct feedback from them. Anyone that spends time with your child would have the opportunity to notice anything unusual or out of character. 

 From there, the physician may order a consultation or appointment with a mental health specialist. This may include a counsellor, nurse, or psychologist. These evaluations may consist of reviewing symptoms, developmental progress, and any standardised assessments or questionnaires. In the United States, the Diagnostic and Statistical Manual of Mental Disorders provides criteria for making a diagnosis based on symptoms. In the United Kingdom, the World Health Organisation's International Classification of Diseases (ICD) is used to diagnose paediatric patients with mental health concerns.

It's essential to recognise that diagnosis with children can take time due to the lack of communication and inability to understand or acknowledge feelings. More importantly, it's important to remember that the overall wellbeing of the child should always be the top priority for parents and educators, making the diagnosis and treatment of mental health disorders a significant and vital component to health and wellbeing.
 

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