Wednesday, February 16, 2011

Childhood trauma, mental health and family support

Hope for the future lies in reducing the impact of trauma on society. Te best way to do that in the long term is to reduce the number of traumatised children. This can be done either by cutting their exposure to potentially traumatic experiences, or by increasing their resilience to cope with such events. Both are aided by good parenting in a stable, loving family environment. Sadly, many families are under pressure and children suffer from the stresses of poverty, neglect and maltreatment, or have parents with poor parenting skills or mental health problems. What can society do to help?

There are several issues here. Parenting skills are seldom taught in schools, and training is not required for this most important of jobs. The majority of us were brought up in much the same way that our parents were raised, and go on to raise our own children this way too, regardless of whether or not it is good. This ignorance is compounded by the stresses of modern life and increasing mental ill-health.

Modern urban societies have fragmented the extended family, and emphasise the privacy of the individual and nuclear family. This often leads to isolation, and resentment of official intervention, particularly where the authorities have the power to remove children to foster homes. As a result, government support programmes may be resisted and treated with suspicion. Such programmes also are frequently split amongst various problem areas such as financial assistance, housing, employment, and child welfare.

These issues and solutions to them are discussed further in our book Hope for Humanity.   The most effective programmes integrate assistance with finance, housing, employment, mental and physical health, parenting, child welfare and other challenges. At best, a home visitor seeks to become a friend and mentor of the family, and draws upon resources of government, local charities and community organisations. To succeed, it is vital that this support person not become associated with regulatory and policing functions.

This approach is exemplified by the UK charity Family Action. Working with tens of thousands of disadvantaged and socially isolated children and families, they provide practical, emotional, financial and educational support. They tackle some of the most complex and difficult issues facing families, including domestic abuse, mental health, learning disabilities and severe financial hardship. By working with the whole family, they help them become safer, stronger and more optimistic about their future.

A particular focus of Family Action is parents with mental health problems as reflected in a recent blog by their head of policy and campaigns, Rhian Beynon. Children in such families are at increased risk of poverty and being taken into care, and are twice as likely as others to experience a psychiatric disorder. Thus, caring for children’s mental health starts with integrated support for their parents. Family Action works with parents in their homes to create a lifestyle that stabilises their condition. This often includes assistance to find suitable accommodation and claim social security benefits to which they are entitled. It may also include working with the parents to improve their relationship with their children, support their learning, and set boundaries and routines for them. Parents are encouraged to get involved in their communities, and to start training, find work, or become a volunteer.

Unfortunately, such services are often seen as too expensive, particularly in this era of savage cost-cutting by the UK government. This leaves the families struggling without support, at the mercy of an unsympathetic and inadequate welfare system. Family Action cites the cost of support services as £4000 (US$6500) per family. This may sound a lot, but what is the cost of the alternative - lifetime care for more people with mental health problems, and more violence, crime, addiction and other behavioural consequences of trauma?

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