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?

An Update on Lessons from the Floods

A few days ago, I wrote about the lessons Australia and the world can learn from the recent floods. Most of the points I made for a strategy to reduce trauma from future natural disasters were supported in a subsequent current affairs programme on ABC TV. Now, the dozens of charities concerned with mental health in Australia have spoken out.

Already there has been almost a 40% increase in demand for mental health services as people struggle to come to terms with what the flood has done to their lives. Amongst children, the increase is nearer 50%. Some victims are already talking about suicide as they face their seemingly hopeless financial situation. A huge crisis in housing is looming as short-term accommodation with friends and family becomes stressful, and ends. There simply are not enough houses available for rent in what was already a tight housing market.

Bob Gilkes, of the mental health charity Lifeline, is quoted as saying: "If we don't address some of the psychosocial issues that will exhibit in the community over the next few months, they will have lasting effects in our society for generations to come. ...
That could be much more expensive than what it would cost to address the issues now. ... If you have families that become dysfunctional because of stress, depression, anxiety, anger, you have families break up. You generally see much more dependence on the welfare system and that can go on generationally."

Similar issues arise wherever in the world there are natural disasters, wars, genocide, and other collective traumas. Few countries have the resources to address them adequately. There will never be enough highly-trained psychologists and counsellors to meet the needs in disaster zones. What is needed is a long-term programme to train large numbers of community members in the symptoms of trauma to watch for, and simple ways of preventing and healing it. More general community-building activies are also essential for increasing mutual support and the resilience to cope. In these ways, we can bring hope to the victims of disaster, and simultaneously reduce the destructive effects of trauma on families, communities and nations.