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?

Our Children, Our Future

If we want to help build a better world and a better life for our descendants, there is nothing more important than to provide a caring, nurturing, yet stimulating environment for our children from conception to adulthood. Possessions and affluence pale into insignificance by comparison with the need for a warm, peaceful, secure home with loving caregivers. Yet all too often, children are neglected or maltreated. In the words of Bruce Perry, millions of children in the USA are ‘literally incubated in terror.’ Many of these will grow up to be fearful, anxious and depressed. Others will become aggressive, violent and predatory. All of them will have their potential blighted. They will learn inappropriate ways of child rearing, and so pass on their dysfunctional patterns to their offspring.

Hope for the future lies in breaking this vicious cycle through conscious interventions. Research suggests that authoritarian policies that result in children being taken into care do not work. They do little to change the home situation, and child welfare workers become seen as police to be feared. Far more effective are approaches that provide integrated support and education to the caregiver, usually the mother. In this case, the welfare worker may become a trusted friend and advisor, who identifies problems the family faces and helps to find solutions. These may include issues such as accommodation, financial support, budgeting, an abusive relationship, physical and mental health, parenting training, and so on. The best of such programmes not only coordinate a range of local, state and national government services through a single local advisor, but also integrate them with local community groups and charities.

Sure Start is a successful programme established by the previous Labour government in the UK. It set up 3,500 centres in communities around the country, reaching out to hundreds of thousands of families and helping 2.7m children in need. In the words of columnist Polly Toynbee in The Guardian newspaper, these “life-enhancing places have become hubs for community activity: mothers creating a fount of local action.” Despite this success story, many of these centres and the services they provide are now at risk due to cutbacks in social services by the current Conservative-Liberal Democrat government, and a rising tide of need.

According to Toynbee, unemployment is leading to higher drug use, and more domestic violence, mental health crises and family breakdowns. The high profile media coverage given to the death of ‘Baby P’ resulted in a rise in children being referred to social services of over 25% last year with 17% more being put in care. “Add in the phenomenal, but largely unmentioned, cost of the rising number of profoundly mentally and physically disabled children … thanks to the heroic neonatal specialists in maternity units. Most of these extreme cases end up in care, costing hundreds of thousands in round-the-clock teams to look after them. Just a few can upend a children's services' budget.”

Faced with this financial crisis, the easiest things for agencies to cut are the long-term programmes which prevent more serious problems in the future. According to Toynbee, Sure Start centres “offer the earliest help to young children, identifying difficulties before it’s too late, a welcoming place to which families can turn. … (T)his is a heartbreaking destruction of a service that was starting to change children’s life chances.” What money remains is no longer ‘ringfenced’, so “early intervention to stop tomorrow’s crises is sucked away to cope with today’s emergencies … This is the way the social deficit grows, costing the next generation more … with a legacy of costly problems that could have been prevented with a little early spending …”

Wherever in the world we live, similar stories are probably being told. Let’s support local and national campaigns for effective child welfare programmes, thus bringing real Hope for Humanity in the long term.