Supporting families in the early years during a pandemic
Rachel Lily | Communications Manager
Recently, our colleagues over at Nesta published a piece called “There will be no back to normal”. They demonstrated that over the coming months there will be vast changes to our political, economical, social, technological, legal and environmental circumstances. Our work at Dartington looks at the health and wellbeing of children and young people – so of course, we’re focused on what’s changing in that area.
This blog looks ahead to the end of lockdown, exploring some of the evidence about risks to children’s mental health and wellbeing in post-infectious disease outbreak and disaster zones. We want to see if it could support decision-making and planning for services and systems which improve outcomes for children and young people. Here we’ll be looking specifically at the evidence around stress, behaviour and early intervention in the early years. A subsequent blog will focus on adolescent mental health and wellbeing.
What we know
There’s already a substantial amount of information in existence around post-infection zones. The Alliance for Child Protection in Humanitarian Action (ACPHA) recently published a report outlining many of the mental health and wellbeing risks of infectious disease outbreaks seen in other parts of the world. These include:
The worsening of pre-existing mental health conditions;
The increased stress levels due to isolation in home-based quarantine or treatment facilities;
Children and parents/caregivers with pre-existing mental health conditions may not be able to access usual supports or treatments.
The list above does not include the added risk factors that some children will face, such as higher levels of domestic abuse, neglect or hunger as a result of being kept at home, compounded by economic insecurity and financial strain.
Whilst much statutory and voluntary provision is (rightly) focused on the here and now, the long-term impact of the experience on children and young people may not be fully known or understood until reintegration occurs, and in some cases, may not appear until years later. However, we can be aware of the likely impacts, and let these inform our planning.
Stress and its consequences for families
For many people, the immediate concern and stress incurred by the restrictions of lockdown are manageable, but for new parents, pregnant women and young families, the physical and emotional strain is compounded, including by the risk factors mentioned above.
We are hearing this clearly from our work with numerous early years providers.
In our learning partner role with Comic Relief and their Rise and Shine initiative, we are hearing that families are struggling to care for children with complex needs and that organisations are struggling to adequately connect and assess their needs.
Working with Shift, Nesta and a collaborative of charities supporting new parents – Connected from the Start – we are hearing the stark realities of families struggling to meet basic needs in the face of crippling economic hardship, all whilst being bombarded with information which is overwhelming and stressful to navigate. Who is struggling the most is exposing stark inequality across ethnic and socioeconomic lines.
These sorts of challenges are shared internationally. Through our partnerships with Comic Relief and the Harvard Centre on the Developing Child we are hearing remarkable consistency in experience across Mexico, Brazil, the US, Kenya and Malawi.
Across contexts, there is the concern of infection and its impact on the family as a whole, but an extra element of ‘toxic stress’ may be added by being forced to stay away from friends and families, as well as by the likely economic crash that will rock many people’s financial stability. As explained by the Harvard Center on the Developing Child, “those elements of stress will only get worse for those already dealing with things like poverty, racism or violence.”
Center Director, Dr Jack Shonkoff has been prominent in reminding parents that the best kind of environment for the healthy development of young children – and indeed, of those during pregnancy – is to ensure the adults who care for them have their needs met. This is further reinforced by studies which highlight the positive correlation between both pre- and antenatal maternal anxiety and stress with cognitive, behavioural and emotional problems in a child’s later life which then may spill into adult life.
So, what can we do to support families in a post-lockdown world where mental health services for both parents and children will likely be at capacity, austerity measures are likely to increase and public spaces may – for a while – remain closed?
Failing to prepare is preparing to fail
Families cannot be held to blame for missed milestones or behavioural changes, and there’s certainly no perfect way to live through a pandemic. However, as schools and nurseries slowly reopen and children soon becoming the first of the generations to reintegrate under a “new normal”, we can think about the consequences of these past few weeks on families and anticipate potential new stressors.
Some parents will worry about their child falling ill from contact with others – or spreading the infection to parents or other family members. Others may be aware that their children’s behaviour has got worse with the long break – others that their children have been happier at home, and now have to return. As parents are expected to return to work, which of the safety nets that ordinarily exist to meet the need will be there – breakfast and after-school clubs, grandparent care, and sports activities?
Some parents and children are worried about how they will catch up developmentally – something that’s likely to impact children from disadvantaged backgrounds more. And how will mental health services, both statutory and voluntary, adapt? These concerns, and the fact there are no obvious answers yet, will be adding to families’ stress.
Addressing this won’t be just down to early years’ services but the wider ‘new normal’ landscape of the economy and employment, financial support, and healthcare. But we should note that the ACPHA report states that one of the core strategies to support children through COVID-19 is to “build on the strengths and positive coping mechanisms of communities, families, caregivers and children”.
Preparing to do this comes in the form of supporting services and systems to capture learning from their current responses to Covid-19, identifying aspects of provisions that can be left behind in the pre-Covid era, and the innovations that can be taken forwards. Alongside the perspectives of parents, practitioners, funders and commissioners, this can help us identify the likely longer-term effects on both families’ needs and services’ ability to respond to these.
We’re continuing to explore the evidence base for what has worked in reducing family stress and its effects on children. Building this understanding, alongside hearing the voices of those dealing with this stress now, is how we are preparing to support families, services, and systems to reduce its long-term effects on children living through the ‘new normal’.
References:
B.R.H. Van den Bergh et al. / Neuroscience and Biobehavioral Reviews 29 (2005) 237–258
Battaglia, Μ., Garon-Carrier, G., Cote, S. M., Dionne, G., Touchette, E., Vitaro, F., …Boivin, M.(2017). Early childhood trajectories of separation anxiety: Bearing on mental health, academic achievement, and physical health from mid-childhood to preadolescence. Depression andAnxiety, 34(10), 918–927