Presentation on theme: "Infant Mental Health in Community & Primary Care Practice Contexts"— Presentation transcript:
1 Infant Mental Health in Community & Primary Care Practice Contexts Catherine MaguireSenior Clinical Psychologist and Infant Mental Health Specialist Child, Adolescent and Family Psychology Service, North CorkHealth Service Executive- SouthPresident, Irish Association of Infant Mental Health
2 Why Infant Mental Health? Everybody knows a baby…What about the baby’s social and emotional development? Can you remember?Why is Infant Mental Health important?Why early experiences and early relationships matterCreating a fluency about early social and emotional developmentTwo case examples from practice
3 What is Infant Mental Health? To experience, regulate & express emotionsForm close & secure relationshipsExplore the environment & learn“All of these capacities will be best accomplished within the contexts of caregiving environments that include family, community, and cultural expectations for young children” (Zero to Three, 2001)Copyright Catherine Maguire & Rochelle Matacz
4 Why is Infant Mental Health so important? What difference does it make? A window of opportunity exists in infancy and early toddlerhoodThe early years are a sensitive and critical period of developmentExtensive research on brain development studies highlight the crucial role of relationship based experiences for the child’s future mental healthCopyright Catherine Maguire & Rochelle Matacz
5 Importance of the parent-child relationship “Among the most significant developments during the past quarter of a century has been the steady growth in evidence that the quality of parental care which a child receives in its earliest years is of vital importance for his future mental health”(John Bowlby, 1953)Copyright Catherine Maguire & Rochelle Matacz
6 Babies can’t waitA critical window of opportunity exists in the first monthsSpurts in brain growth will occur at a rate that will not be repeated in later yearsPathways are experience dependentCopyright Catherine Maguire & Rochelle Matacz
7 Importance of the parenting relationship The majority of parents, provide their children withA loving safe homeProtect & comfortPlay with, praise & enjoy them“In more extreme circumstances of hostile, neglectful environments, babies fail to thrive and their normal development is very seriously compromised”(Joyce 2005)Copyright Catherine Maguire & Rochelle Matacz
8 Importance of Parent-Child Relationship As the P-C relationship develops, the parent helps the infant develop the ability to regulate his/her emotionsPredictable and caring parent –infant responses = infant develops a secure templatePositive experience of early relationships sets the stage for other relationshipsQuality of P-C relationship facilitates development of attachmentParents own parenting experiences tend to be repeatedP-C relationship cannot happen in isolation
10 Understanding social & emotional development in Infancy & Toddlerhood Social & emotional development is largely expressed through behaviourProblems at this developmental stage often misunderstood as ‘misbehaviour’Parents sometimes struggle to interpret the meaning of the cues and signals or misinterpret their child’s emotional displaysCopyright Catherine Maguire & Rochelle Matacz
11 CASE NO 1: IMH INTERVENTION Case identified by Clinician with IMH skills Baby & Mother commenced intervention when Baby 2 months oldDenial regarding her pregnancy, absence of supportOverwhelming feeling of ambivalence for her newbornMother’s own dysregulation & unresolved early childhood experiencesIMH model of service provision implemented
12 CASE NO 2: WITHOUT IMH INTERVENTION Case not identified until 13 months (child taken into care)Unplanned pregnancy, difficult early childhood, ambivalent relationship with her babyMother known to Social Work Department as an adolescentMother places baby in foster care at beginning second year of life2 years later, her toddler is unable to manage a relationship with herChild in long term foster placement until 18yrsNo relationship based therapeutic intervention to date
13 CASE 1 vs CASE 2 CASE 1-with intervention CASE 2-without intervention Cost to the HSE =92 clinical hours of Clinical Psychologist time20 hours in travel timeClinical SupervisionOutcomesP-c relationship repairFamily intactChild remains in his CommunitySociety + benefitsCASE 2-without interventionCost to the HSE =Cost of Foster Care (17yrs) at €350 approx per weekClinical skills of Social WorkFoster Social Worker,Legal costs to HSE.OutcomesChild in secure placementP-C relationship disruptedFamily no longer in intactChild removed from her Community must adjust to new surroundingsSociety will be required to support their mental health needs for some time to come
14 Concluding RemarksFluency regarding early social and emotional development on a par with physical development needs to be fully understood at all levels of family, community and society.0-3 period require awareness across society skills especially - Promotion, prevention and repairing of parent-child relationshipsIntegrate the extensive science available regarding this 0-3 into service delivery.Workforce capacity skills required - Michigan Association of IMH endorsement competenciesFuture mental health of society can be changed through our primary care teams.A critical window of opportunity exists in infancy.This change must start with the baby and his/her first relationship.
15 “In my Beginning is my End” Conclusion“In my Beginning is my End”(TS Eliot, ) (from the four Quartets No 2 of 4, East Croker 1943)
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