This page was first published in September 2014 and has now been archived.
The best start to mental health and wellbeing is a healthy child growing up in a healthy family.
Photo of children at Bellambi Point Preschool

"The strongest influence on children’s development is the quality of the parenting they receive, and the nature of their home learning environments. These have effects on many areas of development, including self-esteem, academic achievement, cognitive development and behaviour. " Benevolent Society

Read about Bellambi Point Preschool and the Early Start program - where children and teachers have access to innovative learning technologies and closer bonds have been forged between the preschool and parents.

On this page

The best start
Who are we talking about?
What"s important for young children?
'Chloe' - a story
Why has it been so tough?
The research tell us
How we can make things better
We can get there

The best start

What is the best start? The best start in life is a healthy infant or child growing up in a healthy family. Our community needs families that can provide the social, emotional and cognitive support children need.

A focus on mental health and wellbeing, from promotion, prevention and early intervention through to more intensive support, can contribute to ensuring children have the best start.

If children’s social, emotional and behavioural development falls behind in the early years, they may struggle in primary school. This pattern is then likely to continue in high school. Issues faced by adults, such as mental illness, chronic health problems, unemployment and offending, can have their beginnings in difficulties experienced during early childhood.

Recent analysis shows NSW has relatively low rates of developmental vulnerability among younger children compared with other Australian states and the ACT, but there’s plenty more work to be done. There are still real differences in vulnerability between children from low and high socioeconomic backgrounds and the inequalities are larger still for Aboriginal children and children whose parents speak English as their second language.

We now understand better how mental health and wellbeing contribute to strong and happy lives for families and, conversely, how family mental health and drug and alcohol issues create a lifelong risk of poor health, social exclusion and poverty.

Who are we talking about?

It really begins before conception, with parents who are happy, healthy and ready for the challenges of welcoming a baby.

Postnatal depression is well known, but for new mothers the risk lies in the continuation or recurrence of mental illness that precedes their pregnancy, as well as drug and alcohol misuse. For some this overlaps with family environments of violence, abuse and trauma.

Young mothers and fathers are particularly at risk, given that the most vulnerable time for developing mental illness is between the ages of 18 and 24. This group has the highest prevalence of mental illness among all age groups.

These disorders are also commonly associated with drug and alcohol issues, especially in younger males.

Young parenthood tends to be associated with a disadvantaged background, having been exposed to abuse as a child, living in a dysfunctional family, being in an unhappy partner relationship and high levels of financial stress.

What's important for young children?

  • Access to services 
  • Early intervention
  • Education
  • Integrated and culturally appropriate services
  • Parenthood training
  • Prevention
  • Self-care tools
  • Support for families
  • Support for young fathers
  • Support for young mothers
  • Support for young parents 

 'Chloe' - a story*

Chloe is a 15-year-old Aboriginal girl who is pregnant. Chloe wants to keep her baby even though the pregnancy was unplanned. She has no mental health diagnosis but has issues of alcohol and cannabis abuse as well as possible mood instability. Her partner is 17 and is known to juvenile justice authorities. He has strong peer associations that include drug and alcohol misuse. Chloe’s family background includes domestic violence and overcrowding but her aunties and her sister are sources of strength for her.

Why has it been so tough?

It’s difficult for our more specialised services – such as child mental health or care and protection – to respond adequately to the needs of vulnerable families for early intervention because their workload is dominated by urgent or crisis support.

Mental health problems in new mothers sometimes follow pregnancies marked by smoking and alcohol use, little or no antenatal care, foetal complications and higher need for hospital services.

While most mothers don’t drink alcohol while pregnant, many do, especially if their pregnancy was unplanned.

There are greater risks for mental illness or distress in the weeks and months after giving birth because of hormonal changes, increased stress, sleeplessness and renegotiation of family roles and relationships.

Mental illness can affect the relationship between the mother and her infant, preventing her and the wider family developing a strong emotional attachment to the child, and affecting their ability to provide adequate care. This can mean delayed social and emotional development or significant behavioural problems for the infant.

Mental health issues of fathers are also commonly under-recognised with many, particularly younger fathers, unable to identify their needs and not seeking help or engaging with appropriate services.

Many services identify and support the transition to parenthood for mothers but fail to engage with or accommodate fathers.

Children of parents who misuse alcohol are more exposed to the risk of maltreatment, have greater risk of mental health problems, learning difficulties, behaviour problems and physical illnesses. They are also more exposed to the risk of dying prematurely.

None of these problems is a simple, direct or inevitable consequence of mental illness. Their likelihood depends on the severity and duration of mental illness and its impact on a family’s social circumstances, combined with the presence or absence of other supports.

The research tells us

Statistics about mental health issues, pregnancy and young children

  • During pregnancy 15-20% of women are affected by mental health or addiction issues
  • Although there has been a strong decline in recent years, an estimated 35% of women drink during pregnancy
  • About 20% of women experience a mental health issue within the first year after the birth of their baby, yet many women go undiagnosed and untreated
  • 10% of children under five have emotional or behavioural problems. Prevalence is higher for kids living in poverty or high-risk environments
  • Behavioural and emotional issues can include
    - defiance
    - impulsivity
    - fearfulness
    - physical aggression
    - extended sadness
    - social withdrawal
    - attachment issues.

How we can make things better

Investing in the best start to life has lifelong benefits. We need an informed and aligned approach that includes families, carers, a wide range of health professionals, community-based organisations, social services and early childhood educational support, with mental health and wellbeing promoted as part of each role and function.

We need a system that links the development of family strengths, close-to-home early interventions and personalised support through shared planning and co-ordination that includes harnessing valuable but limited specialist child mental health service skills and capacity.

That system must address complex issues at a family level. Mental health and drug and alcohol issues will be part of the mix but alongside the social support services provided by a range of agencies.

If the most vulnerable children are to get the best start, we will have to address stigma, bring together mental health services and those focused on behavioural issues, and integrate social and mental health services.

In particular we must continue to develop early childhood health services that meet the needs of Aboriginal families for culturally safe and appropriate support.

We can get there

  • It's never too early to promote mental health: Prevention and early intervention from before conception, readiness for parenthood programs, and reducing the rate of unintended pregnancies have the potential to improve many things for parents and infants, including mental health and wellbeing.
  • We'll give our baby the best start if we're healthy, happy and prepared: Effective parent-child relationships and home learning environments give children the best chance to develop good self-esteem, achieve academic success, and be physically and mentally healthy.
  • As parents we need community-based mental health support: If community-based services get better at supporting parents, including when they are in an acute phase, they probably won’t have to go to a hospital emergency department in the first place.
  • If we can bond with our baby, we'll all do better in life: Social and emotional bonding between mother, father and infant is widely recognised as the foundation for lifelong psychological wellbeing and cognitive development.
  • Supporting our children's mental health is good for society: The early childhood years are when behavioural and emotional difficulties can emerge and where early intervention works, and is cost-effective. But less than one-third of children with mental health difficulties currently receive any professional support.
  • We're afraid to ask for help because we don't want to lose our kids: We must address the needs of vulnerable families with mental health or drug and alcohol issues, who are typically identified through child care and protection services, the justice system or after acute episodes of mental illness. Many won’t seek help for fear of losing their children.

*This composite story describes what the experience of someone on this journey might look like.

Related links

Strategic Plan and Report


Source material for content on this page is from the Living Well Report

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Last updated: 28 June 2017