Emerald Group Publishing Limited
Copyright © 2011, Emerald Group Publishing Limited
Article Type: Editorial From: Journal of Public Mental Health, Volume 10, Issue 3
Words matter. Some terms like “recovery” bring hope and solidarity, some like “genetically inferior” bring prejudice and social exclusion. In this issue, both Yates and Caan consider the nature of recovery while Robinson, Saggino and Tommasi warn against dangerous labelling of entire populations. The effort that professionals put into good communication is most apparent in relation to the mental well-being of young people. Edge describes her networking around the health of mothers and babies, with a national focus on developments for black and ethnic minority families, to whose needs the National Health Service in the past was often unresponsive. Chiumento, Nelki, Dutton and Hughes describe engaging child refugees through media like art, drama and horticulture, but also engaging both education and health services to co-operate for these young people.
On 4 July 2011 the UK Faculty of Public Health and the UK Public Health Association held their first joint meeting. Our host was Lindsey Davies, President of the Faculty, who was also involved in the recent strategy No Health Without Mental Health (HM Government, 2011) which placed a strong emphasis on early interventions to promote long-term well-being. For this meeting, the Faculty of Public Health (2011) published a special report on early intervention, including work mapping the assessment of children’s emotional and behavioural well-being at school entry, across the city of Glasgow. Here, in the East of England, we now use more and more mapping information to predict groups at future risk, for example from hazardous alcohol use (Lakshman et al., 2011). The Secretary of State for Health addressed the Faculty meeting, above, and two key themes emerged for the future of public health. First, the new national body Public Health England would take a strategic role to integrate planning across the spectrum of common health needs. Second, collaborations across the spectrum of Local services would underpin future interventions for health, especially for preventing illness within their own community. In light of the recent national review by Munro (2011) of systems that might improve local inter-agency collaboration for children, I asked the Secretary of State to consider how to integrate child protection and public health policies. We know that abuse in childhood increases the risk of adult ill-health, especially mental illness (Spinelli and Howard, 2011). There is also increased risk of non-clinical problems, for example 40 per cent of children who were exploited sexually then become involved in youth offending (Smith and Cooper, 2011). Munro (2011) recommends “local” attention to “timeliness in the identification of children’s needs and provision of help”. However, during the current “turbulence” of Health Service reform, the Royal College of Paediatrics and Child Health are worried that the co-ordinated protection of vulnerable children will suffer (Mooney, 2011). From a public health perspective, my concern is that many British families seem to be under increasing pressures (like household debt: Ashcroft and Barker, 2011) and the poorest 10 per cent experience growing inequality in the resources available for their children (UNICEF, 2010).
What early interventions are planned to reduce the risks to children’s later mental health? Health visitors are public health nurses specialised in working with mothers and infants in their own home. The UK is undertaking a major expansion of the size, scope and skills of this workforce (Royal College of Nursing, 2011). A small part of this workforce is targeting intensive home support for the youngest, most socially isolated mothers, beginning in pregnancy and continuing for about two years (Barnes, 2011). As well as proactive, home visiting services, US programmes of enhanced education in the early years improve health and health behaviours when those infants reach 21 years old (Muennig et al., 2011) and community interest has grown in the UK for innovative Early Years interventions (including local Forest Schools: Knight, 2009).
Another group of public health practitioners, school nurses, can play a key role in the mental well-being of older children (Caan, 2008). Following on from the recent programme regenerating health visiting, the Department of Health is now beginning a national development programme for school nursing, led by Wendy Nicholson in the Professional Leadership Team. School age young people can also benefit from peer support in community settings: the Youth Health Champion scheme shows real promise here (Royal Society for Public Health, 2011).
Back to child protection and public health policies, the Department for Education has just issued their Report on the Early Years Foundation Stage (Tickell, 2011, p. 6). The Report begins with development affecting a child’s future choices, attainment, well-being, happiness and resilience. It continues:
Keeping children safe is of course, a non-negotiable element of any early years framework.
Tickell (2011) summarises the value of early intervention:
I have paid particular attention to how we can ensure that children who have specific needs, or come from disadvantaged backgrounds, are identified and supported as early as possible given the overwhelming evidence of the positive impact that this has.
This week I heard an inspiring talk by a social worker on the use of Life Story techniques, for children now in foster care because they came from very unsafe home environments. The social worker used many media to enable these children disconnected from their roots to articulate their stories. Communication and connection themselves seemed to improve their resilience.
CHERCHER LE MOT JUSTE
Many young hopes
Hit barbed wires.
For High Flyers.
In weed-free land:
Needs safety net:
Still, close at hand.
Ashcroft, J. and Barker, S. (2011), The Family Pressure Gauge. A Measurement of Progress Towards the Goal of making Britain the “most family friendly” Country in Europe, Relationships Foundation, Cambridge
Barnes, J. (2011), “From evidence-base to practice: implementation of the nurse family partnership programme in England”, Journal of Children’s Services, Vol. 5 No. 4, pp. 4–17
Caan, W. (2008), “More school nurses will reduce inequalities”, Nursing Times, Vol. 104 No. 36, p. 12
Faculty of Public Health (2011), “Special feature: early intervention”, Public Health Today, June, pp. 6–14
HM Government (2011), No Health Without Mental Health: A Cross-Government Mental Health Outcomes Strategy for People of All Ages, Department of Health, London
Knight, S. (2009), Forest Schools & Outdoor Learning in the Early Years, Sage, London
Lakshman, R., McConville, A., How, S., Flowers, J., Wareham, N. and Cosford, P. (2011), “Association between area-level socioeconomic deprivation and a cluster of behavioural risk factors: cross-sectional, population-based study”, Journal of Public Health, Vol. 33 No. 2, pp. 234–45
Mooney, H. (2011), “Turbulence facing the NHS risks having a negative impact on child protection, college says”, BMJ, Vol. 342, d299 (accessed online 6 July)
Muennig, P., Robertson, D., Johnson, G., Campbell, F., Pungello, E.P. and Neidell, M. (2011), “The effect of an early education program on adult health: the Carolina Abecedarian project randomized controlled trial”, American Journal of Public Health, Vol. 101 No. 3, pp. 512–6
Munro, E. (2011), The Munro Review of Child Protection: Final Report. A Child-centred System, HMSO, London
Royal College of Nursing (2011), The RCN’s UK Position on Health Visiting in the Early Years, RCN, London
Royal Society for Public Health (2011), Briefing Report. Youth Health Champion: Bringing Health into the Lives of Children, RSPH, London
Smith, R. and Cooper, J. (2011), “More than a third of sex exploitation victims are involved in youth crime”, Community Care, Vol. 23, June, p. p9
Spinelli, M. and Howard, L.M. (2011), “Has child protection become a form of madness? No”, BMJ, Vol. 342, pp. 1240–1
Tickell, C. (2011), The Early Years: Foundations for Life, Health and Learning, DFE, London
UNICEF (2010), “The children left behind: a league table of inequality in child well-being in the world’s rich countries”, Innocenti Report Card 9, UNICEF Innocenti Research Centre, Florence, SC