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Understanding mental health in infancy and early childhood

Sally Hogg (Senior Policy Fellow)

There is widespread concern about babies’, children’s and young people’s mental health in the UK, particularly after the pandemic. Surveys of children, young people, parents, grandparents and teachers all reveal worries about mental health.

Significant evidence shows us that the foundations for lifelong mental health are laid during pregnancy and the earliest years of life. Thankfully, this is more widely appreciated than it used to be, and in recent years there has been welcome investment in services to support babies’ mental health across the UK.

I have been working in the field of infant mental health for more than a decade, and I have seen some of the challenges that commissioners and managers face when trying to drive local action on the issue. It has, therefore, been a pleasure to work with UNICEF UK on a new toolkit to support action on mental health in infancy and early childhood.

Some of the barriers to action on infant mental health are quite fundamental. Many people don’t really know what mental health means, especially when applied to babies and young children.

Mental health is often misunderstood to mean mental health problems or diagnosable disorders. This framing makes it difficult to understand babies’ and young children’s mental health because, generally, it is not possible or appropriate to diagnose the mental health conditions that occur in older children and adults in infancy and early childhood.

Mental health is also often misconstrued as something inherent in an individual – as an innate strength or deficit. This also acts as a barrier to understanding babies’ and young children’s mental health, which is usually shaped by their environment and relationships. In practice, infant mental health services focus on the vitally important relationships between parents and babies, rather than working with an individual baby.

To understand babies’ and young children’s mental health, therefore, we first need to understand mental health as a positive stave – not just the presence, or lack of, diagnosable conditions. And we also need to understand mental health as something shaped by a complex interaction of individual factors, relationships and environments.

The new toolkit for supporting mental health in infancy and early childhood will support and enhance this deeper understanding of what we mean by mental health in the early years. It contains a framework that describes what mental health is, and a socio-ecological model which sets out the factors that influence mental health, along with supporting evidence, base studies and links to useful resources.

The toolkit aims to give professionals a common language when discussing mental health. Currently, different professionals can use different language to describe different elements of mental health – terms like social and emotional development, or attachment, for example. In creating the framework to describe mental health, we aimed to enable professionals from different sectors to understand and see all their contributions to babies’ and young children’s mental health. The framework includes three elements of mental health relating to understanding and managing emotions; experiencing nurturing relationships, and to be able to explore, play and learn.

In my work on mental health policy, I have also noticed that – while it is fantastic that there is increasing awareness that early mental health is critical for later outcomes – sometimes the early years are seen only in terms of what comes later. Decision makers, for example, are convinced to invest in the early years because they want to ensure children are ‘school ready’ and to prevent poor adult outcomes. Mental health needs to be conceived as a matter of the present as well as the future. The happiness and wellbeing, or conversely the stress and distress, of our babies and young children deserves more attention in its own right. At PEDAL, we are keen to promote and protect all babies’ and children’s rights – including their right to be healthy and their right to play. A good childhood matters on its own terms and not just because it makes happier, healthier adults.

For this reason, the framework to describe has two parts: “being” and “becoming”. It encapsulates both what it means for babies and young children to be mentally healthy now, and how they are developing the capacities to be mentally healthy throughout life.

The framework is part of a wider toolkit which contains resources, prompts and activities to help partners from different sectors, services, and professions have reflective local discussions through which they:

  • develop a deeper, shared understanding of mental health in infancy and early childhood, and the factors that influence it;
  • appreciate the importance of a multi-sector and whole-system approach to promoting mental health in infancy and early childhood;
  • reflect together and have constructive discussions about the needs of babies and young children in their area, and what more might be done to respond to these needs.


The socio-ecological model in the toolkit, which we unpack in some detail, describes how a wide range of social policies can influence mental health in the earliest years. The causes of mental health are complex and multifaceted. But that complexity also represents opportunity, because it means that many different policy makers and professionals can play a role in improving our children’s wellbeing and development.

Many practitioners across different services and sectors have a role to play in promoting babies’ and young children’s mental health. We recognise that joined-up, effective and sustained local action will help local partnerships with the important work they do to ensure our babies and young children are healthy and happy now, and in the future.

The toolkit can be found on UNICEF’s website here: 


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Find out more about the research our Play in Early Life team is doing on protecting babies, children and young people’s mental health below.

  • Through the Helping Little Minds Thrive project, we’re building a pathway of support for families and public services to strengthen mental health in the earliest years.
  • The Healthy Start, Happy Start team are conducting a follow-up study with children aged 7-9 years old to investigate the potential long-term benefits of a play-based video programme, delivered by health visitors, which supports parents to interact with their babies & toddlers in a sensitive and responsive way.