Content area
Full Text
EARLY INTERVENTION
Health visitors are the early warning system for a generation's emotional and mental health difficulties as well as, perhaps even more importantly, the parenting abilities that will one day influence the grandchildren of those with whom they are working right now. CHERYLL ADAMS examines the evidence for early intervention services
The family health visitor is uniquely placed to form a working relationship with every new mother as a basis for understanding, support and offering further help should this be appropriate. It is not simply a question of monitoring the relationship between mother and baby, but more an opportunity to form a trusting relationship with potentially vulnerable parents that in itself models the relationship which will optimise the baby's development.
Perhaps it is worth being quite clear why the mother-baby relationship is so crucial for future development, as it is this that health visitors are specially placed and equipped to tune in to.
Babies always adapt to the relationship that they have with their parents: 'The child's first relationship, the one with the mother, acts as a template, as it permanently moulds the individual's capacities to enter into all later relationships. These early experiences shape the development of a unique personality and its adaptive capacities, as well as vulnerabilities to and resistances against particular forms of future pathologies. '' (p 1 )
Active, satisfying and reciprocal relationships with parents create the basis of a sense of identity, self-esteem, appreciation of others and self-control. More than that, the quality and content of the baby's relationship with his or her parents has a physical effect on the neurobiological structure of the child's brain that will be enduring.
The health visitor who enables a mother and baby to form a better (more secure) relationship has performed minor brain restructuring. If, as the National Service Framework for Children, Young People and Maternity Services states, we are to set up more dedicated services in order to improve the quality of attachment in babies and toddlers, then it is impossible to envisage how health visiting would not play a central role. Such comprehensive and specialist infant mental health services are not a new idea in the UK and we have a body of evidence-based practice to call upon.