Babies can have mental health issues, experts say

Babies and toddlers as young as 18 months and possibly younger can suffer from infant depression, the State's first national infant mental health conference has heard.

The conference, Baby In Mind, which was hosted by the Health Service Executive (HSE) in Cork, heard there was a growing number of referrals of infants and toddlers with social and emotional problems in the Republic.

Antoine Guedeney, professor of child and adolescent psychiatry, MD, Hôpital Bichat Claude Bernard, APHP, University Paris VII Denis Diderot, who addressed the topic of Do Babies Get Depressed? said that while several diagnostic criteria had yielded different prevalence rates, they still did not know when infant depression began or what its outcome was.

"It is suggested that infant depression needs a certain amount of emotional and cognitive development to unfold, and that it might not exist before 18-24 months of age, a crossover during which major auto reflexive, cognitive and emotional abilities emerge," he said.

Much work has been done in this field in Australia, Europe, the UK and America and the international evidence suggests that one in five children will develop social and emotional difficulties before they reach the age of 18.

The concept of infant mental health is being pioneered here by two specialists - HSE South clinical psychologists Catherine Maguire and Rochelle Matacz who have established the State's first dedicated mental health service for children under three years of age.

They highlighted the lack of resources and clinical experience available in infant mental health here and warned that infant mental health training was crucial if long-term changes were to be effected in the mental health of infants and toddlers.

Ms Maguire and Ms Matacz established the Infant Mental Health Training Model in the North Cork Child, Adolescent and Family Psychology Service in 2004. They have been working on the development and integration of infant mental health into existing service delivery and have developed a model of assessment and intervention for infants and toddlers presenting with mental health problems.

"A lot of emphasis is placed on meeting a child's physical developmental milestones, like rolling over, sitting up unaided or taking its first steps. However, understanding the social and emotional needs of children in the under-three age group is less well understood and still needs considerable development," said Ms Maguire.

Ms Matacz explained that in focusing on the zero to three age group, they wanted to develop methods of prevention, intervention, assessment and treatment of developmental, social and emotional concerns involving infants and their families.

"Until recently, a baby or toddler was viewed as the passive recipient in the parent-child relationship. With this in mind, it was believed that just meeting the physical needs of a baby, like changing its nappy or feeding it, was enough.

"We now know differently and it is becoming widely accepted that the baby or toddler is in fact an active participant in the care-giver-child relationship, showing initiatives from very early on."

The model of intervention which has been developed in north Cork is multidisciplinary and comprises health professionals from areas such as child and adolescent mental health, social work, public health nursing and clinical psychology.

"Early intervention by those with the appropriate skills can enhance the infant's relationship with its primary caregivers and effect long-term change at the earliest possible point," said Ms Maguire.

An Irish affiliate of the World Association of Infant Mental Health was set up at the conference.