Tim Loughton MP and former Children’s Minister has said that tackling child mental health issues and maltreatment in the first two years should be no less of a priority for politicians as defending the realm.

He made the comments ahead of the launch of an Inquiry conducted by the APPG for Conception to Age 2- first 1001 days into perinatal mental health and child maltreatment which suggests that the cost of failing to deal with these issues is estimated to be £23 billion- half of annual defence spending of £43 Billion – and that poor parental-child attachment can be passed down from one generation to the next, creating a vicious cycle and damaging environment in which to grow up.

The report is the culmination of months of inquiry sessions which took evidence from a committee panels of experts and Parliamentarians to investigate the various factors that affect the emotional and social development of children from conception to age 2. The report will be launched on Wednesday 25th February at the Speaker’s House in Parliament where a number of leading academics and policy makers in the field will be in attendance.

The over-arching inquiry pulls together previous research in the area to offer two main conclusions:

One is that to deliver socially and emotionally capable children at age 2, local policies need to be based on a commitment to primary prevention. The evidence presented in the Inquiry strongly indicates that identification of need should take place before the child is harmed, not after. Therefore, inspection should look closely at primary prevention measures which would deliver this result.

The second conclusion is that, without intervention, there will be in the future, as there has been in the past, high intergenerational transmission of disadvantage, inequality, dysfunction and child maltreatment and the economic value of breaking these cycles will be enormous.

In addition, the report offers nine recommendations which it says are practical, achievable but, above all, the minimum essential if society is to tackle these issues.

Recommendation 1: Achieving the very best experience for children in their first 1001 days should be a mainstream undertaking by all political parties and a key priority for NHS England. Recognising its influence on the nature of our future society, the priority given to the first 1001 days should be elevated to the same level as Defence of the Realm.

Recommendation 2: Require local authorities, CCGs and Health & Wellbeing Boards to prioritise all factors leading to the development of socially and emotionally capable children at age 2, by: adopting and implementing a ‘1001-days’ strategy, and showing how they intend to implement it in collaboration with their partner agencies, within 5 years.

The ‘1001-days’ strategies should be based on primary preventive principles, with particular emphasis on fostering mental/emotional wellbeing and secure attachment, and preventing child maltreatment.

Recommendation 3: National government should establish a ‘1001-days’ strategy fund to support local authorities and CCGs to make a decisive switch over the next 5 years, to a primary preventive approach in the first 1001 days. Practical support should also be provided, including the measures of success

Recommendation 4: Hold Health & Wellbeing Boards responsible for ensuring that local authorities and CCGs demonstrate delivery of a sound primary prevention approach as outlined in Part II of this report. Promote the delivery of this through establishing scorecards (similar to Adoption Scorecards) and a joined up multi-agency inspection framework which combines CQC and OFSTED.

Recommendation 5: Build on the ‘Early Help’ recommendations of the Munro Review by requiring and supporting all relevant agencies in prevention to work together to prevent child maltreatment and promote secure attachment.

Recommendation 6: Appoint a Minister for Families and Best Start in Life with cross-departmental responsibility, drawing together all relevant departmental ministers, with a remit to draw up a ‘1001-days’ strategy Masterplan within 12 months of the election. The Minister should either be in the Cabinet or reporting directly to Cabinet.

Recommendation 7: Make joint inter-agency training on the importance of the early years for social and emotional development, for all professionals working with children and families in the early years, a priority in the ‘1001-days’ strategy

Recommendation 8: Children’s centres should become a central source of support for families in the early years with access to multi-agency teams and multiple on-site services including health visiting, GP services, housing, finance, parenting classes, birth registration, library and other community services.

Recommendation 9: Research evidence and good local area data are necessary to ensure effective changes are implemented to services. Where data and evidence are not available, these should be prioritised and supported with appropriate funding.

Tim, Chairman of the APPG for Conception to Age 2 has been overseeing the inquiry and commented:

‘The cost of failing to deal adequately with perinatal mental health and child maltreatment has been estimated at £23billion each year. As our report shows the two are closely linked and more importantly largely avoidable. That is the equivalent of more than two thirds of the annual Defence Budget going on a problem that is widespread and when unchecked passes from one poorly parented generation to the next. Tackling it should be no less a priority for our politicians and our health and social care professionals than defence of the realm.’

Frank Field MP, Co-Chairman of the APPG for Conception to Age 2, commented:

‘Generations of well-meaning politicians have attempted to improve social mobility in our country through schools policy. However, a weight of research now indicates that school comes too late to significantly improve the life chances of many poor children. This is why it is so important to act in the first 1001 days, from conception to age two, and I am delighted to be part of the cross-party consensus backing this important report.’

Professor Sheila the Baroness Hollins says “As a psychiatrist and parliamentarian I consider the report of the 1001 critical days inquiry as probably the most important inquiry report I have been privileged to contribute to. Its recommendations are hard hitting, challenging government to forego short-termism in favour of the long term health and well-being of our country. The report’s goals are not idealistic, being eminently attainable and making sound economic sense. Their achievement will require investment in training and a timetable for commissioning comprehensive services.

Dr Alain Gregoire, Consultant Perinatal Psychiatrist and Chair of the Maternal Mental Health Alliance commented:

“Given the demands of being a parent it is not surprising that, particularly in the early years, the joys can be accompanied by emotional upheaval and often by mental health problems. These can make it even more difficult for us to be the parents we want to be, and to give our children the best possible start that we all want for them, and that society collectively calls for. This authoritative report explains the crucial importance for parents and their families of receiving the right kind of help at this critical starting point in life. It highlights the central role of supporting mental wellbeing amongst parents during pregnancy and the early years and providing expert specialist perinatal mental health care for those with mental health problems at this time. The Maternal Mental Health Alliance welcomes this report and these recommendations and looks forward to seeing the improvements in the lives of mothers, their infants, families and the whole of the next generation that will result from their implementation”.

Dr Cheryll Adams, Executive Director of the Institute of Health Visiting commented:

‘This is a seminal piece of work which, if widely supported by all those with the power to implement its findings, could make a huge difference to the health and wellbeing of our society, in particular to the future life trajectories of the very young, the yet to be born and to future generations! The next step must be to increase national investment into this critical period of all our lives. Health visitors will welcome the report, endorsing as it does many of their existing primary preventative services, but recognising the need to strengthen them. Also the focus on good attunement, an area where the iHV is currently rolling out training to all health visitors.’

Dr Andrew Mayers, PhD, MBPsS

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