Last reviewed 16 August 2019

With more children now experiencing mental health issues, it is vital that families and practitioners recognise that children’s emotional wellbeing is just as important as their physical health. Elizabeth Walker looks at how giving the right support in the early years can lead to positive outcomes in later life.

Mental health issues in children

Research suggests that children are more likely to experience mental health issues than 30 years ago and currently 1 in 10 children and young people suffer from mental health problems, such as anxiety, depression and behaviour disorders. Poor mental health in childhood is associated with a number of negative outcomes in later life, including poorer educational attainment and employment prospects. However, 70% of children and adolescents who experience mental health problems have not had appropriate interventions at a sufficiently early age.

Supporting children as early as possible when an issue arises can help to prevent lasting consequences. The early years are a crucial time to nurture strong social and emotional capabilities in children and a well-supported childhood is likely to lead to many positive later outcomes for both children and their families.

Early Years Foundation Stage

Personal, social and emotional development (PSED) is one of the prime areas of learning and development in the Early Years Foundation Stage (EYFS). It is recognised as one of the building blocks for children’s emotional wellbeing and is strongly associated with future success in life and good mental health in adulthood. PSED can enable children to develop their resilience and covers:

  • self-confidence and self-awareness

  • managing feelings and behaviour

  • making relationships.

To meet the EYFS requirements for this area of learning and development, providers must ensure that children are offered experiences and support to:

  • help them develop a positive sense of themselves and others

  • develop their social skills and a positive attitude to learning

  • develop their emotional wellbeing to know themselves and what they can do.

PSED enables children to feel acknowledged and supported by important people in their lives and helps them to interact with others and form positive relationships. It also enables children to feel free to express ideas and feelings and cope with new or stressful situations. Effective practice includes:

  • identifying children’s interests, likes and dislikes and supporting their choices

  • using everyday opportunities for children to learn about sharing

  • identifying children’s individual skills and qualities

  • enabling children to see adults as role models and partners in learning who value differences

  • supporting independence and self-care

  • offering opportunities for play and learning that acknowledge children’s beliefs and cultural backgrounds

  • playing games where children learn to take turns

  • providing opportunities to make choices

  • providing opportunities for children to talk about their feelings

  • promoting physical activity and healthy eating.

PSED should be embedded across all areas of learning rather than treated as a separate area of development. Early years practitioners need a good knowledge and understanding of PSED and effective training in this area is important. Staff may also need more specialist training to deliver targeted support for children with emerging mental health needs.

Attachment and the role of the key person

Positive relationships and secure attachments are key factors that can affect children’s emotional wellbeing. Attachment is central to the key person approach as children form a bond with a designated member of staff who can provide continuity of care and lessen the anxiety around separation from parents. This strong secondary attachment helps a child to feel secure in their new environment. The key person approach also helps to develop trusting relationships between staff, children and parents.

Key persons should actively listen to and model positive behaviours for the children in their care. Encouraging children to listen to one another and notice how others are feeling helps to develop empathy and build relationships. Supporting children to communicate positively with others also helps them to deal with the frustrations often experienced in early childhood.

Observing children is key to identifying their behaviours and the emotions behind them. Staff should show that they understand children’s emotions and behaviours, helping children to label and recognise their feelings. They should also help children to find solutions and learn strategies to calm down or cope with their fears and anxieties. Being consistent in managing behaviour enables the children to feel safe and secure during their time away from home.

Signs of poor emotional wellbeing

It is normal for young children at different stages of development to display negative emotions or behaviour while they are learning to deal with their feelings appropriately. However, there are some signs or persistent behaviours that practitioners should look out for which can indicate that children are struggling with their emotional health. These include:

  • a very short attention span

  • being withdrawn

  • being unresponsive

  • aggressive behaviour or other behaviour problems

  • delayed speech or poor communication and language skills.

It is also important for staff to have an understanding of the range of factors that can adversely affect children’s emotional wellbeing such as:

  • premature/low birth weight

  • long-term physical illness

  • poverty

  • poor maternal bond

  • parental mental health problems

  • parental drug or substance abuse

  • poor housing

  • physical or sexual abuse

  • bereavement

  • parental separation or divorce.

Other changes that can act as triggers include moving home, changing school or the birth of a sibling. Children going through these transitions may be experiencing a range of emotions or a sense of loss.

Early years practitioners should identify any signs that may pose a risk to a child’s social and emotional wellbeing as part of the ongoing assessment of their development.

Procedures should be in place to make referrals to other professionals or specialist services if necessary and staff can also signpost families to other support in the community such as parenting support classes.

Early years providers need to develop trusting relationships with families and adopt a non-judgmental approach while focusing on the needs of the child. Parents and carers should have the opportunity to discuss any changes or difficulties they are experiencing that could affect their child’s development and staff should work with children and their families to provide a safe environment in which to support the child’s individual needs.

Good practice and action points

Early years providers should:

  • ensure all staff have a good understanding of the importance of PSED

  • know how to identify risk factors and signs of poor emotional wellbeing

  • understand the importance of attachment and develop an effective key person system

  • establish positive relationships with parents and with workers from other agencies

  • understand and manage the behaviour of children consistently

  • create an environment where children feel safe and secure, maintaining routines whenever possible

  • understand that physical and mental health are closely related and promote physical activity and healthy eating in the provision

  • ensure staff have effective training in PSED and any other specialist training required to deliver targeted support for individual children

  • know how to manage transitions and support children through changes in their lives

  • have a procedure in place to make referrals to other professionals and agencies.