The Government's Reaching Out: An Action Plan on Social Exclusion is well worth reading for anyone who works with young children, especially the chapter on the early years which advises, 'The child who is nurtured and loved will develop the neural networks which mediate empathy, compassion and the capacity to form healthy relationships.'
So it is now accepted by policy makers that first two or three years of life will lay the psychological and neurological foundations upon which the rest of it will be based. Let us hope the funding follows the need. Tony Blair hints this might be likely in his preface - 'We propose more support for very young children born into vulnerable circumstances because we know the crucial importance of the first months and years of a child's life in framing their opportunities.'
We must not avoid allocating new resources by the usual dodge of more reorganising; it could easily become another excuse for managers high on ambition and low on emotional awareness swanning in to some department for a few years to inflict change without sticking around to realise what a waste of time and money the whole exercise was. We have a good system already in place that could do with more investment, not more messing about.
Few appreciate how the most important adult mental health workers that we have are health visitors. The Dunedin study, from New Zealand, shows how good they are at spotting the potential troubled and unhappy teenagers and adults in babyhood. If we want to tackle social exclusion, then this has to begin with services that are invisible because they are accessed in the normal course of events by everyone.
This is what makes health visitors priceless. They are a universal, non-stigmatising profession, already perfectly positioned to both help and call upon further, more specialised, input for vulnerable families. But if such a service becomes too targeted it becomes valueless; and if it is associated with 'problem families', its function in a plan for tackling social exclusion is totally undermined.
Our system in place is not broke, so let's add to it rather than imagining we need to fix it.
Robin Balbernie is a consultant child psychotherapist in Gloucestershire When I was in America looking at mental health provision for the under-threes, everyone was greatly impressed by our health visitors and the way they are an everyday occurrence for all parents. American health provision is rubbish, the last thing we should emulate.
