Policy and Provision in UK addressing a good start in life
All recent UK public health, child health and mental health policy has covered the need to promote mental health and wellbeing in childhood, and various initiatives and approaches have been tried at national level.
Health visiting. UK health visiting has been provided in the UK for over a century. These services cover the perinatal period and first three years of life. They currently aim to provide universal coverage with proportionate universalism determining the level of support. Universal coverage includes only one home visit and clinic based provision as needed. Funding has recently been made available by central government in England, and ringfenced to increase the number of health visitors available. So far this has survived the cuts to services.
Healthy Child Programme, the currently provided preschool programme of health checks and health promotion, covers emotional and social development of the child and approaches to supporting this. (1)
Family Nurse Partnership. The most evidence-based of the infant parenting support programmes, involving one-to-one home visiting from pregnancy through the first year of life. Developed in the US for high risk families, this is being trialled in some areas of England, targeted at teen mothers. Home visitors receive a high level of training and have regular supervision.
CANParent. An English government (Department of Education) sponsored trial of universal provision of parenting support being carried out in four local authority areas. A national roll-out of this parenting voucher scheme is planned if the evaluation shows it is successful.
Children's Centres. Holistic centres providing care for parents and preschool children on a universal basis in deprived areas. These evolved from Sure Start Centres in England and Flying Start Centres in Wales which were intended originally to cover the entire population. A range of centre-based provision including day care, parenting support and outreach and home visiting services are provided.
Provision of parenting support. This is very variable in the UK with some authorities providing high levels and some none. Under the Labour administration all local authorities were required to appoint Parenting Commissioners to develop parenting services and the legacy of these remains in some areas. Third sector provision is very important in most areas.
Social and Emotional Learning (SEAL). Under the last administration all schools were required to implement programmes of social and emotional learning. The extent of implementation was variable but schools which implemented these programmes well showed an impact on educational achievement, absenteeism, school ethos as well as children and teacher's social experiences of school. The current administration (in 2013) does not recognise the importance of social and emotional learning to the same extent.
NICE has recommended universal and targeted programme in both primary and secondary schools (2)
The Department for Education in England carried out a major trial of parenting support provision through schools covering both Parenting Early Intervention Pathfinders and Parent Support Advisors. Both trials showed positive gain, but support has now been withdrawn.
Targeted Mental Health in Schools (TAMHs). Provides cognitive behavioural approaches to children at risk and with problems in selected schools.
(1) Department of Health (2007). Healthy Child Programme: Pregnancy and the First Five Years of Life.