The Parenting Vision for Solihull

1. The Parenting Vision for Solihull Denise Milnes Senior Public Health Specialist (Children and Young People) Public Health and Commissioning - SMBC

2. John Bowlby (1907-90) • Studied post-war orphanages • Developed ‘Attachment Theory’ • Published ‘Maternal Care and Mental Health’ for WHO in 1951

3. The Urban Child Institute “these early years are a window of opportunity for parents, caregivers, and communities: positive early experiences have a huge effect on children’s chances for achievement, success, and happiness… ..The excess of synapses produced by a child’s brain in the first three years makes the brain especially responsive to external input.” [website – accessed November 2013]

4. Brain development synapse density over time (Diagram adapted from Corel JL, The postnatal development of the human cerebral cortex. Cambridge, MA; Harvard University Press; 1975 cited in The Urban Child Institute http://www.urbanchildinstitute.org/why-0-3/baby-and-brain (accessed 25th July, 2013)

5. Extract: In Brief: the Science of Neglect

6. “If a mother is finding pleasure in her relationship with her baby, then usually there is very little to worry about, even if there are some problems. When the relationship is dominated by pleasurable interactions, the parent and the baby are, without realising it, building up the baby’s prefrontal cortex and developing his capacities for self-regulation and complex social interactions.” Gerhardt (2004) Why Love Matters: how affection shapes a baby’s brain. Routledge, p 39

7. “A child’s relationship with its parents is the most important factor for the child’s health and welfare.” Proposals for new forms of parent support - Swedish National Institute of Public Health “What is done to children they will do to society” Karl Menninger (Wave Trust website)

8. The Challenge…“Turning the science of child development into the art of parenting” www.inspiredchildren.com

9. The Drivers

10. Source – Marmot – Fair Society, Healthy Lives 2010

11. Conception to age 2: the age of opportunity - Wave Trust 2013 Conception to age 2 is a crucial phase when ‘focussed attention can reap great dividends for society’. Policy emphasis needs to shift to reflect that: • “the nature of day-to-day relationship between the child and primary care giver is crucial; • parental mental health (before and after birth) is a key determinant of the quality of that relationship • it is also a key factor in safeguarding children from abuse and neglect.”

12. “The child’s first relationship, the one with the mother, acts as a template … permanently moulds the individual’s capacity to enter into all later emotional relationships” Wave Trust

13. Conclusions of ‘Building Great Britons’ • “We want to create children who at the end of their first 1001 days have the social and emotional resources that form a strong foundation for good citizenship” • “Without intervention, there will be in the future, as in the past, high intergenerational transmission of disadvantage, inequality, dysfunction and child maltreatment. These self-perpetuating cycles create untold and recurring costs for society. The economic value of breaking these cycles will be enormous” Source: APPG - Building Great Britons 2015

14. Early interventions yield higher returns as a preventive measure compared with remedial services later in life Source: Heckman & Carneiro (2003) Human Capital Policy at www.worldbank.org (search for Early Child Development)

15. Adverse Childhood Experiences • Adverse childhood experiences (ACEs) are stressful or traumatic events, including abuse and neglect. They may also include household dysfunction such as witnessing domestic violence or growing up with family members who have substance use disorders • ACEs are strongly related to the development and prevalence of a wide range of health problems throughout a person’s lifespan.

16. ACEs include: • Physical abuse • Sexual abuse • Emotional abuse • Physical neglect • Emotional neglect • Mother treated violently • Substance misuse within household • Household mental illness • Parental separation or divorce • Incarcerated household member • Bereavement

18. Source: https://www.samhsa.gov/capt/practicing-effective-prevention/prevention-behavioral-health/adverse-childhood-experiences

19. REACh – Routine Enquiry • REACh (Routine Enquiry about Adversity in Childhood) is about asking people directly about adverse experiences which may assist them in understanding current circumstances and enable planning of focussed interventions • What do we need in place for REACh? • Increase confidence in routinely asking about adversity • Knowledge and awareness of the consequences of adversity • Skills in responding appropriately to disclosures of adversity and pathways to support this • REACh is about all /any ACEs

20. Solihull Strategy • Out for consultation until Monday 8th August 2016 • Consultation page on SMBC website • Exec Summary • Summary • Full Strategy • Consultation Survey

21. The Vision… To enable every parent in Solihull to be an effective and engaged caregiver via access to advice and support, parenting education and peer support in the community

22. Aims of the Parenting Strategy • To provide continuous, wrap-around professional and peer support for parents from pre-birth to school-age and beyond • To improve parenting skills among new parents in order to promote secure attachment in children in the early years and develop effective behaviour management • To enable parents to design and develop their own support networks • To make parenting advice and support the norm accepting that it is a skill that can be learnt

23. The Leksand Framework • Solihull Leksand Model – self-sustaining groups of parents that meet ante-natally, post-natally and beyond • Experience the menu of parenting education with same parents/carers • Build peer support for both the group and outwards into communities • Create self-sustaining support networks for families • Potentially a universal offer

25. Expected Outcomes (from EHOF) • An increase in school readiness • reduction in non-elective hospital admissions in 0-5s • increased breastfeeding • reduction in domestic abuse in families with pre-school children • improved maternal mental health • improved parent and infant attachment scores • improved family health and wellbeing • improved home environment • improved child education attainment

26. Health Visiting

27. Breastfeeding • Promotes secure attachment • Release of oxytocin – the ‘Lovedrug’, the ‘Trust hormone’ and the ‘Cuddle Chemical’ • Oxytocin • may have a profound impact on how infants interact • has been linked with treatments for postnatal depression, anorexia and schizophrenia • could treat developmental disorders such as autism • Infant Feeding Service supports mums to breastfeed – cafes, peer support, breast pump loan, specialist support

28. FNP is a voluntary, intensive programme for first time young parents, aged 19 or under from pregnancy until 2 • Aims to enable young mums to: • Have a healthy pregnancy • Improve their child’s health and development through effective parenting • Plan their own futures and achieve their aspirations

29. “The very simple story is that children who are … treated with kindliness and thoughtfulness grow up to be adults who are kind and thoughtful … and anything that gets in the way of that very simple process needs to be addressed.” Robin Balbernie, Clinical Director Parent Infant Partnership UK, Oral Evidence

30. “We all need more help with this [parenting]– the most important job we’ll ever have. So I believe we now need to think about how to make it normal – even aspirational – to attend parenting classes.” David Cameron, Jan 2016 Family Icon by Gerald Wildmoser from the Noun Project

31. “Darwin got it wrong. It’s not just survival of the fittest, but also survival of the most loved” Dr Rob Hale,Consultant Psychiatrist and Psychotherapist, Tavistock and Portman Clinics London

32. “It is easier to build strong children than to repair broken men” Frederick Douglass (1855) Social Reformer, Abolitionist and Statesman Any questions? Denise Milnes Senior Public Health Specialist (Children and Young People) Public Health - SMBC denise.milnes@solihull.gov.uk