Infant mental health is at the heart of Family Nurse Partnership. Family nurses develop a therapeutic relationship with young mums so that they in turn can support the development of good mental health in their babies, building resilience in more than 24,205 children in England since the programme began in 2007.
To mark the first annual Infant Mental Health Awareness Week, we’re sharing viewpoints from across the Family Nurse Partnership about how difference aspects of the programme help support infant mental health.
Ruth Rothman – Head of Clinical Quality, FNP National Unit
“In FNP family nurses engage in a therapeutic relationship with clients. This relationship is the basis for a number of things.
“First to support the clients understanding of good, positive relationships that enhance maternal mental health. Second as a safe base from which the client can develop her parenting skills
“Third where the nurse models behaviours that support parenting, attachment and positive infant development
“And finally, a relationship where the parallel process is utilised - how the nurse relates, works with and supports the client generally tends to be the way the client is with her infant.
“All of this enhances good maternal and infant mental health.”
Anne Lynch – Family Nurse Supervisor, Tower Hamlets
“When a baby signals a need to its mother, she has to be able to tolerate and respond to their emotional expressions to ensure they feel cared for. Complex situations within a family environment, caused by things like relationship difficulties, financial challenges and housing problems, can affect how she responds to her child’s communications.
“Continued lack of sensitive response can lead to a baby feeling misunderstood and anxious, which may have an adverse effect on their emotional health and ultimate capacity to regulate their own feelings.
“During weekly meetings with her supervisor, a family nurse can reflect deeply on what's happening within the family unit. Through this process the family nurse can be helped to make sense of her own feelings and the family's situation and think about the best approach to help the mum.
“This translates to the 'parallel process' of baby's communications to his mum, mum to her family nurse, nurse to supervisor, which enhances containment and understanding. It ensures a baby's needs are regularly met so they feel safe and loved.”
Emma Victoria Jefferson –Family Nurse, Lambeth
“Working with the teenage mothers long before the baby is even born to understand the bond that begins between them, the songs, the thoughts and love already affect the baby's mental health in utero.
“I use pictures and information to convey the importance of being 'emotionally available' for a baby, and this in turn develops strong infant mental health that will help that baby emotionally regulate itself over a life time.
“I use the FNP facilitators to identify and support the mother’s personal strengths and parenting capacities so she can tap into her own emotional resources to support her baby.
“I support the young mothers to create boundaries and routines in their lives that enable the baby to feel safe and protected and learn to regulate their emotions and this underpins strong infant mental health.”
Mary Clarke – Consultant Psychologist, Hull and East Riding
“Being a Family Nurse involves establishing and maintaining an emotional connection with clients, their babies, their partners and sometimes even grandparents and siblings.
“Psychological consultation provides nurses with a forum to process the emotional impact of these demands and to make sense of the feelings being stirred up the work. In this way they are more able to maintain a clear focus on what the baby needs.
“Being able to see, hear and understand babies’ communications, to share this understanding with young parents and to gently guide them towards sensitive and timely responses to their baby is a key purpose of the FNP programme. It is also central to the infant’s mental health.“
Rosie* – FNP client and mum to Pippa*
During her time with FNP, Rosie* experienced a range of challenges in her relationship with her child, Pippa* as she struggled to cope with her developing independence and temper tantrums.
Rosie’s family nurse encouraged her to express concerns about Pippa’s behaviour by using an ASQ-SE assessment at 12 months. The concerns Rosie expressed about Pippa’s behaviour and routine can be common for mothers who have a number of unresolved issues themselves.
Rosie and her family nurse made a plan to enable her to better understand her toddler’s behaviour by doing a number of interactive exercises. By using music and rhythm to encourage Pippa to develop self-regulation skills, Rosie both built on her parenting skills and gained an understanding of Pippa’s temperament, positively influencing her mental health.
Rosie and Pippa have now graduated from FNP, with an ASQ-SE score within the expected range for her age. Rosie continues to use child-led play activities to promote Pippa’s development and understands that she can use shared positive emotions to guide her behaviour. Pippa is now a confident, curious child, achieving her expected milestones in all areas of her development with established routines and she has learned ways to self-regulate in an age appropriate manner.
*Names have been changed.