Understanding early trauma
Monday, June 13, 2022
The term ‘trauma’ is much used but less understood. It’s become commonly adopted by those discussing mental health, given that understanding trauma’s causes and effects, particularly for children, is a key component of the challenge we face.
As chair of the Anna Freud Centre, the charity focused on supporting the mental health of children and families, I welcome that the theme of next week’s Infant Mental Health Awareness Week is ‘Understanding Early Trauma.’
Trauma can be triggered by a range of events and experiences. Early trauma generally refers to distressing experiences which impact infants and children aged 0 to six. Some children may have encountered neglect, abuse, or violence, whilst others may be dealing with the fall-out from an accident, bereavement, or natural disaster.
Indeed, the first 1001 days of a child’s life (which include pregnancy up to the second birthday) have become increasingly recognised as being of the utmost importance for development. Moreover, ensuring the healthy development of infants and children at this age helps to safeguard their futures.
Early trauma is important because of the lasting damage it can cause into adulthood. The experiences we have as infants shape the development of our brains for life. Earlier still, trauma in the womb may impact the brain of a developing foetus. Infants born to extremely stressed mothers have an increased risk of mental health problems, including anxiety and depression, learning difficulties, such as ADHD, and physical problems, like asthma, for the rest of their lives.
Trauma increases the probability of mental health problems in adulthood as well as difficulties with personal and social relationships. Overall, it is estimated that one-third of all mental health problems are associated with exposure to childhood trauma and adversity.
The outbreak of the Covid pandemic in early 2020 has exacerbated the mental health problems faced by young people, including incidents of trauma. Widespread bereavement and illness in families, along with the intermittent closure of schools, have placed additional pressure on children and their families. The number of children and young people in England reporting a probable mental health disorder increased to one in six in the summer of 2020, compared to one in eight, three years earlier.
After the first lockdown in 2020, one survey showed that 50 per cent of children felt worse (whilst, intriguingly, 25 per cent of children felt better). The pandemic and the associated lockdowns have had some corrosive secondary impacts.
The number of reported incidents of children dying or being seriously harmed after suspected abuse or neglect rose by a quarter after England’s first lockdown in spring 2020. Many experts have hypothesised financial and social pressures related to the pandemic as amplifying the risk of neglect and abuse for children and young people, tragically increasing the number of those experiencing trauma.
Where first and foremost, our priority should be to ensure that no child experiences trauma, for those that do, there are certain steps we need to take. First, we must recognise that early trauma is a significant part of our rising mental health challenge. Last month, official NHS figures showed that a record 650,000 children and young people were in contact with mental NHS health services over the last year. This increased from 534,000 compared to before the pandemic. To combat this increase, we must consider and address the root causes of mental illness, including early trauma.
Second, the solutions will not come from the NHS or charity sector alone. We need to form partnerships and collaborate. This is something that Anna Freud’s Patron, the Duchess of Cambridge, has been encouraging. Her work has inspired the setting up of the Royal Foundation’s Centre for Early Childhood last June.
A report released at the time highlighted the importance of early years, stating: “A secure relationship with an adult can also buffer a child against the effects of longer-lasting and more severe stress (for example, the loss of a loved one) and therefore protects the developing brain from the potentially harmful impact of trauma.”
At Anna Freud, early trauma is a key area for us. We host the UK Trauma Council, the first UK-wide platform bringing together expertise in research, practice, policy, and lived experience in the field of childhood trauma. Next week, we will be sharing relevant resources, such as the popular Childhood Trauma and the Brain animation, which looks at what happens in the brain after children face traumatic experiences. We will also be holding events, such as the National Centre for Family Hubs hosting an event on early trauma and cultural sensitivity.
As we struggle to meet the huge mental health demands of young people, it’s worth reflecting that one of the key causes is trauma experienced in childhood. We may never be able to totally eliminate trauma but trying to mitigate its impacts and strengthen the support system in place, will not only reap the dividend for today but also for the long-term mental health of the nation.
Michael Samuel MBE is Chair of the Anna Freud Centre