RCPsych urges Government to act as children under five face lifelong mental health conditions

Press release
21 October 2023

Children under five in the UK are at risk of suffering from lifelong mental health conditions which could be prevented with the right care and support. 

Today, the Royal College of Psychiatrists has published a landmark report, Infant and Early Childhood Mental Health: the case for action, which calls on the Government to prioritise the mental health of babies and young children. 

Early action is vital, given half of mental health conditions arise by age 14 and many of these start to develop in the first years of life. In England prior to the Covid-19 pandemic, more than 100,000 (5.5%) of two to four-year-olds struggled with anxiety, behavioural disorders and neurodevelopmental disorders. Globally, an estimated one in five (20.1%) of children aged between one and seven years have a mental health condition.

There are many risk factors which contribute to a child developing a mental health condition, such as smoking, alcohol or substance use during pregnancy, socioeconomic deprivation and adverse childhood experiences like domestic violence or physical and emotional neglect and abuse. 

Most babies, under 5s and their parents do not receive the support they need to address these issues both during and after pregnancy. Mental health services are under-resourced and inconsistent commissioning is putting children’s immediate and long-term mental health at significant risk. 

The College is calling on the Government to introduce new specialist services and ensure every family has access to the support they need, regardless of where they live. 

The Government must also prioritise the development of a cross-government early childhood strategy, workforce and training plan, and improve data collection on early childhood outcomes to better understand and support young children. 

By outlining evidence-based solutions, the report will help to prevent children from suffering from mental illness. It also highlights a multi-agency approach to improve access to care and support. 

Early interventions are critical to preventing mental health conditions, as well as stopping these conditions from becoming more severe and difficult to treat. By supporting babies and children in the first five years of life they will go on to become productive adults who can fully contribute to the wellbeing of our society.

The report warns a failure to effectively tackle this issue could breach statutory legislation and the under 5s right to mental health under Article 24 of The United Nations Convention on the Rights of the Child (UNCRC). 

UNICEF UK joins several leading health organisations in supporting the report, including the Royal College of Paediatrics and Child Health, the Royal College of Obstetricians and Gynaecologists, the Maternal Mental Health Alliance, the Parent-Infant Foundation, the Associate Directors of Public Health and the School and Public Health Nurses Association. 

Consultant Perinatal Psychiatrist and Registrar of the Royal College of Psychiatrists Dr Trudi Seneviratne OBE said: 

“The period from conception to five is essential in securing the healthy development of children into adulthood. Unfortunately, these years are often not given the importance they should be, and many people are unaware of what signs they should be looking out for. 

“Parents, carers and society as a whole have a critical role to play. This includes securing positive relationships and a nurturing environment that supports the building blocks of a child’s social emotional and cognitive development. 

“The majority of under 5s with mental health conditions are not currently receiving the level of support necessary to help them become productive, functioning adults and reach their full potential. That’s why we’re calling on the Government to roll out comprehensive services in every neighbourhood and region to ensure no family is left to struggle alone. 

“Our report makes nine recommendations to bridge the current treatment and prevention gap. We sincerely hope these measures will have a broad and lasting impact on the lives of children being born today and countless generations to come.” 

Joanna Moody, Senior Policy Advisor for Child Mental Health and Wellbeing at UNICEF UK, said:  

“Mental health in infancy and early childhood is often overlooked, yet it lays the foundations for a child’s future. The Royal College of Psychiatrists’ Infant and Early Childhood Mental Health report provides a strong evidence base for action to prioritise mental health right from the start of children’s lives.

“Many services play a vital role in supporting babies’ and young children’s mental health, and that of their parents and caregivers, including early childhood education, social services, maternity, health visiting, primary care, mental health and the voluntary sector.”

Catherine's story

Catherine Mousley, from South London, lost her child at 17 weeks in 2017. She struggled with mental illness, which became more complex following the birth of her son in 2018, and was diagnosed with severe depression and borderline personality disorder.

“As a mother, I know you can sometimes do everything right and things still don’t always work out. There’s nothing worse than having to grieve the loss of a child and it changes how you approach the future.  

“The birth of my son was fine physically but mentally it was incredibly traumatic. I did my best to care for him but didn’t feel that rush of love that everyone had told me I’d get. It reached a point where I couldn’t hold him or even be in the same room as him because I was so terrified of something going wrong.

“I was already being treated by perinatal mental health services when he was born and it became clear I needed to spend time in hospital. They were five of the longest, most difficult months of my life. But they helped me recover which was ultimately what was best for me and my family.

“Hearing him giggle and feeling euphoric for the first time was one of the best experiences of my life. He’s five now and we couldn’t be closer.”

Sara's story

Sara Metz, moved from the USA to the UK when her son was seven months old and struggled with perinatal depression and post-traumatic stress disorder.

“Every mother wants to be there for their child, but sometimes society expects so much from us that it can feel like we’ll never be able to do enough. This can create a harmful spiral of shame and guilt and I remember at my lowest point I was too depressed to sit on the floor and play with my son. I felt jealous of mothers who had the motivation and energy to do meaningful activities with their children like taking them to the park.

“The thought that I wouldn’t be able to bond with my own child was terrifying but it’s very easy to become burnt out as a parent and feel like you don’t have the necessary time or energy. It didn’t help that I had very few people to share my concerns with as I had just moved away from my family. 

“I tried to seek help but it took me months to get an appointment with the right service, and I know there are many other mothers who are too afraid of being judged to even ask for support. Better and faster care would have made a world of difference to me and my son, which is why we as a community need to encourage parents to talk openly about their experiences and difficulties.

“My son is now five-years-old and we’re both doing much better after receiving the right support. I’d urge anyone who feels overwhelmed to see what help is available to them. If you think someone you know is struggling, don’t be afraid to reach out to them as well.”



Campaigning for better mental health policy

Our Policy and Campaigns team leads the College's work to improve mental health care through work with partner organisations – including the Mental Health Policy Group – and government.

Find out more