Investment in perinatal and early years promises the best mental health service outcome, according to Dr Ethel Felice, perinatal psychiatrist and part of the committee of the Association for Child and Adolescent Mental Health (ACAMH).
"Investing in perinatal, infant and early years, that is 0-5 years of age, and even from before, as early as conception, results in the best improvements in mental health," she told The Malta Independent, when interviewed together with other members of the ACAMH committee.
"You can invest in adolescents, and there will be some improvement, but the best time to invest in mental health services, which would also assure the most money saved for the government, is when you start from an early age. It is a novel concept in the UK and in Malta and is something which is not looked into that much," she said. A conference discussing 'Perinatal, Infant & Early Years Mental Health' will be held by ACAMH on 28 and 29 March, aimed at attracting all those professionals who work with young people, from teachers and LSAs to midwives, obstetricians and paediatricians.
"You are targeting a future generation, where, if you tackle problems early on, the return will be much greater than if you tackle them when they are 15 or 16," she added. "It is prevention but also intervention, preventing further harm by treating early on."
Elaborating on the importance of observing the mother's mental state during pregnancy, Dr Felice said: "A lot of attention is given to the physical health aspects of the mother during pregnancy, whilst little is given to the emotional state. We need to stress the importance of noting the mental state of the mother too. There are many psychiatric disorders and emotional problems which arise in pregnancy. We used to believe that a mother blooms during pregnancy, but in actual fact there is quite a high prevalence of depression, anxiety and post-traumatic stress which come about in pregnancy, which can have an effect on the foetus. Especially if a mother has had a history of depression or anxiety," she said, adding that there is now foetal programming for these time periods.
"This act of giving more importance to the physical state and little to the mental state, is repeated in our services. I think it is translated into budgets as well. Whereas in the UK mental health has one of the highest budgets in the medical services, the budget is not the same in Malta, and that is why there is lack of staffing," added Dr Felice.
Dr Nigel Camilleri, consultant psychiatrist for children and adolescents and founder of the ACAMH Malta branch, backed up Dr Felice's argument by saying: "The waiting lists for our services are extremely long and untenable, you have to wait six months to a year probably to see someone and get assessed in the public sector. And there is lack of adequate staffing."
ACAMH is the largest multidisciplinary association of mental health in the UK. An association which is taking a holistic approach towards educating and bettering the practice of doctors, psychologists, paediatricians, social workers and other professionals who are working with young people. It started in the UK in 1956 and Malta recently launched the association's first international branch. The main aims are to educate professionals who work with children and adolescents and to improve the standards of care, following the latest evidence-based research through high impact factor journals and conferences with some of the best speakers in the field. Access to conferences in the UK and Malta will be cheaper through the association and will also be streamed in Malta. "Networking is also an advantage of the association, being linked with professionals in different areas, both in the UK and Malta," said Dr Felice.
When asked what changes ACAMH Malta wishes to see, Dr Nigel Camilleri, said: "I think the main change which ACAMH is striving to achieve is quality of service, to bring the quality of child mental health services up to what we have in physical health services. The step after that is putting it into practice, which is probably the harder bit because it is difficult to change a culture."
The 'Perinatal, Infant and Early Years Mental Health' Conference, will be held on 28 and 29 March at the Radisson Blu Resort & Spa and will include a programme of international professional speakers including Dr Roch Cantwell, Dr Anne McFadyen, Dr Victoria Grahame and Professor Ann Le Couteur, amongst others.