Childrens Health Rights

Child care and the growth of love. Based by permission of the World Health Organization on the report Maternal Care and Mental Health by John Bowlby. Abridged and ed. by Margery Fry. With two new chapters by Mary D. Salter Ainsworth. [Pelican books] [Harmondsworth, England] Penguin Books [1965] Second edition, 1965

John Bowlby was a British psychologist, psychoanalyst and researcher. He was a pioneer who researched and wrote about infant and child development and the importance of bonding with a mother or mother-substitute in a warm and continuous relationship. Bowlby found growing evidence that good mental health was linked with the kind of care an infant and young child received.  Bowlby also wrote about the effects of “maternal deprivation”, permanent harm and harm that is overcome. His well-known works on infant attachment and loss are referred to today in health, psychology and early childhood education.

The World Health Organisation asked Bowlby to research maternal deprivation and the effects on infants. This was in the 1950s when the United Nations were deciding which social problems and programs were in most need of support. The report came about as people looked at care of children after WW2, including children in institutional care, many of whom were orphaned, disabled or hospitalized. Bowlby drew his work from visiting and reviewing studies in Europe and the United States. The report was reproduced and made available for a wider audience in the book ‘Child care and the growth of love’.

Bowlby looked at vulnerable mothers, children and their healthcare needs. Today’s vulnerable mothers and children include asylum seeker refugees.  The Association for the Wellbeing of Children in Healthcare has written a position statement with this focus. The policy draws on the work of the Royal Australian and New Zealand College of Psychiatrists, and the National Inquiry into Children in Immigration Detention 2004 report.

Bowlby begins, there was a common theme amongst research and evidence “mother-love deprivation” harms mental health of an infant or young child. He also described far-reaching consequences for the individual. Infants and young children at key times in socialisation need to have mother or primary carer bonding (infants 6 months to 18 months). The absence of infant attachment leads to slowed development, physically, intellectually and socially.

Bowlby describes infants and young children placed in institutional care, long-term hospitalization and foster care, some with mentally ill mothers. The research identified some of the effects of institutional care. There were children who had never experienced an emotional bond. Infants who were kept in cots, isolated, lonely, without play opportunities, who were part of a Western system with an emphasis on hygiene and lacking social and emotional care. Infants were observed rocking, listless, quiet, failing to smile at a human face or respond to a ‘coo’.

Educators of health professionals today show their students the 1952 film ‘A Two year old goes to hospital’. This is a powerful way to explore the parent-child bond, showing the detrimental effects of what happened when a child was unaccompanied in hospital. The girl is too young to understand why her mother has left her and in 1952, visiting hours were very restricted. She becomes withdrawn from her mother as a way of concealing her distress.

James Robertson produced this film and Bowlby collaborated on this work on attachment. Robertson later wrote ‘Separation and the very young’, and produced ‘Young children and brief separation’ (DVD). To read a summary of Robertson resources visit the Life Spirals blog.

With recent news and radio coverage on asylum seeker refugees and in particular, Professor Gillian Triggs’ visit to Christmas island, the plight of infants, children and mothers is concerning. It is shocking to hear about their great mental and physical stress, mothers who hold their infants with no room or clean and safe place to put them to play and develop.

Professor Elizabeth Elliott, accompanying leading paediatrician, found children who were refusing to eat, bed wetting, had impediments to their speech and poor sleep. Professor Triggs spoke of the boredom and desperation of children. There are children who will not engage in eye contact*. It is not hard to see overlapping similarities between the behaviour of institutionalized children in the 1950s and asylum seeker refugee children in these restrictive circumstances today.

Children are no longer held in detention on Manus Island Photo from: http://www.outofsight.org.au/letters.php

Bowlby observed, gathered evidence and reviewed institutional care in an area with emerging focus. He pointed towards parent and child bonds, ways of improving emotional care and the value of further research to encourage and support families. Bowlby has not been above criticism, some researchers thought he was fundamentally on the wrong track. Others point out both strengths and weaknesses. For example, now it is recognised a child may have a personal relationship with a parent or carer and not necessarily just “mother” as Bowlby emphasised. Despite this, it is not hard to see how messages of parental involvement and emotional care of all infants and children are both valuable and relevant today.

When we read about the gravity of mothers who are on suicide watch at Christmas Island, Bowlby’s writings on the role of a mother providing support bring to mind questions on the harm being done to families. This harm is carried with the children into the future affecting their physical and mental health and wellbeing.

For further information about children in detention visit the Chilout blog  A Last Resort – ten years on from National Inquiry into children in detention and the Refugee Council of Australia. More on attachment and refugee children can be found on the Startts blogspot. The article on healing and refugee children and adolescents within a school context will be informative reading for teachers and counsellors.