Infant Mental Health: A developing field in psychology

September 22, 2023

In 2022, the American Psychological Association declared that there was a mental health crisis for school-aged children. More recently, there has been much consideration about the many changes in the school system (e.g., students attending school virtually) as well as the homelife of these children and the impact these factors may have on their social and emotional development. While highlighting the impact of the COVID-19 pandemic and many other factors such as trauma is vital to understanding school-aged children’s experiences, we, as graduate students and counseling psychologists, are still leaving out specific yet important demographic groups that are also greatly affected—infants, toddlers, and early childhood-aged children. 

The recent rise of mental health issues in children has prompted counseling psychology and other fields to address mental health throughout the lifespan. However, too often when people think and speak of mental health across the lifespan, it is very rare that we include those that are under age 2. Some individuals might even suggest that infants and young children cannot have mental health problems. 

During my training, I only ever considered therapy with school-aged children and adolescents. However, during my internship, I worked in a setting where infant mental health (IMH) was the primary focus. 

Here is what I have learned:

What is Infant Mental Health?

• The term infant mental health was coined by Selma Fraiberg.
• It prioritizes and promotes the social-emotional health of young children.
• IMH was initially defined as aged 3 and under but has since expanded to those under the age of 6. 
• It encompasses both family and caregiving environments as well as the sensitive time period that is characterized by critical yet rapid brain development.
• IMH also highlights the capacity of young children to form secure relationships, have pivotal experiences, and regulate and express themselves.

What is Infant Mental Health, Clinically?

• Infant mental health is the assessment and treatment of very young children from a strengths-based perspective and relational context.
• In infant mental health, the child’s perception of the parent is equally as important as the parent’s perception of the child. 
• Culture, community, and extended family play a role in this bidirectional relationship between parent and child. 
• Research suggests evidence of efficacy for interventions including attachment and parent-based treatment as well as practical skills that are applicable to individuals from diverse backgrounds. Outcomes of treatment include the development and maintenance of healthy relationships, self-regulation, and appropriate expression of feelings.

Why is Infant Mental Health Important? 

Infant mental health is important because good mental health begins during infancy. Additionally, there is a prevalence of mental health problems among young children. According to Think Babies, around 15% of young children experience mental health conditions such as PTSD and anxiety, with this number being higher for young children that are in poverty (22%). It is also important to note that, similar to mental health issues in adolescence and adulthood, issues can present in a variety of ways including sleep and feeding difficulties. A focus on infant mental health not only encourages a strong developmental foundation but seeks to prevent long-term mental health issues and foster lifelong well-being.

Who Benefits?

Focusing on infant mental health as well as assessment and intervention for young children benefits the children themselves but also their caregivers, families, and ultimately the world. Treatment allows for clinicians to target and reduce symptomatology and do so while strengthening the caregiving relationships. Through these relationships and attachment, young children learn how to make meaning of their experiences and how they will navigate future relationships. These children later grow into healthy adults with secure relationships and boundaries. The benefits and impact go beyond the intermediate families of these young children but extends to the community as well.

What Can We Do as Students and Psychologists?

As graduate students and psychologists:

• Familiarize ourselves with the DC:0–5™ Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood. As students, we are trained to learn the diagnoses within the Diagnostic and Statistical Manual of Mental Disorders and stay up to date with every revision. I challenge counseling psychology programs to uphold the same standard regarding the DC:0–5™. 
• Expand our knowledge base to understand the types of treatment that are available when working with young children. While programs may offer courses for specific interventions such as cognitive behavioral therapy and psychodynamic interventions, it is also important that students have an understanding of what it may look like to treat young children and family systems/diverse family structures. 
• Utilize treatments such Child-Parent Psychotherapy (CPP) and Parent Child Interaction Therapy (PCIT) helps the child feel important while creating warmth in the parent-child relationship. It also allows caregivers to see just how important they are.

Additional Resources

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Brittany Hinkle, Ph.D. (she/her) is a recent graduate of Howard University’s Counseling Psychology program. She is currently a Postdoctoral Fellow at Tulane University School of Medicine in New Orleans, LA where she specializes in infant mental health. Her research interests include investigating the functioning of African American children, adolescents, couples, and families regarding communication, parenting, parent-child relationships, and diverse family structures. Her clinical interests include childhood trauma and perinatal issues.