Mental health of under-5s at risk - warns new NCB research published in Infant Mental Health Awareness Week

Our analysis of research and policy relating to the mental health of under-5s, warns that COVID-19 is likely to increase the strain on very young children and their parents, and that now is the moment to make their emotional wellbeing a priority, especially through support that enables richer parent-child relationships.

An analysis by the National Children’s Bureau of research and policy relating to the mental health of under-5s, warns that COVID-19 is likely to increase the strain on very young children and their parents, and that now is the moment to make their emotional wellbeing a priority, especially through support that enables richer parent-child relationships.

While evidence is lacking to reliably estimate how many under-5s are at risk of mental health problems, routinely collected data indicates the size of the challenge. Research published in 2018[1], found that one in eighteen (5.5%) 2 to 4-year olds in England have a diagnosable-level mental health problem. The National Children’s Bureau fears that the anxiety and stress of lockdown, coupled with the extra difficulties in providing face-to-face support at this time could further deepen these difficulties.

Nurturing Healthy Minds Together, published to mark Infant Mental Health Week, emphasises the vital contribution that parents make to improving young children’s mental health. Secure attachment, where a child feels confident in the loving bond between themselves and their parent or carer, is built through positive and responsive everyday interactions, and is shown to support healthy cognitive and emotional development. Building parents’ understanding of this process, and actively involving them in service design, are the keys to reaping mental health benefits for them and their child.


The review finds that while there is an intention to provide a broad scope of support for the emotional wellbeing of babies, infants and their families, despite the range of support on offer, provision of services is inconsistent and take-up is often low.

This new research was made possible thanks to a grant from The National Lottery Community Fund, the largest funder of community activity in the UK. 

While many of the programmes that are widely used in the UK to support very young children’s mental health do not have established evidence supporting their effectiveness, there are common factors that contribute to interventions that work. These include:

  • Supporting the parent-infant relationship;
  • Increasing parents’ and professionals’ knowledge of infant mental health;
  • Dedicating sufficient resources to support effective parental engagement;
  • Providing services delivered by practitioners with specialist early years expertise;
  • Providing services within the context of a multi-disciplinary setting or partnership and integrated with other services within the local area.

Engaging with interventions to support very young children’s mental health can be a daunting experience for parents who may face logistical and emotional barriers to getting involved, especially if they are disadvantaged and vulnerable. However, once trust is established, parents value the support and can notice the positive impact on their own mental health, as well as their child’s.

The report highlights how effective parental engagement is often built on conditions including mutual trust, valuing parents’ knowledge and experiences, and being culturally responsive and reflective.

Anna Feuchtwang, Chief Executive of the National Children’s Bureau, said:

‘During the COVID-19 crisis, babies are arriving into this world without the support of their wider family circle, and many parents and very young children are struggling to maintain their emotional wellbeing: supporting their mental health has never been more important.

‘We’re convinced that building parents’ capacity to have rich and rewarding relationships with their children can bring mental health benefits for them both.  Sharing what might traditionally have been seen as ‘specialist’ knowledge on brain development with families is an important way of enabling them to reach their full potential.’

The National Children’s Bureau, Children in Scotland and Children in Wales are calling on policymakers to:

Building on the findings of the report, the National Children’s Bureau has joined the First 1,001 Days Movement, a broad coalition driving change by inspiring, supporting and challenging decision makers to value and invest in babies' emotional wellbeing and development. The First 1,001 Days Movement has written to the Prime Minister asking him to give urgent attention to the needs of babies and their parents.

Nurturing Healthy Minds Together - Exploring how services and parents can work in partnership to support the social and emotional development of under-5s is available at:


[1] The data refers to 2017:

About the Nurturing Healthy Minds Together study

In 2019, the National Children’s Bureau (NCB) received funding from The National Lottery Community Fund to explore the published literature and policy developments around prioritising and supporting the emotional wellbeing and mental health of very young children – from conception to reception. The research and policy team at NCB undertook a rapid review of the literature around:

  • The extent and nature of mental health support needs in under 5s
  • Interventions offered by different providers for families of children aged 0-5 years
  • Experiences of families of early years’ interventions/programmes
  • Models of parental engagement
  • Parental knowledge of the social and emotional needs of 0-5 year olds

The review focuses mainly on UK-based literature, but also draws upon relevant international publications. The search approach included academic databases, reference lists of journal publications, and grey literature, e.g. relevant governmental and non-statutory reports from across the four nations.

The review of the literature is followed by an analysis of those public policies which focus on support for social and emotional development and mental health from conception to age five across England, Scotland, Northern Ireland and Wales.

While the research for this report was carried out pre-COVID-19, the implications for policy, research and practice included in the summary report have been updated in the light of reported experiences across the early years sector between March and May 2020.

About Infant Mental Health Awareness Week

Led by the Parent-Infant Foundation, Infant Mental Health Awareness Week provides an opportunity for everyone to help raise awareness of this important part of early childhood development and to share work they are doing. The theme for this year's Infant Mental Health Awareness Week (7th to 12th June 2020) is 20:20 Vision Seeing the world through babies' eyes. This theme encourages us to think about the experiences of babies and how these influence their mental health and development.

About the National Children’s Bureau
For more than 50 years, the National Children’s Bureau has worked to champion the rights of children and young people in the UK. We interrogate policy and uncover evidence to shape future legislation and develop more effective ways of supporting children and families. As a leading children’s charity, we take the voices of children to the heart of Government, bringing people and organisations together to drive change in society and deliver a better childhood for the UK. We are united for a better childhood.

For more information visit

About The National Lottery Community Fund

We are the largest funder of community activity in the UK – we’re proud to award money raised by National Lottery players to communities across England, Scotland, Wales and Northern Ireland. Since June 2004, we have made over 200,000 grants and awarded over £9 billion to projects that have benefited millions of people.  

We are passionate about funding great ideas that matter to communities and make a difference to people’s lives. At the heart of everything we do is the belief that when people are in the lead, communities thrive. Thanks to the support of National Lottery players, our funding is open to everyone. We’re privileged to be able to work with the smallest of local groups right up to UK-wide charities, enabling people and communities to bring their ambitions to life.