It might surprise you to learn that mental health difficulties in early childhood are fairly commonplace. One study showed that significant mental health problems, including emotional, behavioural and social problems, affected one in 10 three-to-five year olds. Further, from birth to school-age, around 20 per cent of children can experience a mental health difficulty.

The risk and protective factors present in a child’s life increase or decrease the likelihood of whether or not they will experience a mental health difficulty. Biological, psychological and social risk and protective factors are different for each child and depend on the complex interplay between all types.

“Children who have a number of severe or sustained risk factors are much more at risk of poor developmental outcomes than those children who might have exposure to one or two risks, which are either short or intermittent,” says Dr Sarah Mares, Consultant Infant, Child and Family Psychiatrist.

Some of the most prominent risk factors, according to leading health professionals, include the following:

  • “Stress and trauma is a big risk factor for poor mental health. The experience of stress is different according to developmental age and stage. And it’s not really the event that is important; it’s the reaction to the event. The younger the child is, the fewer coping resources they have.” (Dr Nicole Milburn, Clinical Psychologist and Infant Mental Health Consultant)

  • “If we go to the end and look at adults who have a mental illness, we find that there are some really big influences from the early years. One of them is if people have experienced abuse. Abuse and neglect and those sorts of issues might contribute to the causation of about a quarter to a third of all mental illness in adults.” (Dr Nick Kowalenko, Consultant Infant, Child and Adolescent Psychiatrist)

  • “Temperament is one of the most significant risk factors for children, and there are a couple of styles that tend to be more challenging to look after. That is, children who are very introverted, shy and reluctant to try new things and, at the other end of the spectrum, sparky children that have lots of energy but who also get fiercely angry when they are impeded from doing what they want to do. Both temperaments need lots of help to manage strong feelings and develop positively. This is not always available in all situations.” (Dr Sophie Havighurst, Clinical Child Psychologist)

Thankfully, even the effects of numerous risk factors can be reduced or even prevented by the presence of key protective factors. Warm, responsive and predictable relationships at home and in care are powerfully protective in early childhood and beyond.

“All children have some risk factors, because that’s just what happens in life,” Dr Mares says.

“But what you’re hoping is that there are enough protective factors to balance out the impact of that risk, and to give children another kind of experience to draw on as they’re growing up.”