Mental health articles

What makes an environment high risk for an infant?
High-risk environments for infants are usually multifaceted, with, for example,
psychological risks compounding or contributing to social risk or disadvantage.
Extreme risk in one area is possible. Such environments include interacting risks
in the biological, psychological and social domains, for example, an absence of
parental empathy for the infant. Some authors (Donald & Jureidini, 2004) would argue this is the core issue in assessing risk and, while primarily related to
psychological aspects of the parents, also includes their capacity to empathise
with and meet the needs of this particular infant. It is also about the quality of the relationship between infant and caregivers.
The biological domain includes:
• infants with medical or developmental complications (for example,
prematurity, chronic illness and frequent hospitalisations)
• parents with physical illness or disability. Some would include chronic
psychiatric illness such as schizophrenia here as well as parents with
intellectual disabilities.
In the psychological domain:
• parents with unrealistic expectations of their child and misperceptions of
their needs, usually due to lack of knowledge of child development
• parents with a psychiatric illness, substance misuse or abuse
• parents who themselves have a history of abuse and neglect with unresolved
issues of loss and trust.
The social domain includes:
• poverty and low socioeconomic status, little or no education
• parents with overwhelming external stress or trauma.
Often maltreatment is not because of malicious intent but because of
characteristics of the parent—ongoing mental illness, substance abuse or poor intellectual capacity or disability. Parents are trying but the situation is not ‘good enough’. It is necessary to consider whether there are mitigating
circumstances that can change, but the welfare of the child has to be uppermost in any decision related to child safety.

Tags: infant