Infant mental health: Setting the foundation in the early years

By Tanveer Singh

My interest in understanding mental health in the early years began a few years ago while I was working in the field of adult mental health research. When we look at the data on health outcomes among adults, the burden of mental health and addictions issues is unsettling. One in five Canadians experiences a mental health or addiction problem in any given year. This burden is not only apparent in the pages of our reports and publications; it manifests before our eyes every day. The hardship of emotional and psychological distress is experienced by ourselves as well as the friends, family members, and colleagues around us.

My work with adult populations constantly prompted speculation about the origins of these illnesses and the histories or lived experiences that may have preceded them. There is plenty of research linking early childhood development and experiences in early life to health outcomes later in life. As well, adverse childhood experiences, such as abuse or physical/emotional neglect (among several others), are correlated with many poor health outcomes. Given this link, I have become very interested in the ways in which we can build a strong foundation early on, so that our children can be given a greater chance of growing into physically and mentally healthy adults.

This is why I eagerly took the opportunity to sit in at Dr. Chaya Kulkarni’s full-day pre-conference session at the Best Start Resource Centre conference. Dr. Kulkarni is the Director of Infant Mental Health Promotion at the Hospital for Sick Children. She emphasized the importance of working upstream and addressing the root of the poor health outcomes by focusing on nurturing good infant mental health.

Dr. Kulkarni explained that infant mental health encompasses the social, emotional, and cognitive well-being of infants. It refers to how an infant explores and learns from his/her environment and how he/she learns to establish trusting relationships. Dr. Kulkarni quickly dispelled the myths that infants do not have mental health or that they won’t remember the negative experiences they have early in life. The evidence reveals quite the contrary; infants do have mental health and negative experiences early in life can certainly influence the ways in which the infant learns to function in the world. Infants may not explicitly remember negative experiences, but these experiences are remembered implicitly, and can become embedded in how they conceptualize and experience their surroundings, thereby prompting shifts in both their brain development and behaviour.

So, how can we foster positive mental health in our children early on? Ensuring that we provide infants with the protective environments they need to grow and prosper is one step. Dr. Kulkarni explained that although there are several risk factors that could hinder healthy development in infants, such as violence or poverty, there are also several protective factors that can help to create a strong parent-child relationship – a necessary ingredient for healthy development. It is critical to provide caring environments for our children, ensure that their caregivers maintain mental wellness, that there are support systems available to the child and family, and that families have economic stability to the extent to which it is possible. These protective factors can support a family to ensure positive mental health in an infant, even with the presence of some risk factors. In a world where violence and poverty exists, we must ensure the presence of protective factors to foster resiliency despite their existence.  

When we foster positive early mental health, we help our little ones form secure attachment, regulate their emotions, and feel safe and secure enough to explore their environment and learn from their surroundings, ultimately creating an environment for optimal brain development. It is through these efforts that we can set our children on a strong and positive foundation to continue growing into healthy adolescents and adults. These efforts also work to foster resiliency in children, to help them manage and overcome the adversities that we all, inevitably, face throughout our lives.

Dr. Kulkarni was clear about the value of investing our time and energy in early mental health. After all, not valuing this endeavour can have long-term, lasting, and sometimes devastating implications for a child’s life trajectory. Given the burden of mental health and addictions among adults, perhaps fostering positive mental health from the beginning is a most worthy investment of our time. I am certainly convinced.

To view the slide handout from Dr. Kulkarni’s presentation, visit

Thank you to Dr. Chaya Kulkarni as well as to the hard-working staff members who put together the Best Start Resource Centre conference for an insightful and important learning opportunity!