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Young Mums to Be Study: West Lothian Sure Start
1. Risk factors, engagement in the
Sure Start ‘Young Mums to Be’
programme and further social
work involvement
Fleur-Michelle Coiffait
Paula Huddart
Karen Love
3. Background
• Early years crucial in determining
outcomes in childhood and adult life
• Recent policy emphasis on intervention
in the early years
• Complex picture, many risk factors
interdependent
4. Background
• Huge economic and social costs:
unemployment, residential care, long-
term use of specialist services,
criminal justice involvement
• Often grow up to be parents of
children who experience poor
outcomes, continuing the cycle
5. Serendipity
• West Lothian Council - Sure Start
• NHS - St John’s Clinical Psychology
• University of Edinburgh - Centre for
Research on Families and Relationships
6. Specific risk factors
• Early parenthood
• Parental substance misuse
• Abuse - all types
• Poor parental physical/mental health
• Parental criminal justice involvement
• Housing issues and family disharmony
7. Early parenthood
• Poorer child health
• Poorer maternal mental health
• Increased likelihood long-term poverty
• Less likely to be employed or living
with a partner when reach 30,
compared with those who give birth
age 24 or older
8. Parental substance
misuse
• Poor attachment relationships
• Inadequate supervision and parenting
• Increased likelihood of abuse and
neglect
• Tangled relationships with other
chronic social, psychological, economic
and systemic disadvantages
9. Abuse - all types
• Physical abuse rarely occurs in
isolation of emotional and other abuse
• Negative effects on child development,
pre- and post-natally
• More likely to begin/escalate in
pregnancy
• Increased risk if parent is victim
10. Poor parental mental/
physical health
• Parental physical illness risk factor for
later child emotional/behavioural
difficulties
• Impact of poor maternal mental health on
attachment and responsiveness
• Also linked to poor cognitive, emotional
and behavioural development
11. Criminal justice
involvement
• Factors also linked to child
maltreatment, including substance
misuse, mental health issues, family
problems and poverty
• Children more likely to be in child
protection system
• More likely to end up in care
12. Housing issues and
other family problems
• Likely to reflect chaotic life
circumstances, relationship
difficulties, substance misuse and
unemployment
• Linked with behavioural and emotional
problems in later childhood
13. Early intervention
• Ante- and postnatal support to address
needs, build on strengths/resilience
• Significant period for brain
development, attachment formation,
communication/language development
• Crucial time to break cycles of poor
outcomes, positive economic returns
14. Sure Start West Lothian
• Preventative, non-stigmatising
approach to promoting health/
wellbeing of children and families,
from conception through early years
• Community outreach support to
vulnerable families with children <3
• Approx 60% of parents <22 (in 2009/10)
15. Young Mums to Be
(YM2B) Programme
• 12 week rolling programme, run jointly
by Sure Start and midwives
• Specifically for young mothers
• Information, education, advice
• Peer support, transport
16. Research study
• 43% of young expectant mothers referred to
Sure Start do not engage with antenatal support
(66% nationally, midwifery) - what happens?
• Investigated whether risk factors predicted
engagement or further social work involvement
• Also explored interdependency of risk factors
17. Method
• Retrospective examination of Sure Start
and social work routine records
• Screening forms noted risk factors at
referral
• 90 women referred to YM2B between April
2009 - March 2010
18. Findings
• 44% referred in second trimester
• 69% referred by midwife
• 60% no known involvement of other services,
excl. routine antenatal healthcare)
• 57% engaged with and 43% attended over 3
sessions/ completed YM2B
• 26% further involvement from social work
19. Summary of findings
Interdependency between risk factors
• None were predictive of engagement
Four key predictors of further social work
involvement:
• history of substance misuse
• criminal justice involvement
• abuse
• other family problems
20. Implications
• Early identification of appropriate crucial to
ensuring provision
of risk factors
support
• Multi-agency approach due to interdependency
of risk factors
• Role for targeted individual support?
• How do we gather information?
• Further work to explore non-engagement
21. Summary
• Interdependent social, environmental and
parental risk factors for poor outcomes
transmitted across generations
• Young parents particularly vulnerable
• Importance of early identification and early
intervention to avoid poor outcomes
• Emphasis on better information gathering?
22. Key references
Advisory Council on the Misuse of Drugs (2003). Hidden harm: Responding to the needs of children of problem drug users.
London: Home Office.
Barnard, M. & McKeganey, N. (2004). The impact of parental problem drug use on children: What is the problem and what can be
done to help? Addiction, 99, 552-559.
Barnes, M., Chanfreau, J. & Tomaszewski, W. (2010). Growing up in Scotland: The circumstances of persistently poor children.
Edinburgh: RR Donnelley.
Barnett, W.S. (2003). Economics of early childhood intervention. In: J.P. Shonkoff & S.J. Meisels (Eds.), Handbook of early
childhood intervention. New York: Cambridge University Press.
Bromley, C. & Cunningham-Burley, S. (2010). Growing up in Scotland: Health inequalities in the early years. Edinburgh: RR
Donnelley.
Department for Children, Schools and Families (2010). Teenage pregnancy strategy: Beyond 2010. London: Author.
Department for Education and Skills (2006). Teenage pregnancy: Accelerating the strategy to 2010. London: Author.
Ermisch, J. (2003). Does a ‘teen birth’ have longer term impacts on the mother? Suggestive evidence from the British Household
Panel Study. ISER Working Papers No. 2003-32 http://www.iser.essex.ac.uk/publications/working-papers/iser/2003-32.pdf
Marmot, M. (2010). Fair society, healthy lives: Strategic review of health inequalities in England post-2010. London: The Marmot
23. Key references
Kelley, S.J. (2003). Cumulative environmental risk in substance abusing women: Early intervention, parenting stress, child abuse
potential and child development. Child Abuse and Neglect, 27, 993-995.
Marmot, M. (2010). Fair society, healthy lives: Strategic review of health inequalities in England post-2010. London: The Marmot
Review.
Marryat, L. & Martin, C. (2010). Growing up in Scotland: Maternal mental health and its impact on child behaviour and
development. Edinburgh: RR Donnelley.
Phillips, S.D., Dettlaff, A.J. & Baldwin, M.J. (2010). An exploratory study of the range of implications of families’ criminal justice
system involvement in child welfare cases. Children and Youth Services Review, 32, 544-550.
Rutter, M. (1999). Psychosocial adversity and child psychopathology. British Journal of Psychiatry, 174, 480–493.
Scottish Government. (2008). Early years framework. Edinburgh: RR Donnelley.
