How do health visitors identify, manage and refer infant mental health problems?

A range of electronic databases and two journals were subjected to a detailed literature search, focusing on studies evaluating psychological interventions with children aged 0-5 years of age. Outcome studies, utilising experimental design, were included for critical review. The search strategy revealed predominantly attachment-informed intervention studies, prompting a review of this aspect of the literature. A total of twelve studies were identified for closer scrutiny: five with a preventative focus; four describing interventions with clinical populations and three detailing large-scale intervention programmes. This review found evidence that early interventions are effective in altering maternal sensitivity and insecure patterns of attachment. Moreover, interventions were effective in reducing the effects of postnatal depression on attachment security, reducing the incidence of placement breakdown in fostered and adopted children and preventing behaviour difficulties in school-age children. These findings indicate a burgeoning evidence base for attachment-based intervention models for the prevention or treatment of infant or child psychopathology.