Anna Freud Centre survey on Under 5s mental health

The early years of a child’s life are uniquely important in terms of their development. Therefore, mental health and wellbeing in young children is monitored more and recognised in scientific research.

The Anna Freud Centre survey, carried out at the end of 2020, looked at early years providers’ experiences in relation to the mental health needs of the children they worked with. 905 nursery workers responded to the survey.

Nursery workers are regularly facing challenges including a lack of support and training, particularly in terms of how to support the mental health needs of young children.

Main findings from the survey include:

  • 69% of nursery staff have experienced working with babies and children affected by trauma.
  • 71% had worked with babies and children affected by domestic abuse.
  • 48% had worked with children who had experienced bereavement.
  • 98.5% of nursery workers believe they have a key role in supporting the mental health of babies and young children.


  • 74% of staff said they felt confused and unsure of the best way to deal with them and,
  • 53% said they had not received any additional training that related to early years mental health.

Commenting, Neil Leitch, Early Years Alliance chief executive, said:

‘This report rightly highlights the crucial role that early years workers play in supporting our youngest children, especially those who are facing challenges that no one, at any age, should have to face.

‘We know that practitioners are a source of unwavering emotional safety and security for children, but undoubtedly the level of responsibility when it comes to supporting and safeguarding children can itself take a huge emotional toll on those working in the early years. It is therefore vital that the sector is supported both practically and financially to ensure practitioners are not under undue pressure themselves, and that they have access to the tools and training needed to provide the vital care so many children need.

‘With a whole range of issues arising from the pandemic, from the increase in families struggling with bereavement or trauma, to a reduction in other community support, this is absolutely the right time to invest in providers’ training and wellbeing. We urge the government to carefully consider the findings of this report and to make sure that practitioners feel not only confident in their understanding of early years mental health, but also able to protect their own emotional wellbeing, as well as that of the children in their care.’
Purnima Tanuku OBE, chief executive of National Day Nurseries Association (NDNA), said: ‘The results of this survey clearly show the range of challenges practitioners are facing. They are seeing the impact the Covid-19 pandemic and numerous lockdowns are having on our youngest children first hand and dealing with the difficulties.

‘Practitioners are extremely knowledgeable and can spot issues children are having early on. Research has repeatedly proven that a child’s early years are of paramount importance in preparing them for later life. The vast majority of nurseries have risen to the challenge and are supporting children well but they all need to be supported in order to continue educating and caring for children. To support children and families, settings need to be able to remain open and sustainable, allowing children to experience some ‘normality’ during these challenging times. It is vital that early years workers are also backed with priority access to the vaccination programme and at-home testing.

‘Our own recent research with Education Policy Institute has shown nearly half of settings saying there were not enough opportunities to access specialist training such as child trauma and bereavement or supporting children with special education needs and disabilities (SEND). We wholeheartedly support calls that the sector needs more training to support staff for the complex work they are doing. This training is increasingly important for them to identify problems early as we know this can have the biggest impact on those children’s development. Support to the sector and the workforce is now more important than ever.’

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