Why the natural human failure of imagination stops us from relieving children's suffering

Prime minister Keir Starmer speaks of ‘fixing the foundations of this country’ and addressing a ‘societal black hole’. I’d argue that the deepest hole in our society is the one we’ve dug for our children.

Everyone says, ‘There’s no money’. We must wait for the mythical money tree to bloom before revitalising our parks, improving the working conditions of our family workforce or plugging the gaping holes in our NHS. ‘There’s no money’ is the best excuse for inaction.

But money clearly exists. Yes, high street shops, restaurants and cafes have been boarded up since the pandemic, yet in Glasgow, where I live, the designer clothes shops and high-end cookware outlets are thriving. In the wealthier parts of the city, the oversized four-wheel drives still squeeze through the narrow Victorian streets. The issue isn’t a lack of money, but its distribution. Our youngest citizens – babies and children – are last in line when the struggling money-tree squeezes out a rare fruit. We all know this makes no sense.

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This neglect is both morally questionable and economically unsound. A recent report from the Academy of Medical Sciences revealed that focusing on the health and development of our youngest children could save society more than £16bn every year. The Academy’s ‘Thrive by Five’ activity aims to keep this crucial fact in the consciousness of our new government. Why is this such a hard message for us to hear?

My mother, Joyce Minnis, was a social worker in a materially deprived area of the West of Scotland at a time when the job meant holding a caseload of struggling families. She and her colleagues walked alongside families living in poverty, sometimes over many years, supporting them in times of crisis. As soon as she knew I wanted to become a child psychiatrist, she warned of a phenomenon she had witnessed many times in courtrooms or child protection committees – that adults can no longer imagine being children. She warned that my own memories of childhood would not help me, since the lives of children today are so radically different from my own. This is a profound insight that has guided me ever since. As adults, we must make a special effort to imagine the lives of children. When our imagination fails, as it often does, the consequences are terrible.

Just this week, I was reminded yet again of our lack of imagination about children. My colleague “Linda” has Type 1 diabetes which has become much less problematic since she gained access to an insulin pump several years ago. The pump delivers insulin regularly throughout the day, avoiding the need for regular injections. Her 10-year-old son “Craig” has been diagnosed with the same disease. He is autistic and has always been terrified of needles, so a diabetes diagnosis was a particularly big deal for Craig and his mum. Despite the United Nations Convention of the Rights of the Child (UNCRC) stating that ‘every child has the right to the best possible health’ and ‘governments must provide good quality health care’, Craig faces a two-year wait for an insulin pump. Meanwhile, he must overcome his needle phobia six times daily until he’s 12.

This prioritisation of adult health over children’s is a recurring theme in the UK. Twelve years ago, I had cancer and received superb NHS treatment for which I am extremely grateful. At the Beatson Cancer Institute in Glasgow, I could go to the top-floor wellness centre, arrange a free massage and have a free smoothie – all provided by the cancer charities. Yet, as a child psychiatrist, I couldn’t help thinking of the young children on lengthy waiting lists for psychiatric treatments, some excluded from classrooms due to untreated ADHD.

Despite my appreciation of the cancer charities making my illness journey so much more bearable, I couldn’t help thinking about those wee ones – the ones feeling shamed and judged as they stand outside the headteacher’s office because of a lack of available healthcare. Those kids could really do with a free massage and a smoothie. Yet we rarely fundraise for children with ADHD. We lack the imagination to relieve children’s suffering.

This imaginative deficit becomes more pronounced with younger children. As adults, we struggle to envision the lives of babies or toddlers, partly due to our own lack of early memories and their limited verbal skills to tell us about their experiences, hopes and desires. This natural human failure of imagination was brought home to me recently when reading a student dissertation. The student had interviewed infant mental health experts about ‘infant social connectedness’ – in other words, the degree to which babies have opportunities to meet and connect with other people socially. Despite our ‘expertise’ in infant mental health, we had overlooked babies’ needs for social interaction and new experiences. It had not occurred to any of us that, like other human beings, infants probably enjoy meeting a wide range of people and going to new and exciting places.

But there is one way in which babies and young children differ from adults in this regard – infants need their parents (or care givers) to introduce them to the social world. As a recent Guardian article described, British mothers are among the loneliest members of our society, stuck at home for many hours every day with no human contact – for themselves or their babies.

I have a large extended family in the Caribbean, and anyone who comes from a global majority society will know that the isolation we, in the West, impose on mothers and infants is highly abnormal. In most countries, babies and young children are surrounded by a vibrant mix of people of all ages who love them, and who love and support their parents. My colleague Dennis Ougrin’s experience with a hunter-gatherer community in Tanzania suggests that their children’s superior mental health might be linked to adults spending more time cementing community relationships and collectively caring for children.

According the UNCRC, babies and young children have a right to the best possible health, education and social interaction. If we truly imagined their experiences, we might realise our collective responsibility. Are we spending enough time paying attention to the babies and young children in our neighbourhoods and finding ways to support parents and caregivers? Are we advocating for more money and societal resources to be directed towards family support, nurseries, parks and schools?

It takes a village to raise a child. Every member of that village – from our neighbours to our politicians – has a role in helping our children thrive before five. It’s time we reallocate our resources and reimagine our priorities to build a society that truly values its youngest citizens.

Helen Minnis is professor of child and adolescent psychiatry at the University of Glasgow and co-chair of the Academy of Medical Sciences’ Prioritising Early Childhood to Promote the Nation’s Health, Wellbeing and Prosperity report.

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