When we talk about mental health in Australia, the conversation almost always turns to teenagers, young adults, or within the workplace. Rarely does it acknowledge the beginning, the first months and years of life, when the foundations for everything that follows are quietly being laid.
The statistics tell a confronting story. Mental health accounts for just 8.6% of Australia’s total health funding, despite representing approximately 14.8% of our total burden of disease, second only to cancer. Within that already underfunded system, investment in the earliest years of life remains a fraction of what the evidence says it should be.
Research consistently confirms that a child’s experiences in the first three years shape their future mental health, learning, and relationships more than any other period of childhood. Infants and small children who experience poor mental health in a family relationship context that is not optimal for their emotional development are at significantly greater risk of educational difficulties, social and relational challenges, and mental health problems later in life. These aren’t distant risks; they are predictable outcomes of predictable circumstances. GPs see the downstream consequences of these early in life challenges every day.
What does infant mental health actually mean?
Infant mental health refers to a young child’s capacity to experience and regulate emotions, form close relationships, and engage with the world around them. It is built or eroded through everyday interactions between a baby and their caregivers: responsive touch, eye contact, talk, reassurance and positive response to feeling unsafe, and play.
A secure infant-caregiver attachment is the single strongest protective factor for developing brains. When caregivers are consistent and responsive, infants build the neural architecture for emotional regulation and resilience that will serve them across a lifetime. When that security is absent — when a parent or caregiver is overwhelmed, unsupported, or struggling with their own mental health — the developmental consequences can be profound. The literature also makes clear that fathers and other male caregivers play a critical and often underestimated role in supporting infant mental health.
Emerging research is also showing that the transition to parenthood is itself a sensitive period, a time of heightened neuroplasticity not just for the infant, but for the parent. This makes the perinatal period a uniquely important window for intervention: an opportunity for immediate and intergenerational change, not simply a time of risk.
A secure infant-caregiver attachment is the single strongest protective factor for developing brains (Andrii Yalanskyi/Shutterstock).
The gap between evidence and action
The problem is not a lack of evidence; rather, it’s a persistent mismatch between what we know and what we prioritise for funding.
Perinatal mental health support is typically framed around the first 12 months after birth. But for many families, particularly those experiencing trauma, social disadvantage, or family violence, the critical period of need extends across the full 1 000 days from conception through to a child’s second birthday and beyond. Capping support at 12 months is an arbitrary cutoff that leaves vulnerable families behind.
This gap is especially stark for Aboriginal and Torres Strait Islander families. Secure attachment and the communal nurturing of infants are deeply embedded in Indigenous culture and knowledge systems, but colonisation has profoundly disrupted these intergenerational bonds. Rebuilding them requires culturally grounded approaches, co-designed with communities and properly resourced, including support specifically for fathers and male caregivers.
There is also a strong economic case here. The evidence on early intervention is consistent: investing in parent and infant wellbeing during the perinatal period reduces downstream demand on health, education, child protection, and justice systems. The returns, both human and financial, far exceed the costs of acting early.
What GPs can do right now
General practitioners are often among the first professionals a new family encounters, and the most trusted. That position carries significant opportunity and responsibility.
The key is not the initial appointment alone. Asking the right questions at every interaction matters. Looking for the cues that parents aren’t coping — fatigue beyond the ordinary, withdrawal, expressions of hopelessness, concerns about the baby’s behaviour — and acting on them early can change a family’s trajectory. Early referral, rather than watchful waiting, should be the reflex. PANDA’s National Helpline and the many local community perinatal mental health services exist precisely for these moments.
Adverse Childhood Experiences (ACE) screening offers an evidence-based pathway to identifying vulnerable families before the crisis point. Asking sensitively about a parent’s own history, their relationship supports, and their sense of confidence in caregiving takes minutes but can open critical conversations.
GPs are also uniquely placed to educate parents about why these early years profoundly matter. Explaining the science of attachment — that responding to a baby’s needs doesn’t spoil them, that eye contact and talk build the brain, that the relationship between caregiver and infant is the environment the baby grows in — is information that parents rarely receive clearly. Many are making high-stakes parenting decisions without understanding what the evidence shows about the critical nature of early relationships for a child’s long-term mental health. GPs can change that.
What needs to change
Practitioners on PANDA’s Helpline are often the first point of contact for parents who are struggling. Behind this, accessible referral pathways, screening tools, and coordinated interdisciplinary perinatal support teams must exist, spanning parenting skills, attachment relationships, and the social determinants, including housing and legal support.
What is needed now is whole-of-government commitment: funding that spans health, early childhood education, justice, and social services, coordinated at national, state, and territory levels.
When we support a parent, we protect a child. When we protect a child in their earliest years, we invest in the adult they will become — and in the parent they may one day be themselves.
The first three years of life are not a footnote in the mental health story; they are the opening chapter, so it is time our funding and support of families reflected that.
Dr Leanne Beagley is a perinatal and infant mental health expert with extensive clinical, policy and leadership experience across the mental health, primary health care and social services sectors. She serves as Chair of the Board of Directors at PANDA (Perinatal Anxiety and Depression Australia), which operates Australia’s national perinatal mental health helpline.
She is a strong advocate for embedding lived experience at the centre of system design and decision-making, ensuring the voices of parents and families meaningfully shape the services that support them.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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