Children’s Mental Health Day and the Rana Plaza victims

By now, many people know this story. There had been some 2,400 workers rescued already – some calm, some comatose, some shouting incoherently.  In all of Rana Plaza, though, one woman's first words to rescuers were unique: "Save my baby." Nine months pregnant on the morning of the collapse, she had gone into labour under the rubble. In the two days she was trapped, she had delivered a boy.

It was danger on top of danger for both mother and child. The situation is almost unimaginably extreme: she endured perhaps the most risky 96-hour window in any healthy woman's life, occurring amid the worst industrial disaster in living memory.

While that story is unique, many Rana Plaza workers had children before the collapse. Many more will have children in the months or years to come. So far, no one has articulated how harm to parents will impact their children – and, if we do not act, industrial disasters like Rana Plaza could victimise people who don't even exist yet.

The mechanism is very simple. Hurting a mother can hurt her child – even if the child has not yet been born. This can work in obvious ways. For example, if a woman is too sick or injured to work, she and her children will be poorer. Being impoverished after a workplace injury can mean being hungry, unable to access healthcare, or deprived of education. This much is easy to see.

There is, however, another mechanism for harming a baby through harming its mother. This is less obvious, yet it is proven to be true. The mental health of a mother can impact her baby.

In Bangladesh, this issue has received some attention from excellent researchers. Hashima-E-Nasreen, a researcher from BRAC's Maternal, Neonatal and Child Health, has explored the connection between maternal mental health and child health in a study of birth weight. Women who experience depression and anxiety in pregnancy, she found, deliver babies who are lowered in weight at birth. Low birth weight is associated with decreases in an infant's overall health and chances of survival.

Two other studies (by other authors) measured infant's cognitive development and physical growth at 6-12 months. One study found that at age 12 months, infants whose mothers were depressed had grown less than infants whose mothers were happier. Another study by the same authors found that infants with depressed mothers had acquired fewer cognitive, motor, and social skills between 6–12 months, compared to those with non-depressed mothers.

What happens in infancy can matter long after the child has grown up, too. Adverse child experiences can affect the child across the whole lifespan. Children born into these difficult conditions must work harder to regain health and well-being later in life.

The good news is that setbacks small children experience can be corrected to some extent. The trick is to address the cause – which means, in this case, helping the depressed parent feel better.

A National Institute of Mental Health assessment found psychological difficulties in nearly 90% of the 2,400 people who survived Rana Plaza. Over a year after the disaster, many still report being too physically and mentally ill to work. A large portion will likely remain less than healthy until healthcare reaches them – and this will likely take far too much time, as there has been little money provided for mental healthcare for these survivors.

For many workers, these are prime childbearing years. Only one woman gave birth in the wreckage, but many more will give birth during the years to come. (Some already have.) Challenged by a special difficulty, these mothers and mothers-to-be deserve special help.

These workers are blameless, and their children even more so. Having endured a terrible disaster now past, these women deserve to have the future protected. Giving workers access to mental healthcare is an important way to protect their children.

This May 8 is a special opportunity for recognition.  It's Children's Mental Health Awareness Day. This Day is observed all over the world and is meant as the focus of public health campaigns. Bangladesh is not participating – but then that is no surprise. Indeed, the lack of attention is the exact reason it would need a special day to recognise mental health.

This May 8, we should focus on a simple goal, too long neglected. The best time to provide mental healthcare to the Rana Plaza parents and parents-to-be was the first day after the collapse. The second-best time to do that is right now.

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M. Sophia Newman, MPH, is a public health researcher specialising in mental health.