Valued, loved and safe: the foundations for healthy individuals and a healthier society

Being valued, loved and safe for children and young people, from conception and through their developing years, enables “children and young people in Australia [to] reach their full potential by growing up safe and supported, free from harm and neglect”1 (Box). It is one of seven domains considered in this MJA supplement on the Future Healthy Countdown 2030.

Feeling loved and safe is recognised as vital to a child's development. A child's feelings about themselves, their confidence, and their capacity to be resilient are all affected by the way their parents and carers respond to them. Warm, loving and affectionate relationships with newborns, infants and children enable a child to feel safe and secure as well as loved.

Secure children are more likely to be happy, confident, able to cope with conflicts and anger, and curious to explore and learn.2 Childhood and youth are periods of learning how to take one's place in the world as an adult. Relationships are known to be central to children's development of self‐acceptance, self‐esteem, and higher functioning and thinking skills that contribute to positive learning and later life outcomes.1

Learning suffers when a child or young person fears for their safety or is not confident they are of value.3 Children and young people who are valued by teachers and other adults in their life, such as those supporting them in social and sporting activities, feel safe in those relationships and are able to feel safe about their future. Feeling safe about the future can include feeling safe about the world they are growing up in, including safety in society, in online settings, and in the environment, now and with a view to the future.4

Feeling loved, valued and safe are universal values that transcend cultures and countries. Cross‐cultural studies of historical and diverse models of and for child rearing — ways in which all communities aim to raise children to be the kind of adults valued in that community — have been shown to have four consistent methods to ensure children are brought up to respect and live within the values that are central to the community. These values are:

• community culture and practices provide children with constant and consistent exposure to the values that are central to a community;
• practices within the community make the child's experience of learning about the community's values emotionally arousing and engaging for the child;
• the child's behaviour in keeping with those values is approved or disapproved of by the wider community; and
• the community environment emotionally trains children to predispose them towards living as an adult within those values.5

Australia has a national commitment to ensuring “all children and young people reach their full potential by growing safe and supported, free from harm and neglect”.6 Safe and Supported: the National Framework for Protecting Australia's Children 2021–2031 sets a national goal to “make significant and sustained progress in reducing the rates of child abuse and neglect and its impacts across generations”.6 Priority groups for the Framework are:

• children and families with multiple and complex needs;
• Aboriginal and Torres Strait Islander children and young people experiencing disadvantage or who are vulnerable;
• children and young people with disability and/or parents/carers with disability experiencing disadvantage or who are vulnerable; and
• children and young people who have experienced abuse and/or neglect, including those in out‐of‐home care or leaving care.

The National Framework represents a consensus of contemporary expectations for Australia's children and future adults. However, in Australia, through 2021–22, 55 800 children were placed in out‐of‐home care and 45 500 children were found to have been maltreated.7 In 2022, 42.8% of children in out‐of‐home care were Aboriginal and Torres Strait children.8 In 2019–20, one in 32 children in Australia between the ages of 0 and 17 years received child protection services, with 46 000 children in out‐of‐home care in that year, a rate of eight per 1000 children. Indigenous children continue to be overrepresented with one in six Indigenous children receiving child protection services, and 18 900 (ie, one in 18) Indigenous children in out‐of‐home care at 30 June 2020 — 11 times the rate for non‐Indigenous children.9

Child maltreatment in Australia has been shown to be a major public health issue. In a world‐first study of over 8000 people aged 16 years and older (with oversampling of 16–24‐year‐olds), five forms of child maltreatment were examined. One or more types of child maltreatment were reported by 62% of people, with multiple types of maltreatment more common for gender diverse respondents (66%) and women (43%).10 As a first‐ever population representative study of child maltreatment, this provides a grim mirror to our societal aspirations for our children and the future adults our society would wish them to be.

The impacts of not feeling valued, loved or safe are well established. Emotional neglect of a child — not being valued or loved by primary carers — is the dysfunction of the protective parental relationship on which children depend while they learn the skills needed for safe independence. It is also central to all abuse, and is described as frequently its most damaging aspect.11 Children who do not have healthy relationships or attachments are more vulnerable to emotional volatility, to stress and, in adult life, to problems in personal relationships and with authority figures.12 These effects are not only social and emotional, they are also physiological with impacts on an individual's immune system and a higher likelihood of preventable chronic diseases and risky health behaviours in adulthood. Along with adequate nutrition, sufficient freedom from stress and anxiety, emotional and physical safety and encouragement are necessary conditions for development and learning.

Poor mental health early in a child's life is more common among children with more difficult life circumstances, such as those living with a disability and those living in poverty. Half of all adult mental health concerns are evident before the age of 14 years. Less than half of children with mental health challenges have been found to receive professional help.13,14 This has been recognised by the National Support for Child and Youth Mental Health Program and the National Children's Mental Health and Wellbeing Strategy. The Strategy acknowledges that the mental health and wellbeing of children requires that children need to feel safe, happy and supported, and to have loving connections with family, friends and community.13

Being loved and valued is considered by children and adults to be the most important contributor to a good life. During development of the Nest, Australia's national framework for child and youth wellbeing, by the Australian Research Alliance for Children and Youth (ARACY), a participant survey that was considered broadly reflective of the population was undertaken.15 Of the 300 respondents, 78% of young people and 88% of adult participants said that being “loved and valued” was one of the top three aspects of wellbeing. In addition, being “safe” was identified by half of the survey respondents as one of the most important contributors to wellbeing.16 The Nest developed descriptors for each of these central factors and these were recently updated in 2021 with a new generation of child and youth voices.17

Being loved and safe is described as having loving, trusted relationships with family and friends. It involves a child or a young person feeling valued by teachers and other adults in their life and knowing they are important to others and that others are caring and supportive of them. It involves feeling safe at home, in the community and online. Safety also means feeling safe about their future, which includes the knowledge that the environment and climate are a priority and are being protected.4

Children and young people who are loved and safe have positive family relationships and connections with others together with personal and community safety. They are confident, have a strong sense of self‐identity, and have high self‐esteem. These children and young people form secure attachments, have pro‐social peer connections and positive adult role models in their lives. They are resilient and can respond constructively to setbacks and unanticipated events.18

For Australia to move surely and determinedly from a nation in which the experience of maltreatment as a child is reported by almost two‐thirds of a representative sample of our population, what do we need to do to bring about change and how will we know we are making progress?

Policy priorities for children's wellbeing and safety

The first 1000 days of a child's life, from conception to two years of age, is an important foundational period which shapes a child's development and wellbeing. Children thrive when they have supportive environments in these early years.19

Based on the evidence of the significance of this period for children's immediate and future development and wellbeing, a collaboration of Australian organisations recommended that public awareness of the importance of the first 1000 days should be raised. The Strong Foundations Collaboration urged that there should be greater investment in services for future parents and new families, particularly through targeted and practical services for at‐risk populations, with investment in research to understand what works in antenatal care and the impact of housing circumstances, among other social determinants of health, on children's development.20

The National Framework for Protecting Australia's Children6 aims to improve outcomes for vulnerable children through actions in four areas. The first of these is a national approach to early intervention and targeted support for children and families experiencing vulnerability or disadvantage;21 the second is reducing the over‐representation of Aboriginal and Torres Strait Islander children in child protection systems. These two areas of focus are emphasised in the Nest action agenda, which recommended investments in:18

• a national universal platform of services for all children aged 0 to three years, providing an important foundation for the development of resilience;
• expansion of parental support programs tailored to particular skills and capabilities at key life stages and transition points and targeted for families under stress, such as those living with mental health or drug and alcohol issues, financial pressures, or family violence; and
• placement prevention and intensive family support services to prevent placement of children and youth in out‐of‐home care.

There is consistent evidence and agreement that focusing on future parents, new families and particularly those families known to be vulnerable is essential if Australia is to increase the proportion of children who are valued, loved and safe, and have the opportunity to develop into resilient and confident adults.

The additional areas of focus in the Framework address infrastructure requirements to support improved outcomes for children — that is, increasing capacity to collect, share and measure outcomes in child safety through improved information sharing, data development and analysis, and strengthening the child and family sector and workforce capability.21

Indicators of what matters

Existing measures of the extent to which Australia's children are valued, loved and safe are primarily deficit focused — identifying children whose nurturing environments are not meeting these needs. These measures include children referred to child protective services, children in out‐of‐home care, and children identified with mental health needs. Other measures, such as the Australian Early Development Census, provide a whole‐of‐population measure of child development and risk factors. Reducing these measures at the population level and reducing these indicators for Aboriginal and Torres Strait Islander children in line with those in the general population would demonstrate progress toward improved outcomes for individual children.

These key indicators are:

• children in out‐of‐home care (aged 0–17 years, per 1000 children);
• children developmentally vulnerable in one or more domains of the Australian Early Development Census;22
• children receiving child protective services (aged 0–17 years, per 1000 children);
• children experiencing family conflict (percentage of adults who have children in their care while experiencing violence from a current partner); and
• percentage of young people extremely or very concerned about family conflict.

Additionally, an indicator of children reporting bullying in education, social and online environments (such as the Longitudinal Study of Australian's Children and the eSafety Commissioner's Youth Digital Participation Survey) is an important measure of safety and wellbeing for students and young people.23

Measuring the reach and impact of support programs and investments in families and children with complex and multiple needs, and children in vulnerable population groups, particularly through the first 1000 days of life, would introduce a strengths approach to policy focusing on the capacity of Australian society to support children to be valued, loved and safe. Indicators would include government investments in frameworks providing parental, newborn and infant support through the first 1000 days of life, particularly for vulnerable population cohorts and families.20