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The Role of Child Psychiatrists as Consultants to Day Cares

An increasing number of mothers of preschool children in Canada (either by choice or economic necessity) have entered the workforce. It is estimated for example that 58–80% of mothers of preschool children are working. In Canada in 1986, 51.6% of women in the workforce had children under the age of five (1). It is beyond the scope and intent of this paper to discuss the merits (or possible harm) of day care per se. The aim of this paper is to discuss aspects of the quality of day care, and how this might be improved by child psychiatrists being involved in day care centres and in their organization. Few would doubt that the emotional climate and the development of trusting relationships to significant others, in the first year of life, are essential determinants of the healthy personality. Hence the quality of the day care experience of small children is an essential area of study for the child psychiatrist which is as yet insufficiently recognized. This paper discusses what has been learned from the literature and from experience as a consultation-liaison child psychiatrist to a day care centre. A case example illustrates some of the important issues.