A common phrase that encapsulates the importance of community, family and friends to help support families. Build your own village. Have the courage and self righteosness to ensure that your personal conceptions and values, enable you to have a strong and reliable support network, thus giving you an adequate matrix for effective functionality. Without having to channel your inner superhero, the mastery of adaptability has shown us that, no matter what, nothing can stop a determined parent.
Globally, many families face multiple adversities. These advertises may include mental illness, substance use and addiction problems, physical illness, domestic and community violence, poverty, insecure housing and war. Moreover, many of these problems are accumulative, with one problem, for example, parental mental illness, cascading into other problems, such as relationship breakdowns, unemployment and poverty (1). Preventing and mitigating the impact of these problems on parents and children is critical for improving population health for families now and in the future. However, no one sector or organization is in a position to address all the issues that these families may face. Hence, it is proposed that a “village approach” is needed when bringing up children.
The genesis for this perspective article comes from the It takes a village, an international conference held in Oslo, 2018. The conference brought together those with lived experience, researchers, practitioners and policy makers to discuss the needs of such families but arguably more importantly, optimal service responses. Given its audience, efforts were made, when putting together symposiums and accepting articles, to highlight ways the village might work together. Others also employ the term “village”, for example, the Austrian How to raise the village to raise the child, an initiative funded by the Ludwig Boltzmann Society and the Medical University of Innsbruck. The initiative aims to strengthen formal and informal support for children living with parental mental illness. Drawing on these initiatives, this article documents what is meant by the concept of a village approach. This article constitutes an attempt to “move toward” clarifying and discussing the concept of “the village” rather than provide a definitive set of guidelines or recommendations.
In this perspective, we first define what we mean by the “village” and then provide some discussion about what we mean by the term “families”. The need to move past traditional practice silos and how the village might work with families is then discussed using two, brief case studies.
Defining the “Village”
The phrase “it takes a village to raise a child” originates from an African proverb and conveys the message that it takes many people (“the village”) to provide a safe, healthy environment for children, where children are given the security they need to develop and flourish, and to be able to realize their hopes and dreams. This requires an environment where children's voices are taken seriously (2) and where multiple people (the “villagers”) including parents, siblings, extended family members, neighbors, teachers, professionals, community members and policy makers, care for a child. All these ‘villagers' may provide direct care to the children and/or support the parent in looking after their children. However, the village, in many countries today, is dissipated and fragmented and individuals are increasingly isolated and are not eager to ask for, or provide help to, others. Family breakdown, economic pressures, long working hours and increased mobility have all contributed to families feeling less connected to extended family members and others around them (3).
In this perspective article, we propose a village that has the capacity to provide support and guidance to families living with adversity. Inherent in the concept of the village is the notion that caring for children is a shared responsibility amongst many. In this article we explore the notion of the village further, provide case studies of when it is occurring and provide principles of a village approach.
Families mean different things for different people. It has been suggested that family is defined by its members, and each family defines itself. Likewise, this may not necessarily include one's biological family, but instead consists of those who share a common purpose, set of conventions and customs. Hence, there are different types of families, which may include the traditional nuclear (two parent) families, single parent families, adoptive families, same-sex parents, foster families, stepfamilies, and those in which children are raised by grandparents or other relatives.
One important role of families is to provide love, guidance, care, and support for its members. How they do this will differ, according to culture, family values, and the availability of educational, economic, and welfare resources. Through an interpretative framework, parents convey to their children the values, standards and rules about relationships and social structures. In turn, parents' beliefs and practices reflect the norms and expectations of their time and the culture in which they live. All of these factors impact the family environment and inform how family members show emotions, make decisions, resolve conflicts, interact with, and care for each other. When one family member is ill, facing addiction problems, or is otherwise under stress, other family members, including children, are inevitably impacted (1). In these instances, other family members may support the family member who is ill or under stress; alternatively (or in some instances, additionally), the family may itself be the source of trauma and ongoing stress and anxiety. Multiple studies have shown that compared to other children, children growing up in such families may experience negative impacts on their own mental health and well-being, physical health and education. However, not all children whose families experience adversity will be negatively impacted, nor will all children be affected in the same way. Moreover, it is argued that rather than being passive victims, many young people living in these families have their own agency, and in the face of great adversity, can be highly resilient and active contributors to family life.
Throughout recent history there have been different ways of describing families experiencing multiple adversities. In an address at a 1946 conference, Wofinden, a public health researcher, defined families who experience problems as “families with social defectiveness of such a degree that they require care, supervision and control for their own well-being and for the well-being of others”. He continued by suggesting that “help from outside [the family] can hardly be of permanent value, except in proportion as it tends to develop the self helping faculties”. In more recent times, public policy has mirrored similar sentiments. The 2011 Troubled Families Programme launched in England aimed to “turn around” the lives of the 120,000 most troubled families in England by 2015. In that policy, these “troubled families” were seen to “have” problems and “cause” problems to those around them. Such simplistic arguments condoned and extenuated the complex and interrelated relations between socioeconomic and psychosocial problems that many families experience, often over multiple generations. Such positioning also negates the responsibility of the “village” to support families.
Even though parents may be a child's primary caregivers, a family does not exist in a vacuum. Social connectedness has been defined as those subjective psychological bonds that people experience in relation to others including, for example, a sense of belonging and feeling cared for. It also includes objective measures such as the frequency of social participation and marital status. There is much evidence that strong, positive connections are linked to positive mental health and well-being, especially in times of stress or trauma. Social connectedness is one way of describing the members of the village and the need for families to have multiple supports. Given that responding to, and overcoming adversity, occurs in a social context that extends beyond individual and family levels, social connections for families living in adversity includes but extends past members of the immediate family. There are, however, many families who are not included within their communities. Likewise, families with complex health and social needs may be excluded from services, for many reasons, leading to poor health outcomes and multiple morbidities and in some cases early mortality. Families may be excluded because of the stigma associated with adversity (such as mental illness or poverty) and an inappropriate representation in the media or because they are not recognized by a government's criteria of “troubled”, and are missing from public policy. Rather than being “hard to reach”, some families may not have the ability to access services (because of transport or time), may have had negative experiences with similar services previously and/or find them intimidating or unhelpful. Some may not be aware of services that could assist them and may need professionals to serve as conduits to other services. The village concept implies a need to identify the magnitude of exclusion (that is, who is being excluded and from what), specify why they are excluded and, on that basis, promote access to essential services for individuals and their families and challenge societal attitudes and media misrepresentations. Families need different forms of connections, formal and informal, from the individual level to the policy and government level, to address the upstream causes of exclusion and disadvantage, including adverse childhood experiences and poverty.
Though the importance of social connections might be self-evident, it is argued that in western societies there is a trend toward parenting as a private concern, and when any presenting problems (experienced by the child or family) are referred to professionals rather than shared amongst the family's social networks. In this approach, the village shrinks considerably, especially when professional services are limited or are not accessed by the family (for whatever reason). However, in many societies, nonparental caretaking is either the norm or occurs frequently. In Polynesian society, both parents and nonparents were involved in the upbringing of other people's children. Polynesian adults viewed the western ideal of sole parental responsibility as a “lack [of] compassion” for other people's children. Likewise, it is considered that Cameroonian mothers discouraged maternal exclusivity, believing that multiple caregivers are optimal, with one mother stating, “Just one person cannot take care of a child throughout”. There are, however, times when parents in western cultures draw on different members of the village. In the UK, although many parents receive less informal support than in the past (because of divorce, or because extended families are geographically dispersed), parents still identified relatives and friends as the main source of emotional support and advice about their children's behaviour. In the USA, communities where neighbours trust each other, parents are more likely to utilize informal childcare from their neighbours, rather than relying exclusively on their relatives to look after their children when working or ill. Both neighbours and parents can be involved in caring for children when they have “shared expectations and mutual engagement by adults in the active support and social control of children”. Professionals, such as teachers and youth workers, play a role in these neighborhoods by organizing neighbourhood activities and events and by “caring” for children. Governments in many western countries focus on parenting in public provision and policy, and provide some families with government financial support and information and hands-on support through different initiatives and parenting programs. There are also different parenting blogs and other online sites that parents might access, to meet other parents and/or obtain emotional support and advice. In sum, the different connections that a family might make help us understand the different forms of support that may be provided, and those that may be missing.
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