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Improving Early Childhood Mental Health

Alyssa Haywoode, Eye on Early Education Blog, August 15, 2013

Publication Date: 
August 16, 2013

Just as children and adults sometimes do, infants, toddlers and preschoolers can struggle with behavioral and mental health issues. Fortunately, early childhood programs can address this challenge by connecting children and their families to appropriate services. The sooner very young children get the help they need, the better off they are likely to be.

To serve children in the commonwealth, Massachusetts is investing $1.25 million in grant funds for the Early Childhood Mental Health Consultation Services Program.

Jointly supported by the Department of Early Education and Care (EEC) and the Department of Mental Health (DMH), the program provides “social and emotional development supports for early education programs serving young children,” according to an EEC press release from earlier this summer.

The plan is to boost educators’ “core competencies, skills and abilities to assess children’s social and emotional progress and to respond to children in behavioral distress,” the press release explains. Doing so can help children and families overcome behavioral challenges and also reduce unnecessary suspensions and expulsions in early education and care settings.

“Six agencies have been selected to provide services in 351 communities across the state,” reaching an estimated 1,000 licensed early education and care programs for young children. The agencies are:

- The Behavioral Health Network: which will serve the western part of the state

- Community Healthlink, Inc: which will serve central Massachusetts

- The Massachusetts Society for the Prevention of Cruelty to Children: which will serve the Northeast

- Enable: serving Metrowest

- The Justice Resource Institute, Inc.: serving the Southeast, Cape Cod, and the Islands

- The Home for Little Wanderers: which will serve Greater Boston

“The agencies funded through this grant will coordinate classrooms observations of children; assessments of children’s physical environments; training, coaching, and mentoring to help educators identify behavior risks and prevent or reduce social-emotional issues; and referrals to community-based services that meet the mental health, social welfare, and other basic needs of children and their family members,” the press release explains.

Mental Health Issues

“Children can show clear characteristics of anxiety disorders, attention-deficit/hyperactivity disorder, conduct disorder, depression, post- traumatic stress disorder, and neurodevelopmental disabilities, such as autism, at a very early age,” according to a brief from Harvard’s Center on the Developing Child. And because young children react differently than older children and adults, “diagnosis in early childhood can be even more difficult than it is in adults.”

Toxic stress – resulting from frequent or prolonged exposure to severe adversity, such as abuse, neglect, or maternal depression – can “damage the architecture of the developing brain and increase the likelihood of significant mental health problems that may emerge either quickly or years later,” the brief explains.

The Center points to three policy implications. First, infants, toddlers and young children should receive services that focus on “their full environment of relationships,” including parents, caregivers and early education providers. Second, doctors and early education providers could be of more help to children if they had “more appropriate professional training and easier access to child mental health professionals when they are needed.”  And third, better coordination of resources would “provide a more stable and efficient vehicle for assuring access to effective prevention and treatment programs.”

That kind of coordination is what Massachusetts is working hard to provide. As DMH Commissioner Marcia Fowler explains in the EEC press release, “DMH supports effective early childhood mental health consultation and we enthusiastically lend our expertise to identify and provide appropriate interventions as early as possible in the lives of young people.” Fowler praises partnerships that unite early education and care providers with mental health consultants and community-based mental health care providers.

A National Issue

“Far too many children — especially those known to the child welfare system — have experienced trauma related to neglect, exposure to violence, physical and sexual abuse, and psychological maltreatment,” U.S. Secretary of Health and Human Services Kathleen Sebelius wrote last month in a Huffington Post article.

To address this problem, HHS has issued a letter to states explaining new guidelines on how to better provide mental health services to children, particularly children in foster care and children with disabilities – since both are known to be at risk for experiencing what Sebelius calls “complex trauma.”

Sebelius explains: “The letter released today introduces a new model of service delivery and workforce training. It will improve the way we promote and protect the health of children in child welfare and mental health systems. And it describes how comprehensive approaches can be funded or reimbursed by three federal sources: child welfare, mental health and Medicaid.”

Among the resources listed in the letter is a list of tools that can be used to measure early childhood outcomes, as well as a link to a database of tools to screen for trauma.

Meeting the Challenge

Improving mental health services for very young children who need it is essential to their success.

“We must do more to give young students every opportunity to achieve at the highest level and that includes emotional and social supports,” Massachusetts Secretary of Education Matt Malone said in the state’s press release. “By providing teachers with strategies to connect parents with mental health resources for their children, we know the students will do better and that our communities as a whole will be better off.”

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