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Mental Health Consultation in Early Care and Education

Key Features

  1. Use of a mental health clinician to build the capacity of providers, programs, and systems to foster children’s social, emotional, and behavioral health and development
  2. Observation of children and classrooms, classroom management support, and modeling and coaching
  3. Screening and assessment to support the early identification of children with or at risk for mental health challenges
  4. Referrals and follow-up for children and families to community-based services
  5. Training and staff development activities to build providers’ knowledge of mental health issues in infancy and early childhood

Infant and early childhood mental health consultation (IECMHC) is a multilevel approach to promotion and prevention that teams mental health professionals with people who work with young children and their families to improve their social, emotional, and behavioral health and development. IECMHC can occur in various child-serving settings, including early care and education (ECE). This Project LAUNCH strategy focuses specifically on IECMHC in ECE programs, although many grantees also are applying IECMHC to home visiting programs and in primary care settings.

IECMHC encompasses a broad array of strategies implemented at multiple levels: the child, the family, the provider, the program, and the community. Although mental health consultants do work directly with individual children and families, many of their efforts are intended to build the capacities of ECE providers, programs, and systems to foster young children’s development and to prevent or address emotional and behavioral issues.

Studies have confirmed that children’s emotional well-being serves as the foundation for all their growth and development, including physical, cognitive, health, and language outcomes.

An estimated 9.5 percent to 14.2 percent[1] of children from birth to 5 years of age experience emotional or behavioral challenges. IECMHC has proven to be an effective strategy to address these issues. For example, the use of a mental health consultant improves the capacities of providers to address challenging behavior in young children, reduces stress in parents and teachers, and decreases the rates at which children are expelled from early childhood programs for behavior problems.

The value of IECMHC was highlighted in a 2014 policy statement released by the U.S. Department of Education and the U.S. Department of Health and Human Services. This statement provided recommendations for expulsion and suspension practices in early childhood settings, including advocating for teachers’ access to mental health consultants to provide specialized support and to build their own skills in working effectively with young children and families. The policy statement also includes references and resources related to mental health consultation in early care and education.

Mental health consultants have specific knowledge and competencies to deliver effective prevention and promotion services. It is recommended that IECMHC consultants, at a minimum, have master’s degrees in mental health; be licensed or license-eligible and well-trained in their fields; have at least 2–3 years of work experience as mental health professionals; practice a consultative stance; and possess attributes and skills critical to this work (e.g., facilitate partnerships and demonstrate cultural sensitivity, flexibility, empathy, and curiosity).

Mental health consultants also have specialized knowledge of ECE systems and child development. They understand the effects of stressors on child development and mental health, how substance use and domestic and community violence can affect mental well-being, and the relationship between adult mental illness and infant social–emotional development.

Project LAUNCH grantees implement numerous IECMHC activities. For example, grantees:

  • Provide services in child care and in early care and education programs, including observing children and classrooms, offering individualized strategies for staff to promote children’s well-being, providing classroom management support, and modeling and coaching.
  • Work with individual children and their families and teachers to address issues, conduct screening and assessment to support the early identification of children with or at risk for mental health challenges, and link families to appropriate services in the community.
  • Provide consultation at a program level to improve the capacities of providers to promote wellness in young children and to address challenges.
  • Offer training and staff development activities to build providers’ knowledge of mental health in infancy and early childhood.
  • Promote a statewide competency or credentialing system as a means to build capacity and improve early childhood workforce development.
  • Inform state, tribal, or territorial policy to support the development of sustainable mental health consultation systems.
  • Contribute to the growing evidence base regarding IECMHC implementation models, including measures to demonstrate efficacy and outcomes.

Grantee Highlights

  • Maryland Project LAUNCH is implementing statewide initiatives to support IECMHC in various settings, including early care and education, home visiting, and primary care.
  • At the community level, Project LAUNCH transformed the provision of mental health consultation in the pilot community from an “on-call,” child-centered focus to an embedded model. In this model, IECMH consultants work at the sites regularly and are able to build relationships with staff, parents, and administrators. They are thereby able to provide a more comprehensive approach toward mental health consultation, expanding beyond child observation to include family consultation as well as classroom and program consultation and support.
  • New York City Project LAUNCH, with additional funding from the city, pairs an ECMH consultant with Incredible Years (IY) teacher training, drawing on the tools from IY to support classroom work and consultation to teachers.
  • Cherokee Project LAUNCH supports mental health consultants in Head Start settings and is integrating ECMH consultants within its home visiting consortium.
  • In Wisconsin, Project LAUNCH is supporting a comprehensive mental health consultation model, which includes training; group consultation with reflective practice and case problem-solving components; and child-, classroom-, and program-level consultation.
  • Project LAUNCH in Multnomah County, Oregon, provides ECMH consultation (ECMHC) and Early Childhood Positive Behavioral Interventions and Supports (EC-PBIS) to two large child care centers in the county through a regional social services agency. EC-PBIS is a model the consultants use to provide early childhood teachers with strategies and tools for increasing positive behavior and decreasing negative behavior in the classroom via a tiered approach (universal promotion, secondary prevention, and tertiary intervention).
 

[1] Brauner, C. B., & Stephens, C. B. (2006). Estimating the prevalence of early childhood serious emotional/behavioral disorder: Challenges and recommendations. Public Health Reports, 121(3), 303–310.

Beyond the Grant: LAUNCH Grantees’ Successes in Expanding and Sustaining Services to Children and Families

This brief highlights many notable and emerging successes of grantees in expanding and sustaining services for children and families in the five core Project LAUNCH strategies (screening and assessment; enhanced home visiting through increased focus on social and emotional well-being; mental health consultation in early care and education programs; family strengthening and parent skills training; and integration of behavioral health into primary care settings).

Examining the Associations Between Infant/Toddler Workforce Preparation, Program Quality and Child Outcomes: A Review of the Research Evidence

Considers the role of educational attainment, degree type (e.g., concentration or major in early childhood or a related field), years of experience, and training. The brief concludes with implications for future research, as well as for policy and practice.

Early Childhood Mental Health Consultation to Home Visiting Programs: Addressing the Unmet Mental Health Needs of Families with Young Children

Describes the model used by IL Children's Mental Health Partnership in providing grants to home visiting programs to fund Early Childhood Mental Health Consultants to work with program supervisors and staff.

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