Infant-Early Childhood Mental Health Matters

By Cindy Oser, ZERO TO THREE

Last month, ZERO TO THREE and Manatt Health produced a policy brief and webinar highlighting the steps states should take to ensure resources to support infant and early childhood mental health (I-ECMH) are in place and working. Why? Because early investments in mental health will yield big outcomes for future learners and workers.

Contrary to what many believe, infants and young children do have mental health. Beginning at birth, babies’ brains are growing rapidly, and the environmental inputs they receive are building the cognitive, emotional and social functions that will serve them throughout their lives. When these inputs are healthy and positive, children have a better chance for future success, including school readiness, work success and productivity. When inputs are negative, they are at greater risk of facing challenges that become harder and more costly to affect down the road, impacting spending on health care, education, child welfare, and criminal justice, as well as economic productivity. In fact, the Centers for Disease Control and Prevention estimates that childhood abuse and neglect results in a lifetime cost of more than $200,000 per child, amounting to approximately $124 billion in total lifetime costs as a result of new child maltreatment cases in the U.S. each year.

I-ECMH is the capacity of a child from birth to 5 years old to experience, express and regulate emotions; form close, secure interpersonal relationships; and explore his/her environment and learn, within the context of family and cultural expectations. So how do state agencies and partners work to ensure children get what they need to be healthy and succeed?

Embed I-ECMH into All Programs That Work with Young Children and Their Families

First and foremost, states can coordinate I-ECMH services across agencies and programs in order to streamline efforts and close gaps in program funding and access. Designating a clear leadership role can establish accountability for meeting goals and making adjustments when necessary. Look at Colorado, which created an Office of Early Childhood and designated a Director of Early Childhood Mental Health to oversee development and implementation of the State’s I-ECMH policy agenda.

Whole Family Approach to Mental Health

Second, states must adopt a whole-family approach to I-ECMH. When parents have mental health challenges, it directly affects their children’s health and well-being. By ensuring Medicaid covers mental health services for families and children, both together and separately, under the child’s Medicaid number – along with multiple screenings for parent and child in the same setting and/or on the same day – states can improve the efficacy of I-ECMH programs and achieve better outcomes for families. Minnesota stands out in this area, permitting Medicaid payment for two-generational treatment for infants, young children and their families, either together or individually. The state also covers maternal depression screening using the child’s Medicaid number under Early and Periodic Screening, Diagnostic and Treatment (EPSDT).

Invest In Prevention

For long-term gains, states must also invest in I-ECMH prevention efforts, such as mental health consultation. Ideally, states would fund a statewide system of mental health consultants who are integrated into services including early intervention, home visiting, primary care, and early care and education settings, as well as non-traditional settings, such as Women, Infants and Children (WIC) offices and domestic violence shelters. In Arizona, the state’s network of local councils used tobacco tax revenue to fund mental health consultation across the majority of the state.

Quality Training Makes a Difference

Quality training for the I-ECMH workforce is equally important to a state’s ability to meet its policy and programmatic goals. Implementing competency standards and endorsements for mental health professionals gives states the tools they need for cultivating and maintaining the best talent. Endorsement®, a four-level workforce development process created by the Michigan Association for Infant Mental Health, verifies an individual’s specific level of education, service provision to infants and families, participation in specialized in-service trainings, receipt of guidance and reflective supervision or consultation, and the ability to deliver quality, culturally-sensitive I-ECMH services. More than 20 states have adopted the Endorsement® through their infant mental health associations.

Turn Up the Volume

While I-ECMH services are changing the course for families across the country, they remain underutilized and unrealized for many others. States need to turn up the volume on the importance of positive social and emotional development. New York City is doing just that with the launch of the “Talk to Your Baby” initiative to teach parents and caregivers about the importance of communicating with preverbal infants for their brain development.

The mental health of infants and young children is inextricably linked to the future stability, economic growth, and success of every community. By investing in these five strategic areas, states can create an environment that nurtures physical and mental health across generations, for all families.

Cindy Oser is Director of I-ECMH Strategy at ZERO TO THREE and Co-Director of the Project LAUNCH Resource Center, part of the National Resource Center on Mental Health Promotion and Youth Violence Prevention.