Advancing Infant and Early Childhood Mental Health — One Relationship at a Time

As early childhood policymakers and advocates, we know that early relationships matter – a lot. We know that babies’ earliest relationships and experiences shape the architecture of the brain. Babies who engage with responsive, consistent and nurturing caregivers are more likely to have strong emotional health, or, infant and early childhood mental health (IECMH).

Most legislators, agency directors and other policy makers are not familiar with IECMH, and if they are, IECMH competes with many other priority issues – health care reform, tax reform, state budget deficits, disaster relief, etc.  Policy makers may be aware that brain development happens in the first years of life, but do they know that IECMH is directly linked to the formation of a child’s brain architecture, shaping neural connections and pathways through repeated experiences and early relationships?  Do our decision makers know that IECMH is the cornerstone of healthy development providing the foundation upon which all future development rests including physical growth, health, cognitive skills and communication?  

Given all the competing issues, policymakers need a compelling reason to take action on IECMH.  They need information about the potential benefits of early identification, the expected “pay off” or return on investment, and they need to hear directly from families (their constituents) about the value of services and supports. Policymakers also need to see how investments in IECMH can affect their other priorities. For example, access to high quality child care translates into better employment opportunities in communities that can attract young families and create a stronger economy. Improving early identification and treatment of mental health disorders prevents more serious and costly mental illness later on. And of course, school success factors such as self-confidence, curiosity, persistence, self-control, and trust have their roots in infancy, and policies such as paid parental leave allow families to establish secure, healthy relationships with their babies.

It is important to note that IECMH disorders can occur in children irrespective of parenting practices, socioeconomic status, health care or family support.Research tells us that when these disorders occur, regardless of their source, their effects can be at least ameliorated with timely and effective interventions. Unfortunately, only a small percentage of children who need mental health treatment actually receive it. When disorders are left untreated, they can impact every facet of a child’s development – physical, cognitive, communication, sensory and motor skills, emotional resiliency, and social – and in turn, a child’s ability to succeed. And if not addressed in early childhood, IECMH disorders can impact functioning into adulthood including success in the workforce and in relationships.  

Just as infants and young children develop in the context of relationships, change happens in the context of relationships. As someone interested in IECMH, think about spreading the word on IECMH. Everyone has a sphere of interest. Figure out what your sphere is and use it! Build a relationship with your state children’s mental health director. Volunteer to be your agency’s representative to offer the early childhood perspective on a mental health or Medicaid workgroup. Talk with the state staff working in child care, early intervention, home visiting and child welfare. Each of these interactions is a way to create a relationship and make improvements in IECMH. Meet with these decision-makers to learn what is being done in their respective areas to support young children’s mental health. Have an informal conversation. Build a relationship. Offer to be a resource to them. Help educate them on the critical importance of early relationships and consistent care.  

Changes in policy and practice start with building relationships with individuals who have the power to make decisions.  Share information in clear simple terms. Your message matters. Help policy makers understand that infants and young children have mental health needs.  

ZERO TO THREE has developed a series of short briefing papers to help you in your work. These papers can be used to raise awareness, interest and action among state policy makers, mental health providers, advocates and early childhood providers. Bring one of the papers with you and leave it with the person you are trying to influence. Topics include:

In addition, in order to better understand awareness of and attitudes toward emotional development in young children and infants, ZERO TO THREE and the Robert Wood Johnson Foundation commissioned a national survey to explore awareness of the topic, parents’ attitudes and behaviors, and perspectives on policy ideas to support the healthy development of infants and toddlers. The research findings can help inform your policy strategies and advocacy messages.

Remember everyone has a sphere of interest. Figure out what your sphere is and use it! We all need to work together to advance IECMH – one relationship at a time.

Cindy Oser, Julie Cohen, and Therese Ahlers work at ZERO TO THREE, whose mission is to ensure all babies and toddlers have a strong start in life.