Transcript Document 7116409

A Systems Approach That Addresses Early
Childhood Mental Health
Services and Supports
Hope or Experience
Roxane K. Kaufmann
Georgetown University National Technical Assistance Center for
Children’s Mental Health
• [email protected]
• gucchd.georgetown.edu
Early Childhood Mental Health
Early Childhood Mental Health
• The social, emotional and behavioral wellbeing of young children and their families
• The developing capacity to experience,
regulate, express emotion
• Form close, secure relationships
• Explore the environment and learn
Adapted from ZERO TO THREE
Early Childhood Mental Health
A set of strategies to:
• Promote the behavioral/emotional well-being of all
• Strengthen well-being of children and families at
risk
• Help families address their own barriers
• Expand competencies of non-familial caregivers
• Ensure access to services for those w/ atypical
development
Jane Knitzer
Why and What For?
• Early childhood policies and procedures are
fragmented, with complex and confusing
points of entry… NRC/IOM Neurons to
Neighborhoods, 2000
• The goal of system-building is to integrate
multiple and diverse, formal and informal
supports and services in ways that recognize
the strengths of families and respond to
their daily needs. Fenichel and Kaufmann, 1987
Picture of a little girl frowning
2
CSEFEL
Voices of Families
• The Oklahoma story
• Josie R. - Expelled from childcare; soccer
the answer
• Susan – In treatment; baby in foster care
• Tina Marie – A concerned home visitor;
maternal depression
• Michal – A witness to tragedy; where to turn
• Andy Gomez – Wants to support his staff;
mental health consultation and training
Challenges
Population:
• Lack of focus on promotion and prevention
• Lack of acknowledgement of mental health
problems
Services and Supports:
• Unmet need and disparities
• Silos and eligibility restrictions
• Lack of family support
• Need for evidence-base
Challenges to Infant/EC Mental
Health
• Infrastructure:
– Lack of prepared workforce
– Fragmentation in responsibility (interagency
governance)
– Restrictive funding
– Need for family advocacy
– Lack of accountability and incentives for
quality improvement
Opportunities: Through any Door
•
•
•
•
•
•
•
•
•
ECCS
EHS and HS
Part C and 619
TANF
Home Visitation
Maternal Depression
Early Literacy
Expulsion Prevention
EBPs
• Foundation initiatives
• Universal Pre-K
• Healthy Start/Bright
Futures
• SAMHSA grants
• Child Care Quality set
asides
• Foundations for Learning
• Child Abuse Prevention
• Adult Services
EARLY CHILDHOOD MENTAL HEALTH SYSTEM OF CARE
Fosters the social and emotional well-being of infants toddlers, preschool-age
children and their families
•
•
•
•
•
•
•
VALUES
Family Voice
Child and Family
Centered
Relationship Based
Culturally
Competent
Infused into Natural
Settings and Services
Grounded in
Developmental
Knowledge
Strategic
Planning,
Policies, and
Procedures
Promotion
Services and Supports
Supports for
Parents and
Families
Supports for
Other
Caregivers
Services for Children
and Families
Building Blocks
Interagency
Partnerships
Maximized and
Flexible
Funding
Prevention
Developed by Roxane Kaufmann, GUCCHD
Prepared
Workforce
Outcome
Evaluation
Intervention
Core Values
• Child and family centered
• Relationship based
• Family voice
• Infused into natural settings and services
• Culturally competent
• Grounded in developmental knowledge
What is Family Partnership?
• “Family partnership” means
the identification, outreach to,
and engagement of diverse
families from the community
so that their experiences and
perspectives collectively drive
the planning, analysis,
implementation, monitoring,
and evaluation of the change
process and service delivery.
Why Culture Matters
Because it affects…
• Attitudes and beliefs about mental health
• Expression of symptoms
• Coping strategies
• Help-seeking behaviors
• Utilization of services
• Appropriateness of services and supports
Lazear, K., (2003). Primer Hands On
Image of a little girl smiling
2
CSEFEL
The Pyramid Model: Promoting Social Emotional
Competence in Infants and Young Children
Continuum of Services and
Supports: Promotion
• Dissemination of
information promoting
healthy social-emotional
development
• Developmental screening
• High quality child care
• Use of an evidence-based
curriculum
• Screening for maternal
depression
Prevention
• Home visiting
• Mental health
consultation
• Family mentors
• Social skills curricula
• Family supports
• Caregiver supports
Of the young children who show early
signs of problem behavior, it has been
estimated that fewer than 10% receive
services for these difficulties.
(Kazdin & Kendall, 1998)
Center for Evidence Based Practice: Young Children with Challenging Behavior
www.challengingbehavior.org
Intervention
•
•
•
•
•
•
On-site mental health consultation
Crisis teams
Wraparound services
Relationship-based therapy
Hotline for families
Behaviorally-based programs in a variety of
settings
• In-home treatment
• Multi-generational
Building Blocks
• Strategic Planning
• Interagency and
Collaborative
Partnerships
• Policies and
Procedures
• Family Involvement
and Advocacy
• Maximized and
Flexible Funding
• A Prepared Workforce
• Outcome Evaluation
and Data Management
State and Local Responsibilities
• STATE:
Clear point of
responsibility/accountability in
Exec. Branch
Committee on interagency
collaboration at senior level
Regular feedback from community
and families
Policy shifts related to funding and
HRD
State family organization/coalition
• COMMUNITY:
Local cross-system team
responsible for planning, policy
development, resource
identification, training,
monitoring
Strong family involvement on this
management committee
Interagency review mechanism
System for referrals
Local family supports
Core Elements of an
Effective System-Building Process
•
•
•
•
•
•
•
•
•
A core cross-community and state leadership group
Effective collaboration with a focus on outcomes
Partnerships with families at all levels
Cultural competence training and policies
Emphasis on promotion, prevention and treatment
Connection to neighborhood resources and natural helpers
Bottom up and top down approach (state and local)
Effective communication
Conflict resolution, mediation, and team-building
mechanisms
• A positive attitude
Pires, S. (2002).Building Systems of Care: A Primer. Washington, D.C.: Human Service Collaborative.
Achieving System Reform Goals
Hope and Experience
• Work together
• Emphasize shared values
• Learn from differences
• Engage key stakeholders
• Focus on the philosophy and
values