Infusing Mental Health Into an Early Childhood System of Care

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Infusing Mental Health Into an Early Childhood
System of Care
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Early Childhood Mental Health

• The Social, emotional and behavioral well-being
  of young children and their families
• The developing capacity to
• Experience, regulate, and express emotion
• Form close, secure relationships
• Explore the environment and learn
• Adapted from ZERO TO THREE

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Values and Principles

• INFUSE Mental Health in early childhood natural
  settings where kids are

Supports for care givers, parents, services for
children and families

• USE PUBLIC HEALTH MODEL (intervention is not
  enough)

• Promotion - for healthy social emotional
  development of all kids and families
• Prevention - focus supports for at risk children
  and families
• Intervention - services to kids with diagnosis

• ACCEPT THAT THIS IS A CULTURAL EXCHANGE PROCESS

Engaging and involving families, caregivers,
early childhood providers, mental health
providers, and community at large.
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Strategic Planning

• Why?

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• We know more now about the importance of early
  life experience than we ever have.
• We know more now about what works than we ever
  have.
• We know more about strengths of families
  than we ever have.
• We know more about the power of
  community than we ever have.
• The time to invest in the future is now.

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• The Department of Developmental and Mental Health
  Services applied for and received from the Center
  for Mental Health Services
• Services Initiative Grant
• 5.7 Million Dollars
• Five Years Duration

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STRATEGIC PLANNING

• Interagency Partnership

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Vermont Early Childhood System Work Group
Children Families
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Regional Planning Process

• Management team
• Priority needs and services
• Budgets
• Fiscal agent
• Local outcomes

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Who participated?

• Family members
• Early childhood System of Care (including health)
• Systems of Care for Children with Emotional and
  Behavioral Challenges (school-ages)
• Other community agencies and leaders

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Identified Top 3 Community Survey and Forum
Priorities

• Parenting and child care training opportunities.
• Behavioral consultation in child care settings
  and school settings.
• In-home direct therapeutic and consultation
  services.

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State Outreach Team

• Family members
• and
• Representatives from
• Agency of Human Services
• Department of Developmental and Mental Health
  Services
• Department of Health
• Department of Social Welfare, Social and
  Rehabilitation Services (child welfare)
• Department of Education

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SERVICES AND SUPPORTS

• What?

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Regional Services 26 FTEs hired statewide















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DIFFERENT SERVICES

• Consultation without identified client
• Cross training of early childhood caregivers

DIFFERENT PLACES TO SERVE

• Childcare
• Parent Child Centers
• Pediatric practices

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PREPARED WORKFORCE

• HOW and WHO?

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Learning Team Commitments

• Operate as learning organization
• Strengthen existing skills, knowledge and systems
  of care
• Build competent workforce
• Strive for meaningful family participation
• Make community priorities our priorities
• Address needs of under-served families

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CUPS Learning Team Initiatives

• Coordinate with early childhood initiatives
• Provide philosophical leadership
• Identify core competencies
• Address local training priorities
• Conduct statewide learning series
• Collaborate with Family Consortium
• Facilitate network for reflective supervision
• Provide training scholarships
• Explore higher education and in-service training
  opportunities

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Early Childhood Mental Health Knowledge and
Practices Document Includes
A description of the field of early childhood
mental health.
A set of Guiding Principles underlying all
services, supports and practices in the field.
Core Competencies organize into four domains

Child
Family

Community
Interpersonal relationships and teamwork
A Personal or Team Summary
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CUPS HANDBOOKFINDING HELP WITH
SOCIAL-EMOTIONAL-BEHAVIORAL PROBLEMS FOR YOUNG
CHILDREN THEIR FAMILIES
TABLE OF CONTENTS
Introduction 1. Families in the 21st.
Century2. Assessment as Discovery3. Early
developmental delays and differences4. Teen
parenting5. Trauma to the child including
sexual and physical abuse6. Domestic violence
witnessed by the child7. Neglect of the
child8. Challenging behaviors 9. Parent
substance abuse and chemical addictions10. Parent
psychosocial/developmental challenges11. Environ
mental stressors   APPENDIX I Legal
Definitions APPENDIX II General Resources,
State-wide (Vermont) APPENDIX III General
Resources, National International
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Financing

• How?

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BIG QUESTIONS

• How to leverage Federal dollars for these
  services that dont identify a specific client?
• Promoting public health model.
• Consulting and providing Technical Assistance to
  early childhood providers.
• Screening all children for social and emotional
  issues.

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FINANCING

• How?
• Many new partners, many new opportunities to
  blend resources.
• Early Childhood providers fear of Medicaid and
  diagnosis.
• Use of V codes
• Use of treatment planning

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Evaluation

• 134 parents of children ages1 to 6 participated
  in the evaluation
• Significant positive changes were reported after
  six-months of services they appear to have been
  maintained after one year.
• Childrens emotional problems decreased.
• Parents stress was reduced.
• Parents were more satisfied with their
  childrens progress than before service.

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Key Findings

• Parents felt that services helped their family.
• Parents were satisfied with their childs
  progress.
• Children demonstrated improved social and
  emotional outcomes.

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• Billys story

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Risk and Protective factors

• Resilient children tend to have had environments
  that are supportive in critical ways and the
  capacity for resilience develops over time in the
  context of environmental support (Egeland,
  Carlson Sroufe,1993)

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Protective Factors

• Positive self-esteem
• Active style of responding to stress
• Ability to elicit positive attention form adults

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EARLY CHILDHOOD MENTAL HEALTH SYSTEM OF
CARE Fosters the social and emotional well-being
of infants toddlers, preschool-age children and
their families
Services and Supports
VALUES Family Voice Child and Family
Centered Relationship Based Culturally
Competent Infused into Natural Settings and
Services Grounded in Developmental Knowledge
Supports for Parents and Families
Supports for Other Caregivers
Services for Children and Families
Building Blocks
Strategic Planning, Policies, and Procedures
Maximized and Flexible Funding
Prepared Workforce
Interagency Partnerships
Outcome Evaluation
Developed by Roxane Kaufmann, GUCCHD
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Promotion

• Dissemination of information promoting healthy
  social-emotional development
• Developmental screening
• High quality child care
• Use of an evidence-based curriculum

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Prevention

• Home visiting
• Mental health consultation
• Family mentors
• Social skills curricula
• Family supports
• Caregiver supports

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Intervention

• On-site mental health consultation
• Crisis teams
• Wraparound services
• Relationship-based therapy
• Hotlines for families
• Behaviorally-based programs provided in a variety
  of settings
• In-home treatment

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Achieving System Reform Goals

• Work together
• Emphasize shared values
• Learn from differences
• Engage key stakeholders
• Focus on the philosophy and values

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Charlie Biss, DirectorChild, Adolescence
Family UnitPhone (802) 652-200Fax (802)
652-2005e-mail cbiss_at_vdh.state.vt.us

• Division of Mental Health
• 108 Cherry Street
• PO Box 70
• Burlington, VT 05402-0070
• Website www.HealthyVermonters.info
• Click on mental health
• Click on mental health again to get to DMHS
• You will then click on research publications
• Once you get to publications, click on child
  adolescent
• Click on CUPs handbook
• Then click on knowledge and practices