Building Strong Systems of Support for Young Children's Mental Health: Key Strategies for States and a Planning Tool

Sheila Smith; Shannon M. Stagman; Susan Blank; Christine Ong; Kendra McDow

Building Strong Systems of Support for Young Children's Mental Health: Key Strategies for States and a Planning Tool
Smith, Sheila
Stagman, Shannon M.
Blank, Susan
Ong, Christine
McDow, Kendra
National Center for Children in Poverty
Permanent URL:
Columbia University. National Center for Children in Poverty, Mailman School of Public Health, Columbia University
Publisher Location:
New York
Young children's mental health provides an essential foundation for early learning and development. In the early years, children's mental health can be seen in a wide range of behaviors that promote engagement in social relationships and learning. An infant who joyfully participates in "conversation" with parents is acquiring a capacity for strong social relationships while learning language and the patterns of communication. A toddler shows positive mental health by actively investigating her environment while gaining new cognitive and motor skills during play and exploration. A preschooler who helps his friend build a robot, shares his favorite markers, and rebuilds his block tower after it tumbles is learning social and problem-solving skills that will fuel learning in preschool and beyond. In sum, young children's "mental health" refers to emotional wellbeing and positive social development from birth through age 5. Young children with mental health problems miss out on developmental experiences that promote early learning. The behavior problems of some children result in actual expulsion from early care and education settings. For other children, mental health problems and challenging behavior may limit positive engagement in learning by contributing to conflictual relationships with teachers and classmates. Young children experiencing sadness or anxiety may find it hard to fully participate in growth-promoting play and learning activities. At home, young children with problem behaviors may be caught in a cycle of negative interactions with parents that disrupt a nurturing parent-child relationship and further limit support for the child's healthy development. Recent estimates suggest that between nine and 14 percent of children under age experience emotional and behavioral problems. The prevalence of mental health problems is markedly higher for children in families facing economic hardship and other stressful circumstances, such as maternal depression. In the absence of interventions, mental health conditions that emerge in the early years tend to persist and interfere with healthy development and learning. State leaders increasingly recognize the critical link between young children's mental health and later social adjustment and success in school. In recent years, states have begun to develop new policies and programs that help establish supports for young children's mental health across a wide range of settings, including pediatric offices and community clinics, early childhood and home-visiting programs, and child welfare agencies. These efforts focus on promoting positive mental health, preventing potential mental health problems, and treating identified delays or difficulties in social-emotional development. Many states' efforts include the use of evidence-based models and training experiences for service providers to increase their knowledge and skills. Part I of this report describes key strategies that should be part of a comprehensive system of supports for young children's mental health and examples from states that are developing and implementing them. These strategies are: promoting early childhood mental health (ECMH) in home visiting and parenting programs; enhancing supports for ECMH in early care and education programs; screening parents for depression; screening children for social-emotional problems; developing a better-trained workforce to address the social-emotional needs of young children; using evidence-based practices and evaluation to promote effective ECMH programs; and supporting the well-being of exceptionally vulnerable children. Part II of this report presents a simple tool that state planners can use for two purposes: 1) to assess the current status of the state's ECMH supports; and 2) to plan for specific enhancements in the state's current system, including expansion of certain ECMH strategies, such as child screening or training for early childhood teachers, and improvements in the quality of interventions. Since the creation of strong systems of ECMH supports requires collaboration among multiple agencies and programs, this tool may be especially useful for Early Childhood Advisory Councils, Early Childhood Comprehensive Systems initiatives, and similar state-level planning entities that bring together leaders from different sectors.
Individual and family studies
Mental health
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