The program is promoting a better understanding that child mental health - (mental well-being) exists within a context of family and community who interact with young children on a regular basis. There are lots of dynamics that contribute to adults who may prefer a traditional child mental health approach that "blames the victim", tries to identify "quick and easy" solutions (such as psychotropic medication or blaming teachers or parents), and has parents who may have difficulty accepting that a child may have a developmental delay or other special need (and not a mental health issue), or teachers who work within school and childcare systems that are inadequately prepared to effectively address mental health concerns in the child's natural environments.
The solutions include maximizing those psychosocial interventions that include the context directly (classrooms, parents, community) and "slow down" the process to ensure adequate assessment where the environment or context of the child is examined as closely as the child and his/her behavior. These psychosocial interventions include early childhood practitioners who can effectively implement evidence-based practices in partnership with parents and teachers who can impact the full context of the child using EBP's such as Parent Child Interaction Therapy, Incredible Years parenting programs, 2nd Step Social Skills Curriculum, and Positive Behavioral Intervention and Support .
To provide an example of program services, the following describes what one of the early childhood clinicians may experience in a typical day. They often start at a campus to observe a referred child and conclude their 1-2 hour visit with a consultation for the teacher with written recommendations (usually classroom or behavioral management strategies). They will visit several campuses in a day. After so many visits for a referred child, the clinician may develop a behavioral plan in collaboration with the teacher and we do follow up coaching and support for the teacher. Staff may hold off on full family integration (for classroom referrals until after 2-3 visits) as 50-80% of those referrals are due to classroom management problems and not a true mental health problems although they may be difficult to differentiate without those extensive observations. Clinicians do home visits after a few classroom observations to do a family assessment and then begin individualized parenting sessions (PCIT and Incredible Years strategies used) with an option of brief counseling for child, parents, or other family members. Most of the interventions are integrated into the classroom so lots of training, coaching and guidance is given to teachers. Staff may attend an IEP meeting (called ARD meetings in Texas) to help parents advocate for their child. All staff provide training related to early childhood mental health (program does an average of 1-2 training sessions per month with teachers and parents being the primary participants). Late afternoon, eves or Saturday mornings may include home visits. Program staff are quite excited about a new project, Early Intervention Court (baby court) in which 0-3 year olds in the foster care system get the comprehensive services that may include foster parents, biological parents, other caregivers and the child. It is modeled after drug courts so parents get increased visits and expedited reunification based on progress.
ECWB is also working on the child advocacy and policy advocacy side of mental health working in partnership with many local and state advocacy agencies to help remove barriers to availability and access to developmentally appropriate early childhood mental health services. The program has led the creation of a local chapter of an infant mental health association, has brought policy experts to train community members and leaders in policy advocacy, and helped to create opportunities for professionals to help educate and bring awareness to policy makers regarding early childhood mental health and related issues.
The latest part of the program now is collaborating with a local Federally Qualified Health Center to provide integrated healthcare where the center's child psychiatrists and pediatricians divert mental health referrals of young children to ECWB to provide those more developmentally appropriate psychosocial interventions.
All of this work includes advocating for teachers and families and educating them and learning from them to maximize the effectiveness of early childhood mental health services.