Early Childhood Mental Health Services and First Steps

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Early Childhood Mental Health Services and First
Steps

• Indiana Association for Infant and Toddler Mental
  Health
• Mental Health Task Force

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Early Childhood Mental Health

• What is ECMH?
• Why is ECMH important?
• What MH services are provided in First Steps?
• When are MH services needed?
• Who provides services?
• What can families expect?
• How are referrals made?

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Experiences with MH Services

• First Thoughts?
• Different kinds of providers?
• Experiences?
• Made a referral?
• How would it feel?
• Hesitation about referrals?

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MH True and False

• Babies cannot experience emotional distress
• Young children will not remember traumatic events
• Emotional and behavioral problems of young
  children will always be outgrown.
• There are no methods for treating emotional
  concerns in young children

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Early Childhood Mental Health

• Babies and toddlers can experience
• Emotional distress
• Problems with early relationships
• Behavior difficulties
• Atypical development

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ECMH

• Tommy
• Charlie
• Caroline
• Valerie
• Steven

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ECMH

• These experiences justify the need for MH
  interventions
• MH interventions can be successful
• First Steps providers can help recognize when
  families need intervention and help them access
  services

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What is ECMH?

• A broad term that encompasses
• Theory
• Research
• Clinical practice

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Early Childhood Mental Health

• Three basic concepts
• A positive outcome for infants
• Identifying what leads to positive outcomes
• Clinical assessment, treatment, and prevention

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In the first few years of life

• Mental health should be understood within the
  context of social and emotional development
• Meaning, the childs ways of establishing
  positive relationships
• In order to support emotional regulation, well
  defined sense of self

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Early Childhood Mental Health

• Provides a frameworkto support
  parents,children, and theirrelationships...thro
  ugh the relationshipsthat are developedbetween
  the provider and the family

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Early Childhood Mental Health

• Babies are social creatures who need meaningful
  emotional experiences
• Some families need help to attain positive
  emotional experiences and interactions

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Early Childhood Mental Health

• Promote positive relationships between infants
  and toddlers and important adults
• Become socially competent through these
  relationships
• Know how to have other positive relationships
• Manage unpleasant feelings and impulses

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ECMH and EI

• Shared philosophies
• Emotional and behavioralconcerns can hinder the
  childs overall development and/orprogress in
  intervention
• MH providers can supportthe work of EI
  specialists

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What services are available?

• Specialized Individual and Family
  Counseling/Psychological Services
• Social Work

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What kinds of providers?

• Families will choose a provider
• Experience with the age group more important than
  specific degree
• Providers include psychologist, social workers,
  and LMHC

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Psychological Services

• Individual and family counseling
• Testing and other assessments
• Consultation around child development
• Parent training

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Social Work

• Individual and family counseling
• Group counseling

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Mental Health Provider Training

• Social Workers
• Masters degree
• License (LCSW)
• Supervised Internship

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Psychologist

• School Psychologist
• Masters or Doctorate
• Private Practice Endorsement
• Supervised Internship

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Psychologist

• Health Service Provider in Psychology
• Doctorate in applied area of psychology
• License
• Supervised Internship

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Licensed Mental Health Counselor

• Masters Degree
• License
• Supervised Internship

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When are services needed?

• Consider
• Infant/toddler behaviors
• Parent behaviors
• Family situations
• Recent transitions

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When are services needed?

• Infant (0 to 1 year) social and emotional
  characteristics that may signal the need for MH
  assessment
• Excessive crying (colicky, cries more than 3
  hours in 24 hrs)
• Sleep disturbance
• Feeding disorders
• Extreme stranger anxiety
• Wont cuddle

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When are services needed?

• No or limited eye contact
• No smiling
• Little or no social reciprocity (enjoyment of
  interactions with others)
• Muscular rigidity (freezing)
• Little emotion (rarely coos or babbles)
• Irritability related to mood dysregulation
• Sensory sensitivity (unusual sensitivity to
  sight, sound, and/or touch)

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When are services needed?

• Toddler (1 to 3 years) social and emotional
  characteristics that may signal the need for MH
  assessment
• No or limited eye contact
• Significant sleeping problems (night terrors,
  wakes numerous times, difficulty settling at bed
  time)
• Eating problems
• Frustration with communication
• Continual thumb sucking

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When are services needed?

• Inability to separate from caregiver without
  extreme anxiety
• Severe temper tantrums or aggression
• Too social to unfamiliar adults
• Trouble attending to play or social activities
• Difficulty with transitions between activities
• Self injurious behaviors
• Tries to take care of parent
• Loss of skills in any developmental area

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When are services needed?

• Parent social and emotional characteristics that
  may signal the need for MH assessment
• Parent looks sad and/or exceedingly tired
• Parent feels no joy regarding child
• Parent states feeling blue and overwhelmed
• Limited family support
• Parent has MH issues, cognitive limitations, or
  problems with addiction

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When are services needed?

• Family risk factors that, when combined with
  child concerns, may signal the need for MH
  assessment
• Violence in home
• Drug/alcohol use in home
• Family economic stress
• Chaotic or stressful home environment
• Low socio-economic status/poverty

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When are services needed?

• Multiple moves or changes in placement
• Young parent/single parent
• Child abuse or neglect/CPS involvement
• Sibling issues
• Parental discord around child's developmental
  differences, acceptance, treatment, and family
  responses (nuclear and extended)

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Activity

• Vignettes
• Small Groups

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What can families expect?

• Assessment
• Parent Interview
• Observations of Child and Child with Family
• Play with Child
• Assessment Tools with Child or Family

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What can families expect?

• Treatment
• Parent training
• Working with child adult
• Less often direct treatment with child alone
• Services are available in the natural environment
• Co-Treatment with other provider

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Making referrals

• There are NO rights or wrongs
• If a parent is concerned, refer
• Call us! Ask questions!
• The MH provider can help you know if this
  appropriate for First Steps or give you ideas
  about other community referral sources

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Making referrals

• MH Provider will determine need for service with
  the Team
• Is the family well enough for intervention?
• Is the family situation too complex?

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Making referrals

• Activity Making Referrals
• What to say
• How to say it

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Question and Answer
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Want to learn more?

• Indiana Association for Infant and Toddler Mental
  Health (mentalhealthassociation.com)
• 317/638-3501 EXT 221
• Zero to Three (zerotothree.org)
• The Center for Social and Emotional Foundations
  for Early Learning (csefel.uiuc.edu)

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Early Childhood Mental Health Services and First
Steps

• Indiana Association for Infant and Toddler Mental
  Health
• Mental Health Task Force