Five Ways Policymakers Can Support Children’s Mental Health

As Mental Health Awareness month comes to a close, it is important to remember that fostering mental health starts in infancy. From birth to age three a child’s brain is developing rapidly with over 700 new neural connections formed every second. Nurturing environments and positive experiences that promote early learning help to foster healthy brain development, but negative experiences in a child’s early years can be detrimental to development. Adverse childhood experiences, known as ACEs, can negatively impact a child’s brain and have long-lasting effects on physical and mental health well into adulthood. ACEs can also impact a child’s academic performance and behavior in school, placing children at increased risk for school dropout and absenteeism. For a short video on ACEs from Dr. Nadine Burke Harris see below:

Promoting healthy brain development through increased exposure to nurturing environments at home and in early learning programs are essential. One way federal, state, and local policymakers can bolster their investment in the early years is by understanding the importance of infant and early childhood mental health (I-ECMH) and by making sure that mental health is included in policies that support children’s development.

In a report released earlier this month for National Children’s Mental Health Awareness Day, ZERO TO THREE and Manatt Health define I-ECMH as “the capacity of a child from birth to age five to:

• experience, express, and regulate emotions;
• form close, secure interpersonal relationships; and
• explore his/her environment and learn, within the context of family and cultural expectations.”

Early childhood educators along with healthcare professionals and family members serve on the front line to support children who have experienced trauma or who are suffering from a mental health disorder or condition. All of these key individuals can benefit from policies that will help them to support children's well-being, healthy development. The report recommends several ways policies could help ensure that infants and toddlers are in supportive early learning environments:

1. Encourage state policymakers to establish cross-agency I-ECMH leadership. When a state designates a person or team to be responsible for their mental health work they can foster cross-agency collaboration and recommend the best uses of funding and implementation of services. For instance, in Colorado, the state designated a director of Early Childhood Mental Health to make sure infant and toddler needs are addressed.
2. Ensure Medicaid payment for I-ECMH services. The use of Medicaid Managed Care Organizations to promote best practices for health care providers is a lever that states should use. States should require providers to follow Bright Futures, which offers pediatricians the most-up-to-date screening guidelines for developmental delays, hearing and vision problems, and psychological and behavioral issues. The initiative also aligns with Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment program. The use of Bright Futures guidelines and tools can help to ensure that the most vulnerable children are evaluated and treated early for mental health disorders.
3. Invest in prevention through mental health consultation. Early childhood mental health consultation should be embedded into all early childhood education programs and settings, including home visiting. They should also be integrated into non-traditional settings, such as homeless or domestic violence shelters. These consultations can help families and educators promote positive social and emotional development and intervene when mental health issues arise, which is essential for ending the inappropriate use of suspension and expulsion in the early years.
4. Train workforce on young children's mental health needs. Early childhood professionals across all sectors need more pre-service and ongoing training, particularly as our knowledge about how the brain develops expands. Both the Academy of Medicine's Transforming the Workforce report and ZERO TO THREE conclude that the early childhood workforce should incorporate mental health into the core knowledge and competencies of early childhood educators. One way that this can be achieved is through state child care licensing training requirements.
5. Raise public awareness of I-ECMH. Public health campaigns that build the public’s awareness of mental health can help families understand how to promote a child’s positive social and emotional development. New York City began an awareness campaign in 2015 called “Talk to Your Baby” to help families and caregivers communicate with preverbal infants in order to promote positive development.

The investment in infant and early childhood mental health can help to ameliorate the long-term impact of trauma and enable healthy child development. If mental health disorders in young children are not treated early, states may instead spend money later on suspension and expulsion, absenteeism, and juvenile justice. When policymakers think about investing in early childhood education, they should focus on preventive rather than reactive strategies and consider investment in children’s well-being as a key component to their educational success.