SECTION V
Conclusions and Recommendations for Action

The early Roundtable participants recognized that increasing numbers of young children in early childhood, early intervention, child care, and home-visiting programs are at risk for developing mental health problems, and that staff and families often lack the skills and resources to manage and respond effectively to these children. More emphasis must be placed on integrating a mental health perspective into these programs. Ongoing mental health consultation is one pathway to reach this goal.

They agreed on the following guidelines for early childhood mental health consultation:

• Early childhood mental health refers to a comprehensive perspective on social and emotional well-being in young children and on the processes that support it, including family and caregiver functioning and the context of young child-adult relationships.
  
  
• To make a difference in the lives of young children and their families, mental health professionals should identify the children’s social and emotional disorders, delays, and risk conditions and should design and implement appropriate interventions as early as possible.
  
  
• Stable, nurturing, and enduring relationships are basic prerequisites for mental health.
  
  
• Programs should be designed to promote staff well-being and functioning through training, supervision, and ongoing consultation and support.

Those participants offered the following recommendations to agencies and systems that seek to create responsive programs and interventions, as well as to individuals who are responsible for funding, educating, or providing early childhood mental health consultation.

ADMINISTRATORS OF COMMUNITY-BASED PROGRAMS

• Operationalize the agency’s commitment to integrate a mental health perspective into all parts of the program or system. Several aspects of the agency’s administrative, financing, personnel, and compensation infrastructure may require changes to support a mental health perspective. For example, if the consultation process results in the recommendation that a provider have more interaction with family members, the family contacts must be valued and approved by supervisors, counted as in-service hours, and included in the provider’s job evaluation.
  
  
• Maximize all available sources of funding, not only private funding, but also Medicaid and other public funding sources, strategically and creatively.
  
  
• Hold mental health consultants to the highest standards of respect for the early childhood education and child care programs and staff.
  
  
• Include managers and supervisors in decision making regarding the mental health consultation process. Develop an infrastructure for open communication among consultants, supervisors, and staff.

POLICY MAKERS AND FUNDERS

• Fund programs that offer or aim to develop a continuum of high-quality mental health services designed to promote the well-being and functioning of early childhood program staff. Such services include training, supervision, and regular long-term consultation and support.
  
  
• Assist state agencies (those serving children) that should collaborate to develop an Early Childhood Mental Health Plan for all professionals, providers, and parents involved in such programs as Early Head Start and Head Start, family preservation, TANF, early intervention, health and mental health, child care, and education. Professional provider groups and service delivery systems should address the training and support of staff for early childhood mental health.
  
  
• Help sponsor the development of approaches to early childhood mental health consultation that can be adapted for various program settings and populations. An integral part of the development of these models should be the evaluation of their effectiveness with children, families, and staff. Then disseminate information on these approaches.
  
  
• Offer financial incentives (or build requirements into current grants) to universities and other mental health programs to train students to provide consultation to early childhood programs and systems.

EDUCATIONAL INSTITUTIONS

• Review pre-service curricula to train early childhood and mental health providers and consultants who have the skills to work with each other, across agencies, and in partnership with families and communities.
  
  
• Structure training activities for early childhood and mental health professionals (for example, social workers, counselors, psychologists, and psychiatrists) to recognize the changing milieu in which services are provided. Although managed care settings may provide access to and continuity of services, incentives to reduce such services are encouraged and may compete with mental health professionals’ decision-making ability.
  
  
• Guide and support faculty members who place students and monitor their field-site (practicum) experiences. Encourage student placement as consultants in community-based agencies and systems working with young children and their families.
  
  
• Develop strategies for recruiting and retaining students from underrepresented groups in mental health disciplines to serve ethnic and linguistic communities and families more effectively.
  
  
• Allocate research dollars to demonstrate the efficacy of providing mental health consultation to staff in child care settings for the benefit of young children and their families.

CONSULTANTS

• Work with agencies and systems to develop an ongoing early childhood mental health component and to incorporate it into staff development plans. Relevant, accessible information can help providers understand the mental health context and ways to use consultants to help them do a better job.
  
  
• Create forums for community-based agencies; administrators; early childhood, early intervention, and child care providers; support staff; parents; and other service providers to define the specific issues that can be addressed through early mental health consultation.
  
  
• Disseminate findings of evaluation studies that demonstrate the efficacy of providing consultation and mental health services to young children and families.

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