Support Early Social, Emotional and Behavioral Health

Children progress through many stages of social, emotional and behavioral development; while all children need the loving support of caring adults to be developmentally healthy, sometimes children’s needs include specialized support from qualified professionals.  An estimated 13-20% of children and youth in the US experience a mental disorder (defined as a serious deviation from expected cognitive, social, and emotional development) in a given year.[1] Promoting children’s social, emotional and behavioral health requires working in the context of their family environment. Building strong families that have the skills they need to foster children’s social, emotional and behavioral well-being is critical to ensuring developmental health. Some of the strategies for supporting early social, emotional and behavioral health include:

•  Support the Integration of Mental Health Consultations in Early Care and Education. Providing mental health consultations in the familiar environment of the child’s school or child care provider helps to reach as many children as possible and ensure that when parents, caregivers and teachers have concerns about a child’s mental health they know where to go for information on the resources and options available to them. By embedding these services in early care and education programs, caregivers and school staff can partner with parents to ensure that each child’s mental health needs are being supported in child care and early education settings. To integrate mental health consultations into child care and preschool settings, Maryland introduced the Early Childhood Mental Health Consultation (ECMHC) program in over 300 child care and preschool settings. Consultants work with child care providers, teachers and parents both on issues specific to child behaviors and on improving classroom environments. An evaluation of the program found that over a period of four months, children showed a significant increase in characteristics related to resilience (initiative, self-control and attachment to caregivers) and a significant decrease in challenging behaviors.[2]
• Ensure the Integration of Behavioral Health Care in Primary Care Settings. Behavioral health is critical to a child’s social and emotional development. Integrating behavioral health care into a child’s ongoing care in primary care settings ensures that issues are being identified and addressed as early as possible. It also provides parents with regular opportunities to discuss concerns with their child’s health care professional and to get information about how to support children’s behavioral health. The Massachusetts Child Psychiatry Access Project (MCPAP) builds links between primary care providers and behavioral health care through the use of a hotline for pediatricians to get timely access to child psychiatry consultations and referrals when needed to a psychiatrist, social worker or care coordinator.[3] The percentage of primary care physicians who say they agree or strongly agree that their patients have adequate access to child psychiatry rose from 5.9% before MCPAP to 34% in 2009. The percentage of physicians who agreed or strongly agreed that they are usually able to meet the needs of children with psychiatric problems with the resources available was 8.4% before MCPAP, but was 63.1% after the program was introduced. The number of participating primary care practices has risen to cover about 95% of children in Massachusetts.[4]
• Support Opportunities for Family Strengthening and Family Skill Development. Children grow and thrive as part of a family. The family is a child’s first and most important support network as they grow and develop. Policies that empower and support parents as well as promoting family skill development help to strengthen families. Such policies build the protective and promotive factors that reduce risk and create optimal outcomes for children, youth and families. The Incredible Years parent education program has been implemented in a number of states to enhance parenting skills, knowledge of child development, positive child behavior, and build strong parent-child relationships. In North Carolina, a public-private collaborative between the North Carolina Department of Health and Human Services Division of Social Services and the Division of Public Health, the North Carolina Partnership for Children and private foundations has expanded the use of the program in North Carolina. The Division of Social Services funds ‘scaffolding’ to help local agencies implement the program. An independent evaluation of the program’s effectiveness in North Carolina found significant reductions in harsh and inconsistent discipline, and significant increase in appropriate discipline, positive parenting, and setting clear expectations.[5]