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With so much going on in the world today, from the recent shootings, to economic hardships, and moving through waves of the pandemic, everyone’s mental health has been challenged. Some families have been affected more than others, building on years of stress and trauma.
Infants and young children are no exception. Experiences with stress can begin before babies are born, in their mother’s womb and early years of life as they develop neural connections, build attachments with caregivers, and establish ways of engaging with the world that will lay the foundation for their healthy development and future success.
Equitable access to high-quality mental health services for children birth-to-age-eight, built on a strong mental health workforce, is critical for families and the future of our state. Mental Health Awareness Month offers an opportunity to bring attention to the importance of infant and early childhood mental health (IECMH), in addition to the mental health of youth and adults who care for young children. Each contribute to children’s early relational health and social-emotional development—key ingredients to health and happiness later in life.
Mental health is also a key ingredient for early literacy. The Pathways to Grade-Level Reading Initiative (Pathways) identified social-emotional health as a priority area for North Carolina to focus on to ensure every child is reading on grade-level by the end of third grade. Engaging with characters in a book, interacting with teachers and peers in a classroom, and snuggling up with a parent for a bedtime story are all easier when children are socially and emotionally secure.
To help support babies’ and young children’s mental health, and ensure all kids are on the path to grade-level reading, Pathways sets an expectation that North Carolina’s social-emotional health system is accessible and high-quality. It also prioritizes strategies and actions to help get us there.
Similar to North Carolina’s current focus on strengthening its early educator and teacher workforce, one strategy to realizing this expectation is building a well-trained and adequate workforce of IECMH clinicians, with a focus on increasing the number of providers of color. Four actions to help do this are highlighted below.
Recruit and Retain Infant and Toddler Mental Health Clinicians
Evidence-based treatments provided by qualified IECMH professionals are effective at improving young children’s mental health, especially for those who have experienced trauma. Like many states, North Carolina lacks enough mental health clinicians who are qualified and certified to work with infants and toddlers.1, 2 Recruitment is especially difficult in rural areas. These shortages lead to gaps in available mental health services for families that need support. Reducing turnover of clinicians is also important to providing high quality care and stability for agencies implementing services.
In addition to offering strong training and support programs, part of recruiting and retaining clinicians includes advocating for and providing adequate payment for infant and toddler mental health services so that providers and agencies are adequately compensated for their work. Health insurance coverage for these services is often limited. Without sufficient resources, it’s hard to recruit and maintain talent to serve this age group.
Build a Pipeline of Health Providers of Color
Providers of color are underrepresented in many health professions, including IECMH. Families may prefer a provider who has a similar background or who understands their culture.1 Building a diverse workforce that reflects all families served and supports IECMH providers of color in their training and practice can help to improve access and quality of services.2, 3 One way to help support this includes additional investment in programs through public universities, community colleges, and Historically Black Colleges and Universities that build and maintain medical and health care profession pipeline programs for students of color.
Expand the NC Child Treatment Program
As stated earlier, North Carolina needs more clinicians who are trained to provide evidence-based mental health treatment to young children and families. The NC Child Treatment Program, based at the Center for Child and Family Health in Durham, NC, specializes in this type of training, including the delivery of evidence-based treatment models addressing childhood trauma, behavior, and attachment for children ages birth to eight. They provide services across the state, with an emphasis on racial and geographic equity. Providing resources to expand the NC Child Treatment Program’s reach, and others programs doing similar work, can help improve access to needed mental health services for families with young children.
Create a Mental Health Professional Development System
Professional development for mental health clinicians in NC is largely piecemeal, with no overarching system. Creating a broad, connected, trauma-informed mental health professional development system with individualized plans can help improve recruitment and retention of providers and quality of care. Across sectors, effective professional development systems are interconnected and research-informed, including areas such as active learning, coaching, reflective supervision, and training on models of effective practice.1, 2,
Promoting professional IECMH competencies and credentials that support and recognize the development and proficiency of professionals who work with pregnant women, young children, and their families is one strategy to build this system. Infant Mental Health Endorsement®, led by the NC Infant and Early Childhood Mental Health Association, is a new and promising effort in this area.
Initiatives Leading the Work
The Pathways Action Map aims to highlight state and local initiatives that are leading efforts in these and other actions to help improve North Carolina’s social-emotional health system for young children. Learn more about the following initiatives on the Action Map, and stay tuned for future spotlights on their work to build a strong mental health workforce for North Carolina’s youngest children.