Beyond The Pod: Addressing Early Relational Health in Early Childhood Education

Meet Lisa Garcia, our new Director of Early Relational Health

The second episode of Season 4 of our hit podcast “No One is Coming to Save Us” focuses on early relational health and underscores the importance of relationships that children form with their caregivers during the critical early years of their lives. These relationships lay the foundation for their social, emotional, and cognitive development and contribute to their overall lifelong well-being.

Across the country, an estimated 10-16% of young children experience behavioral and mental health conditions, rising to 22% for children impacted by poverty. However, early educators rarely receive enough training on how to foster children’s social emotional growth and needed services are often inaccessible to families with extensive waitlists. This leads to high levels of burnout for teachers and poorer outcomes for children, with children of Color disproportionately impacted. The pandemic certainly exacerbated these challenges, making it increasingly difficult for families to access critical services that they need to support their child’s mental health and development. 

At Neighborhood Villages, we understand that embedding early relational health supports in early childhood education programs, where children are deeply known and families have trusted relationships with caregivers, leads to improved outcomes for children, particularly children impacted by poverty. Importantly, this also reduces stress for early educators. 

That’s why, over the past year, we worked with early childhood mental health experts from across the Commonwealth to articulate a comprehensive menu of resources to meet the needs of children in ECE programs, mirroring the multi-tiered system of supports (MTSS) used by K-12 school systems. Our MTSS for early childhood education includes infant and early childhood mental health consultation services, needs-based educator coaching, and funded staffing supports to increase access to needed services for children and their families. You can read more about it in our recent blog.

Now, in partnership with a network of five Boston-based early education providers, The Neighborhood, we’re setting off to pilot how these services can and should be delivered. Leading this work is our new Director of Early Relational Health, Lisa Garcia, who brings a wealth of experience to Neighborhood Villages as a licensed mental health counselor with a depth of expertise and experience in infant and early childhood mental health. 

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We sat down with Lisa to discuss what drives her to do this work, as well as her plans to support early education and care providers to cultivate strong, healthy relationships between children and their caregivers.

Lisa Garcia, LMHC, IMH-E, Director of Early Relational Health

Can you tell us about yourself?

I was born in Cambridge, Massachusetts, but spent a significant part of my childhood traveling between the Dominican Republic and Massachusetts until I was in sixth grade. I went to college in Boston and later earned my master’s degree from William James College. Now, I live just outside of Boston with my husband and toddler.

Becoming a parent has given me a new perspective on the work I do, not just in mental health but also in understanding the broader system. When my son was born, my husband and I quickly realized how difficult it was to manage work and child care simultaneously. We were lucky to find child care, but the experience highlighted the challenges that many families face, especially those without the same privileges we have. This realization has deepened my commitment to my role, which I see as an opportunity to support families and help address systemic issues in child care and early education.

What brings you to this work?

I am a licensed mental health counselor in Massachusetts with 15 years of experience in the field. My journey into community mental health was somewhat accidental. About fifteen years ago, Massachusetts was rolling out CBHI Services, and in 2011, I was starting my career. Like many of us in the field at that time, I expected to work as a therapist in an office setting but I was introduced to in-home therapy, which was a new concept to me then. That experience launched my career in community mental health, and I’ve remained committed to it ever since.

Even though I’ve had opportunities to shift into private practice, I’ve stayed in community mental health because I believe in the importance of the work. Supporting families and children in this space is crucial for helping them build better lives and futures. Mental wellness is foundational to our overall well-being. I truly believe that healthier people, means healthier families and ultimately, healthier communities.

What is your role at Neighborhood Villages?

My role is to support early childhood care settings by focusing on the development of a system to be able to support the relationships that live around a child. Mental health, especially for young children, is often seen as the responsibility of the parents or caregivers, but that’s far from the truth. A child’s mental wellness is influenced by all the systems and relationships they encounter, including educators.

Educators play a significant role in a child’s life, especially during the crucial ages of zero to five. By integrating an early relational health approach into child care settings, we can improve outcomes for young children and their families, ultimately benefiting society and communities as a whole.

How would you characterize the current state of early relational health in early education and care?

The systems are often siloed—early childhood education focuses on learning and developmental milestones, while mental health is viewed as a separate issue, typically something that falls on the family or requires outside referrals. This separation doesn’t work, and we have enough data to prove it.

The current state of early relational health in early education is, at best, fragmented. We might have a social worker or therapist involved, but the work is often isolated. Our goal is to break down these silos and approach early education through a relational health lens, integrating mental wellness into all aspects of a child’s care and education.

What is Neighborhood Villages doing to tackle this early relational health crisis?

Neighborhood Villages is deeply engaged on the ground, working closely with programs to identify their needs and provide the necessary support. For example, we’re involved in curriculum development and supporting educators in managing classrooms in ways that address mental health and behavioral health concerns.

My role is to help formalize these supports and think about the broader structural issues. We’re already doing a lot of hands-on work, but now we need to look at how we can create a more cohesive system that supports the mental health of children and their families across the board.

What are some of your top priorities in your role to continue this work?

One of my top priorities is creating a cohesive language across all systems involved in early childhood care. We need to move away from viewing behavioral issues in isolation and start thinking about the quality of relationships and the environments in which children grow. My focus is on shifting from an individualized lens to a relational lens, where we consider how systems, both small and large, can create ecosystems where children can thrive.

Why do you do this work?

It may sound idealistic, but my motivation comes from a deep commitment to helping children and families, especially those from marginalized communities. When you’re working with one family, the goal is to improve their quality of life, but I’m increasingly focused on the systems that impact that family. If a system isn’t working for a child, it won’t work for that child as an adult, and it won’t work for the family they might have in the future.

The families most affected by these systemic failures are often Black and Brown families or those with lower economic status. I believe that when we serve these families, we serve all families, and that’s why I’m committed to this work.

How do you go about addressing disparities for families in this field?

We start by understanding the specific challenges these families face. For instance, economically disadvantaged families often lack access to quality child care, which sets their children at a disadvantage from the start. Low wages for educators lead to high turnover, which negatively impacts the quality of relationships between teachers and children.

Addressing these disparities requires looking at the structural deficits in the system and thinking about how we can support Black and Brown families in particular. We know that racism, prejudice, and stigma have a significant impact on a child’s development, and by focusing on relationships, we can begin to mitigate some of these harmful effects.

Do you have any long-term goals in this new role?

My long-term goal is to change the way we view children and families. If we see our work with young children as preventive, securing our future by addressing issues early on, we can create a healthier society. Often, children are seen as blank slates or a forgotten population, but they are the foundation of our future.

We need to focus on preventive work, not just reactive responses to crises like mental health or substance abuse. Research shows that reducing stress in young children and families can prevent chronic illnesses like heart disease and diabetes later in life. It’s all connected, and we need to work on these issues in parallel to create lasting change.

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As we further develop and pilot a menu of early relational health supports, we remain focused on our mission to improve early education and care for all children–and are excited to continue this work with Lisa Garcia leading the charge for Neighborhood Villages.