How we’re tackling the children’s mental health crisis

We’re facing a children’s mental health crisis and our child care system cannot be left out of the solution. Fortunately, here at Neighborhood Villages, we’ve created a pilot to address these issues.

There is no doubt that we are in the midst of a children's mental health crisis.

Yet, as policymakers discuss ways to address it, it is often in the context of our teens, or even elementary-aged children. This approach ignores what may be the most important time to identify mental health issues and offer nurturing environments to alleviate them — in early childhood when children are under five years old.

These first years of a child’s life are a time of rapid and critical development. Studies show that young children are capable of experiencing the emotional highs of happiness and elation, as well as the challenges of anxiety, grief, and anger. When toxic stress in our youngest children is not met with supportive environments, it can impact the very architecture of a child’s brain. And if they experience trauma, abuse, or neglect, the impact can be debilitating — and lifelong.

The pandemic has left unprecedented mental health needs in its wake. And while the K-12 system has mental health supports built into its very funding model, in 0-5, programs are often left on their own to navigate an insufficient and complicated system. Many needed supports are not even available to families and children under 5 and those that do exist are not available in the kind of abundance to meet the need.

That’s why one of the solutions to our children’s mental health crisis starts with our early childhood education (ECE) system.

Unfortunately, the ECE sector is in the midst of an acute behavioral health crisis that has not been resourced to address. It’s straining already understaffed child care programs, where teachers want to meet all the needs of their children and families but often don’t have enough people, training, or resources to do so.

As the number of young children experiencing distress and requiring a high level of support increases, teachers struggle to balance student need and classroom quality. Often, ECE providers receive limited training on how to foster children’s social emotional growth through relationship based practices. This leads to high levels of burnout and turnover for teachers, against the backdrop of the existing ECE workforce crisis. 

Not surprisingly, unmet behavioral health needs for young children coupled with limited teacher capacity contributes to poorer outcomes for children and children of color are disproportionately impacted. 

Providing and scaffolding supports for young children, parents, and caregivers with social and emotional supports during this critical time can help prevent more costly interventions later in life. In fact, investments in infant and early childhood mental health yield returns of $3.64 for each dollar contributed.

And while studies have demonstrated that access to behavioral health supports in ECE settings leads to improved outcomes for children, little investment has been made to provide access to behavioral health supports. 

It’s clear that we need a more holistic approach to meet the behavioral health needs of young children. Fortunately, stakeholders in Massachusetts have identified investments in centralized, coordinated behavioral health supports for the ECE sector as a priority need. The Children’s Mental Health Campaign’s Infant and Early Childhood Mental Health advocacy Working Group, CHIMEBoston, and other coalitions and programs across the state are already finding solutions. The coalitions and workgroups link the community based work with the state agency work to find equitable solutions to support families and their youngest with social emotional need.

In partnership with these organizations, Neighborhood Villages is piloting a multi-layered, comprehensive behavioral health model for ECE settings that can be scaled across the state. 

Neighborhood Villages has created a menu of behavioral health supports that represents the full scope of services needed to meet the unprecedented behavioral health needs in the 0-5 landscape. This multi-tiered system of support, similar to the ones used by K-12 school systems across the country, allows for universal preventative support while ensuring that students and families experiencing more acute challenges receive support in the least restrictive environment appropriate for their needs. The model includes a curriculum for parents, early childhood mental health consultation services in classrooms, and other in-classroom student support services.

Multi-Tiered System of Support for Early Childhood

Right now, Neighborhood Villages is piloting parts of this programming across several Boston child care centers. And the results are already promising. Educators involved in the pilot program have reported that access to a mental health consultant has had a positive impact on staff, families, and children. For example, they report being able to better support and engage families in mental health services, better understand family and child trauma, and be more reflective in their daily practices. 

And while we continue to iterate this program to make these supports work even more seamlessly in child care settings, it stands to be a fundamentally new approach to addressing the behavioral health crisis in Massachusetts and a model nationally. It’s a step in the right direction at a time when we can no longer sit idly by as our youngest and most vulnerable children and their families suffer under the weight of untreated behavioral health needs.