Overview of the Overview of the Second National Infant and Early National Infant and Early

Childhood Mental Health Childhood Mental Health Systems Summit Systems Summit

Overview of the Overview of the Second National Infant and Early National Infant and Early

Childhood Mental Health Childhood Mental Health Systems Summit Systems Summit

Therese Ahlers, MS, MPATherese Ahlers, MS, MPA

Wisconsin Alliance for Infant Mental HealthWisconsin Alliance for Infant Mental Health

BackgroundIn 2003 – 2004, states met via conference calls to discuss infant mental health system development and wanted to meet face to face

A.L. Mailman, Georgetown, and Value Health funded first Summit in 2005 in Washington DC

Sponsored by ZERO TO THREE, Georgetown University, and WI Alliance for Infant Mental Health

Purpose of the Summit• Develop collegial relationships leading to

consultation and support across the country

• Provide opportunities for state teams to reflect on their successes and challenges and to strategize on advancing infant mental health within own state

• Share system development information to integrate policy, professional development, service delivery, collaboration, and financing

Content of First Summit

• Eleven states with mixed discipline teams from both the public and private sector and one parent representative

• Ten knotty questions presented with two different answers regarding financing, policy, training, service delivery, and system collaboration

• State sharing strategies to overcome barriers

Progress Made From the 2005 Summit

• DC: 0-3R to determine eligibility and reimbursement in New Jersey, Illinois and Wisconsin

• Work on mental health consultation in child care settings in both Florida and Wisconsin

• Efforts on infant mental health competencies in Arizona, California, Minnesota, and Texas

Second National Summit

• With success of first Summit, consensus was to have another

• AL Mailman and Harris Foundations Funded

• Held in October 2007 in Milwaukee

• Sixteen state with teams

• ZERO TO THREE, Georgetown, and Build Initiative

Content of Second Summit

Large Group Discussions• State of the States: Infant Mental Health

System Development self-assessment • Illinois and Wyoming provided examples on

integrating Policy, Professional Development, Service Delivery, Advocacy, and Financing

• Financing Infant Mental Health Service Delivery

Integrating Policy, Professional Development, Service Delivery, Advocacy, and FinancingIllinois: • Mental health consultation in a variety of systems• Education dollars supporting professional development• Strengthening Families:  child care, child welfare and a trauma curriculumWyoming• Professional development through developmental preschool system• Legislation to scale up professional development

• Medicaid reimbursement of early social and emotional services

Small Group Workshops

• Professional Competencies: Michigan• Competencies: Similarities and Differences

across Five States• DC:0-3R: Professional Development,

Reimbursement and Crosswalk • Infant Mental Health Integrated with Early

Care and Education• Infant Mental Health and Child Welfare

• Screening and Early Identification

Examples of State’s Progress

Infant Mental Health Competencies Michigan Competencies

• Seven states have adopted

• Can be used to train workforce

Five State Competency Comparison

• Herr Research Center for Children and Social Policy at Erikson Institute

Eboni Howard and Aimee V. Hilado,

Ways to Use the DC: 0-3R

Diagnostic tool for children under the age of four – similar to the DSM

•Washington: Sherry Hill Billing Medicaid for dyadic therapy

•Colorado: Claudia Zundel Using DC:0-3R as professional development tool

•Illinois: Karen Freel Developing a crosswalk with DSM and ICD9/10

for reimbursement

Early Care and EducationPennsylvania: Kelli Thompson • Infant toddler standards and infant mental health

consultation within early learning programsOhio: Ben Kearney • Statewide evaluation of early childhood mental

health consultation models New Jersey: Gerry Costa• Infusion of an infant mental health component

into infant/toddler credential and other statewide early childhood initiatives.

Child Welfare

Texas: Connie Almeida• Court team project in Fort Bend: a partnership between

judicial leadership and a child development/mental health specialist to improve outcomes for maltreated infants and toddlers.

Massachusetts: Kate Roper • The evolving relationship between child welfare and early

intervention in Massachusetts to support infant/toddler social-emotional well-being.

New York: Susan Chinitz• Judicial training and consultation, therapeutic visiting, and

enhanced pediatric care for children in foster care in New York.

Screening and Early Identification

National Academy for State Health Policy: Neva Kaye

• Increase the rate of screening through use of an objective screening tool in selected physician practices

• Strengthen primary health care services and systems supporting the healthy mental development of young children, ages birth to three.

Screening and Early Identification

Minnesota: Candy Kragthorpe, • Early childhood mental health screening activities

in Minnesota

Illinois: Stephanie Hanko, • Perinatal depression initiative in Illinois

New York: David Woodlock, • Public health approach to early identification in

early childhood programs, schools, and child welfare prevention programs

Common Challenges

Funding

• Limited braiding and blending ability

• Limited funds for professional development

System Collaboration

• Competing priorities

• Coordination among agencies

Common ChallengesLimited Services• Lack multi-discipline/system approach• Fragmented with lack of service delivery

structureWorkforce • Few trained mental health clinicians• Cultural competency issues • Lack of national standards or

competencies

It’s All About Relationships

Parallel Process• Infant and Parent• Parent and Provider• Provider and Employer• Discipline to Discipline• System to System

JUST START ANYWHERE

ReferencesNational Academy for State Health Policy http://www.nashp.org

Talarishttp://www.talaris.org

Center on the Social and Emotional Foundations of Early Learning

http://www.vanderbilt.edu/csefel