Ohio’s Early Childhood Ohio’s Early Childhood Mental Health InitiativeMental Health Initiative

March 14, 2008March 14, 2008

Ohio’s Early Childhood Ohio’s Early Childhood Mental Health InitiativeMental Health Initiative

March 14, 2008March 14, 2008

Babies on Couches

Early Childhood Mental Health

• Promoting the emotional and social development and well-being of young children and their families.

Image of a newspaper cartoon “He’s 2 ½ day sold and he’s already had nine time-outs!”

ODMH EARLY CHILDHOOD MENTAL HEALTH INITIATIVE

• Advisory Council includes:– ODJFS – child welfare and child care– ODE– ODH – Help Me Grow– MR/DD– ODADAS– ODDC– OFCF– OAIMH– OCCRRA– Head Start– Children’s Hospital Association– Local and state children’s advocacy organizations– Local ADAMHS Boards– Local mental health providers– Families – ODMH staff

Early Childhood Mental Health (ECMH) State Plan for Ohio

• Goal (Service Continuum)

• Goal (Training)

• Goal (Funding/Financing)

• Goal (Public Awareness & Advocacy)

• Goal (Evaluation/Research)

Logo of the ABC Access to Better Care Initiative

ABC Values and Principles• The ABC workgroup established core principles and

committed to:• Expand development of and access to priority areas (prevention, early intervention, treatment).• Emphasize community-based, family-centered solutions.• Strengthen and support parent involvement.• Support outcome-based, effective services and evidenced based programs where possible.• Increase collaboration and accountability between child serving agencies• Align and redirect resources in addition to increasing capacity

Major Access to Better Care Recommendations:

• Focus Prevention Efforts• Continue support for early childhood mental health professionals and target resources to school districts on academic watch.• Offer the Partnerships for Success strategic planning model to additional counties.• Target resources to prevent and address Fetal Alcohol Spectrum Disorder.

Major Access to Better Care Recommendations:

• Intervene Earlier with Children and Their Families• Expand proven effective parent and caregiver training and education.• Increase awareness regarding maternal depression.• Conduct behavioral health assessments in early childhood settings• Conduct behavioral health assessments in schools through the Columbia Teen Screen Program for suicide prevention.• Expand effective school and community partnerships for youth at risk.

Major Access to Better Care Recommendations:

• Reduce treatment gaps and empower parents so children with behavioral disorders do not fall through the cracks, and families do not have to trade custody for care.

Early Childhood Mental Health Program Strengths

• ECMH programming and services are characterized by flexibility.

• ECMH specialists are knowledgeable and skilled.

• Strength-based approaches are used.• Evidence-based programs are employed. • Strong community relationships exist.

Early Childhood Mental Health Consultation

• Increase knowledge, awareness, resources and skills necessary for communities to meet the behavioral health needs of young children and their families, especially those at risk for abuse, neglect and mental health issues.

• building protective factors in young children and increasing competencies and skills of parents

and early childhood providers

CRITERIA FOR CONSULTANTS• It is recommended that mental health consultants be licensed mental

health professionals with certain skills and areas of expertise including but not limited to:– child development– cultural competence– dynamics of early childhood care settings– sensitivity to the community’s attitudes and strengths– recognition of indicators of child abuse and neglect– family-centered, strength-based practice– understanding of Ohio’s public mental health system

10 most frequent issues for consultation1) aggression and anger issues 2) typical development of children, behavioral and emotional

development and developmental delays in young children3) noncompliance to the directives of teachers and parents as

well as working with oppositional children4) inattentiveness and ADHD symptoms and identification5) adjustment to traumatic life events (death, divorce, removal

from home for abuse/neglect)6) self-regulation, tantrums, impulse control and out of control

behaviors7) behavior problems in early childhood settings such as biting,

acting out at transition times, and verbal and physical aggression

8) peer social skill problems and social skills training9) engaging parents and family communication patterns10)mood, anxiety, depression, and withdrawal

ECMH Funding SourcesSFY 2007

• GRF– $1.4 ECMH Initiative ($1 million ECMH Consultation)– $261,306 Treatment

• CBCAP– $1.5 ECMH Consultation

• IVB Part 2– $167,359 Incredible Years

• TSIG– $300,000

• Local Funds– $1.4 approximately each year

Early Childhood Mental Health Consultation SFY 2007

• 16,021 children in group settings received consultation services

• 6,951 families of young children received consultation services

• 6,186 infants, toddlers, and preschoolers received individual services

• 3,469 early childhood providers received specialized early childhood consultation and training supports

• 1,029 early childhood programs sites and child-serving agencies received consultation on individual children and/or their social and emotional learning environments for young children

»166 ECMH Consultants

ECMH Consultation Programs/ Sites

• 433 Childcare Centers• 206 Head Start and Early Head Start Sites• 41 Help Me Grow Program Sites • 156 Public and Private Preschools• 15 Family Childcare Homes• 63 Public Children’s Services Agencies• 115 Other

»Total of 1,029 programs/sites reported as receiving services

ECMH Consultation Education and Training

• Education and Training for Parents and Early Childhood Staff totaled:– 1,653 sessions held – 3,597 parent participants– 5,641 early childhood staff participated

• Cross-Systems Training for Other Child-serving Professionals included:

–375 trainings held –3066 professional participants

ECMH Consultation Education and Training

Topical sessions focused on:

• 418 - behavior management of young children• 371 - observation and assessment of young children• 304 - early childhood growth and development• 159 - social and emotional processes of young children• 77 - family & community relations• 60 - professional development• 44 - learning environment and experiences of young

children• 32 - health, safety and nutrition needs of young children• 77 - a wide spectrum of other topical areas

Satisfaction with ECMH Consultation Services

• 99.4% overall rate of parent satisfaction with the consultation services. offered support and encouragement

easy to contact and schedule

• 97% overall rate of early childhood providers satisfaction with the consultation services provided. had strong understanding of child development,

behavior and mental health issues

easy to contact and schedule

SFY 2007 Outcomes

• Child-specific consultations were provided for 1163 children at risk of removal from an early childhood setting.

• 1044 children that received consultation services, approximately 90%, were maintained in their setting.

• For those children that were not able to be maintained in a setting, the most common reasons given included: – children were removed by parents who then chose

to care for the child at home or in relative care.– qualified for other programs specifically designed to

meet special needs, or – enrolled in a different, and many times, a more

appropriate setting to meet the children’s needs.

SFY 2007 OutcomesDECA Post-Test: Behavioral Concerns

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

Concern Typical

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tage

of T

otal

Concern

Typical

DECA Pre-Test: Behavioral Concerns

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

Concern Typical

Score Ranges

Perc

enta

ge o

f Tot

als

Concern

Typical

• Forty-five boards reported using the DECA program as an integral part of their consultation services for FY 2007 and completing 8,506 individual assessments

Parent/caregiver Training and Education

• Goal: Expand proven effective parent and caregiver training and education that research has shown to prevent abuse and neglect and severe behavioral, emotional and developmental problems in children through training and education designed to enhance the knowledge, skills and confidence of parents and other caregivers.

The Incredible Years • 32 Boards reported using IY programs as part of ECMH services• Parent Group

– 161 groups – 1062 parents

• Dinosaur Child Small Group– 30 groups– 191 children

• Classroom Dinosaur Group– 168 classrooms– 3030 children

• Teacher Classroom Management – 17 groups– 239 teachers

• Increase of 21.6% in positive parent practices• Decrease of 23.6% in negative parenting behaviors• Satisfaction measure data – 93.4%

Maternal Depression

• Goal: Increase awareness regarding the effects of maternal depression through general training for early childhood service providers and piloting identification and linkages to services for at-risk families.

Maternal Depression

• screening for maternal depression for mothers of infants 4-12 weeks of age

• a collaborative effort of 7 local mental health boards and Help Me Grow programs.

• 28 boards reported that as part of ECMH services, mothers, and in a few areas fathers as well, are being routinely screened for signs of maternal and other depressive symptoms.

• 569 mothers screened as part of pilot program

• 54 referred for further services

http://www.ohiocando4kids.org

Ohio TSIG

• Goal: Promote Early ScreeningCollaborate with other systems (e.g., physical health, schools, prisons, senior centers, etc.) to provide prevention and early mental health screening assessmentacross the lifespan.

• Strategy – Promote, enhance and support the positive social and emotional development of Ohio’s young children through building professional development, infrastructure, and family and community engagement.

Ohio TSIG1. Expand the use of the “Incredible Years” program 2. Develop competencies for Early Childhood Mental Health

Professionals 3. Provide cross-system training on the use of the screening

tool Ages and Stages Questionnaire: Social Emotional (ASQ:SE).

4. Provide early childhood professional development and training on the use of the Devereux Early Childhood Assessment Program (DECA).

5. Provide Maternal Depression training and materials to Help Me Grow and mental health professionals

6. Increase education and public awareness to all parents and caregivers on children’s social and emotional development

7. Establish uniform data collection and reporting for ECMH consultation services

ODMH Early Childhood Mental Health Initiative

• For more information contact:

Marla HimmegerMental Health AdministratorOhio Department of Mental Health30 East Broad Street, 8th FloorColumbus, Ohio 43215-3430(614) 466-1984(614) 466-1571 faxHimmegerm@mh.state.oh.us