Mental Health

Tips for Offering Effective Mental Health Consultation in Ever-changing Contexts

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The COVID-19 pandemic has caused many Head Start children, families, and staff to experience prolonged or chronic stress, trauma, and significant loss. Many other conditions also present challenges to their mental health, including longstanding issues of racism and economic injustice, devastating weather events, and dramatic national or local events.

Infant and Early Childhood Mental Health Consultation (IECMHC) helps ensure that children, families, and staff receive needed mental health supports. The mental health consultant helps strategize and guide the specific services that each Head Start and Early Head Start program offers, tailored to its own situation and community.

Head Start and Early Head Start programs are required to provide a continuum of mental health services under the Head Start Program Performance Standards (45 CFR §1302.45). These services include mental health promotion and prevention, early identification of mental health concerns, and referrals for treatment of children and families. With assistance from their mental health consultant, programs decide how to implement their continuum of services in ways that respond to the unique needs of the families they serve.

Decades of research show that IECMHC is effective. Mental health consultants help develop a culture that promotes mental health by building the adults' capacity to strengthen and support the healthy social and emotional development of children ― early and before intervention is needed. Head Start programs can build strong IECMHC services by following the tips below.

Tip 1: Provide Services Across Levels of the Head Start Program

Mental health consultants can make positive contributions across multiple aspects of the Head Start program, from program planning to service delivery. Some of the many responsibilities that can be guided by mental health consultants include:

  • Helping develop the program's wellness policies and procedures
  • Contributing to planning for workforce development
  • Participating in quality improvement efforts
  • Partnering with the program leaders, staff, and families to ensure the program supports and promotes children's mental health

The table below provides more description of the multidimensional work of the mental health consultant.

Range of Services Offered by the Mental Health Consultant

Focus of Services

Role

Child and family

  • Collaborates with families and staff to understand and respond effectively to an infant's or young child's mental health needs, behavioral difficulties, and developmental challenges.
  • Partners respectfully with families and staff to understand the context and nature of a particular family's life to enhance the child's and family's well-being.

Classroom and home

  • Collaborates with families and staff to promote equitable, warm, and trusting relationships, consistent routines, and interactions in classrooms and homes. 

Program

  • Focuses on issues that affect quality and equity in program service provision.
  • Assists administrators and staff in creating an optimum social and emotional climate.
  • Supports the development and implementation of policies that create equitable, inclusive, and culturally and linguistically appropriate experiences for all children, families, and staff.

System

  • Works within and across systems that serve infants, young children, and families (e.g., systems that offer educational, nutritional, housing, employment, and other services).
  • Helps integrate across systems equity and mental health concepts and supports.
  • Works to strengthen bridges between systems to facilitate positive change and to improve access to comprehensive and integrated care.

Adapted from the Center of Excellence for Infant and Early Childhood Mental Health Consultation Competencies.

Tip 2: Demonstrate Cultural Responsiveness

No two Head Start programs are identical in design or the children, families, and staff served. Therefore, effective mental health consultants must be familiar with the unique cultures, environments, and experiences related to equity and discrimination, within the programs and communities they are serving.

Mental health consultants must know and understand the historical, political, and sociocultural contexts that shape perceptions, experiences, and help-seeking behaviors in the communities they serve. It is also important that they be aware of issues of race and racism, power and privilege, and cultural variations. Having this knowledge will help the consultants understand cultural differences and be culturally responsive.

Mental health consultants may encounter people who do not want to receive formal mental health services when recommended. People may vary in their comfort levels with a mental health consultant or other mental health provider. In some cases, people may prefer informal and community supports from those who are not formal mental health providers, such as family, friends, religious advisers, or natural healers. The Diversity-Informed Tenets for Work with Infants, Children and Families suggest it is necessary to "recognize and respect nondominant bodies of knowledge, sources of strengths, and routes of healing within diverse families." There are indeed many ways to promote child, family, and staff mental health and well-being.

Tip 3: Use Technology as a Substitute or Supplement to In-person Services

A family member is quarantined at home because of COVID-19 exposure. A staff member is balancing work responsibilities while at home caring for a sick child. A Head Start family is grieving the loss of a loved one. These are three examples where technology tools and strategies can engage families and staff in mental health services who otherwise might not be reached. Some technology-based tools and strategies mental health consultants may help programs implement include:

  • Virtual check-ins to connect with parents and staff
  • Virtual parent cafés for peer-to-peer support
  • Online resource sharing on such topics as mindfulness or stress reduction
  • Virtual live or recorded trainings for staff
  • Virtual staff wellness activities

Many of these ideas work well while everyone is remote, but they can also be continued as a supplement to in-person services.

When selecting a virtual strategy, programs should consider whether the intended audience (families or staff members) have access to the technology tools. Do they have a computer or smart phone? Do know how to use them, such as how to join a video call or open a PDF?

Tip 4: Keep Current on the Range of Mental Health Resources

Mental health consultants help families by sharing information, prevention, and intervention strategies and by making referrals for mental health and other supportive services. Mental health consultants can also support the needs of children they serve by providing information to the adults who care for them on topics such as typical development, social and emotional skills, and problem-solving. The consultants should be prepared to help families access and navigate a variety of local, available mental health supports, both formal and informal. These might include mental health services, parenting and support groups, spiritually oriented services, yoga or other exercise classes, and meditation spaces.

Tip 5: Provide Ongoing Professional Development to All Staff

Mental health consultants can assess the training needs of programs and identify specific topics of interest among staff. This is one way to be responsive to the needs, preferences, and barriers identified by programs and communities. In addition to tailoring the content, mental health consultants might help develop or facilitate communities of learning, which offer opportunities for self-reflection and peer-to-peer support in programs.

For mental health consultants to remain effective in providing services to programs, it is important to support their professional development and needs, too. This can include ongoing learning to understand children, families, and staff, and self-exploration to understand how one's own backgrounds, beliefs, and values impact the work. Reflective practices and supervision can be a structure and space of support to enhance self-awareness, perspective taking, self-care, and professional competency.

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