Overview of the National Infant and Early Childhood Mental Health Systems Summit Overview of the Second National Infant and Early Childhood Mental Health Systems Summit Therese Ahlers, MS, MPA Wisconsin Alliance for Infant Mental Health

Background In 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 Financing Illinois: Mental health consultation in a variety of systems Education dollars supporting professional development Strengthening Families: child care, child welfare and a trauma curriculum Wyoming 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 Education Pennsylvania: Kelli Thompson Infant toddler standards and infant mental health consultation within early learning programs Ohio: 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 Challenges Limited Services Lack multi-discipline/system approach Fragmented with lack of service delivery structure Workforce 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

References National Academy for State Health Policy Talaris Center on the Social and Emotional Foundations of Early Learning