Early childhood mental health services potentially expanding in Alabama
Mental health is often associated with mental illness, which in turn leads to a misunderstanding of why access to mental health services for Alabama’s youngest children and their families is important, said Dallas Rabig, the state’s coordinator for infant and early childhood mental health.
But, she believes investing in children’s mental health at an early age can decrease the need later in life.
“If we reframe the term mental health from mental illness to mental wellness and we begin supporting and promoting that mental wellness early in the life of the child, meaning the child and the family,” Rabig said. “If we address it in the first three to five years of that child’s life, we could quite possibly positively affect that preschool to prison pipeline or that birth to prison pipeline. … We can impact trajectory of a child becoming mentally sick by addressing this early.”
The work to promote a “paradigm shift in how we view mental health,” in Alabama has already begun, with the birth of Alabama’s Project LAUNCH, an infant and early childhood mental health consultation program in Tuscaloosa, started in 2014.
Rabig had spent the three years prior in Colorado, learning the ins and outs of their consultation program, and witnessing its impact. Tuscaloosa’s pilot program was an opportunity for her to share that knowledge and ensure its success in her home state.
Since then, she and mental health professionals throughout Alabama have been preparing to take the program statewide. Today, Rabig thinks that dream is nearing reality, despite two big barriers: a large enough workforce and funding.
“Teachers don’t know what to do. … Teachers need the tools to promote that optimal child development and consultants have been really helpful in providing training and tools,” Kendrick said.
Entering its fifth year, the Tuscaloosa program was formed through a partnership with the Dept. of Mental Health, Dept. of Public Health, Child Development Resources of the University of Alabama and the Alabama Partnership for Children. It operates with two consultants that have worked in pre-K classrooms, with early interventionists and home visitors. Recently, they started working to introduce the consultation into pediatric offices.
Consultants do not serve as supervisors, but rather as support, “to come alongside the person,” Kendrick said. “If a teacher is experiencing a child who may be having some difficulty or behavior challenges, we help the teacher with creating developmental assessments and coming up with plans of what that teacher might do differently — from changing the environment of the classroom, setting up the structure of the room differently, changing up the timing of day. The consultant is able to be that outside observer to assess and work with the teacher.”
The consultants work to help childcare providers get to the root of a child’s behavior issues, as well as offer support and guidance when talking with families, so the teacher and parents can have a joint approach to helping the child. Additionally, consultants are able to recognize when a child might need access to support outside the classroom and connect families to it.
Anecdotally, Kendrick said, “people have been very strongly in favor of the process and the demand has increased.”
In terms of the shortage in the needed workforce to expand the program, Rabig said the state has mental health providers that provide services for ages 3-5, but they are struggling to find adequate access to mental health providers for birth through 3.
Parents, she said, often have the thought, “’Why do I need mental health services for my infant? My infant isn’t mentally ill’.”
But, “infant mental health is the ability of a child to grow and thrive within the context of their cultural relations; a child’s ability to develop attachment relationships with their primary caregiver and other family members as well,” she said.
Pointing to intergenerational poverty, adverse childhood experiences can negatively impact those relationships, she added, and “impact genetic expressions in the next generation.”
Increasing awareness and access to young children, ages birth to 5, allows caregivers to “offer nurturing relationships to those children and decrease the chances of those genetic expressions being turned on later on life.”
One of the things Rabig has been working on, in conjunction with First 5 Alabama, an association affiliated with the international Alliance for the Advancement of Infant Mental Health, is to find ways to properly prepare more providers.
“We have a lot of mental health providers coming out of their program without a full understanding of early childhood health and brain development,” Rabig said. To counter this, the association is influencing universities and colleges to increase course work in the areas of brain development and social and emotional development.
Additionally, First 5 has created an endorsement that acknowledges professionals that have done the extra work to learn about infant and early childhood mental health – including clinicians, pediatricians, researchers and faculty members and policy makers.
With four categories representing the scope of knowledge and work, Rabig said 30 professionals will have received endorsements by January 2018.
“What we’re hoping is that as the endorsement grows throughout the state, it will influence funding in the future. But more than that, it recognizes the professional’s capacity to address infant and early childhood mental health issues, to recognize and know what to do when they see those issues. We’re hoping that this becomes the standard for the state,” she said.
Funding for mental health in Alabama in all areas is limited, but Rabig said she is optimistic about the consultation program’s future.
“I think we’re going to see some exciting things happening in Alabama in this next fiscal year,” she said, adding that while she can’t “guarantee we’ll see some big lump sum of funding coming down,” there “are a lot of people on board with what we’re doing.”
It is important to increase families’ exposure to what healthy, social-emotional-development is, she said, and this service can help parents address their own adverse childhood experiences.
Her hope is that consultants will begin working statewide in the coming year. How much expansion would cost is still something the association is trying to work out.
In Colorado, the program was funded both with state dollars and donations from philanthropic agencies, Rabig said.
In California, which started a Project LAUNCH pilot program as well, AB 2698 was signed into law on Sept. 30, providing funding to expand the consultation program statewide.
“We want to implement it in all early childhood settings … but where we start is wherever the funding tells us to start,” Rabig said of Alabama, adding that the expansion will likely start in early care providers and early childhood education settings.
“We can impact trajectory of a child becoming mentally sick by addressing this early,” she said.