Investing in the Early Childhood Mental Health Workforce Development: Enhancing Professionals' Competencies to Support Emotion and Behavior Regulation in Young Children

Addressing challenges at the intersection of early intervention and child welfare

BACKGROUND

The Keep Children and Families Safe Act amendment to the Child Abuse Prevention and Treatment Act (CAPTA) of 2003 mandated children under age three who are involved with Child Welfare (CW) to receive a referral to the system for early intervention (EI). While there is strong rationale for providing developmental services to young children and families impacted by maltreatment, the early implementation of this policy brought about many challenges related to interagency coordination and readiness of providers to provide cross-systems care. Currently, as the system and providers within the system recover from the effects of Covid-19, a predicted increase in need of services may exacerbate historical gaps in the provision of services to families involved with CW.

PARTICIPANTS AND SETTING

This policy-focused paper explores issues impacting CW and EI providers who coordinate care between CW and EI services.

METHODS

This paper provides a historical examination of these challenges and proposes an approach for improving developmental services for families referred from CW, specifically through the lens of addressing resources and supports available to providers.

RESULTS

The proposed approach includes an increase and reprioritization of resources to support provider readiness and well-being.

CONCLUSIONS

By focusing on support for providers, the authors propose a reduction of stress and improvement of services at each level of the "well-being" system.

Mental health services in Scandinavia and Eurasia: comparison of financing and provision

The aim of this study was to compare financial and human resources for mental health services in selected Scandinavian and Eurasian countries. A cross-sectional descriptive and analytical approach was adopted to analyse questionnaire data provided by members of the Ukraine-Norway-Armenia Partnership Project. We compared Scandinavia (Sweden and Norway) and Eurasia (Armenia, Georgia, Kyrgyzstan and Ukraine). Health expenditure in Eurasia was generally below 4% of gross domestic product, with the exception of Georgia (10.2%), compared with 11% in Scandinavia. Inpatient hospital care commonly exceeded 50% of the mental health budget. The central governments in Eurasia paid for over 50% of the health expenditure, compared to 2% in Scandinavia. The number of mental health personnel per head of population was much smaller in Eurasia than Scandinavia. Financial and human resources were limited in Eurasia and mainly concentrated on institutional services. Health activities were largely managed by central governments. Community-based mental healthcare was poorly implemented, compared to Scandinavia, especially for children and adolescents.

Telemedicine solutions for patients with mental disorders: a Delphi study and review of mobile applications in virtual stores

Mental disorders are a critical public health challenge since they profoundly affected people lifestyle. Mental healthcare treatments aim to promote a higher quality of life of the patients. These procedures include interventions for prolonged mental illness which can be supported by telemedicine technologies. This paper presents a comprehensive analysis of mobile applications selected to address the most critical needs of people with mental problems. Needs include areas of the patient's life, such as basic activities, behavioral changes, and daily life tasks. This work has two main objectives; (1) identify critical needs for patients with mental disorders and (2) identify and analyze apps that can meet the identified critical needs. A Delphi methodology survey was carried with a group of thirteen volunteers, including nurses, assistants, and psychiatrists who are working in Zamora and Valladolid, Spain. This survey has recommended different needs for patients with mental disorders and address objective 1. Google Play and Apple Store have been assessed to select the most relevant mobile applications that were recommended in the Delphi study to address the essential needs of these patients according to objective 2. The results of the Delphi survey show 24 different needs for patients with mental disorders. This study has analyzed 62 mobile applications which address the essential needs recommended in the Delphi study. The selected mobile applications represent 31 applications with feedback (50%); 15 informative applications (24%), and 16 independent applications (26%). On the one hand, applications with feedback request can address 13 recommended needs (54%). On the other hand, informative applications can address 7 needs (29%). Finally, the independent applications are only able to respond to 4 of the 24 recommend needs (17%). Mobile health applications present effective technologies to support the needs of patients with mental disorders. However, this study suggests a critical limitation of mobile applications for mental health since the majority of the applications require user activity. Therefore, future research initiatives on the design and development of mobile apps for people who have mental disorders should focus on independent applications.

A mental health course for developmental allied healthcare professionals: An exploration of potential effectiveness

We examined the effectiveness of a mental health course for developmental allied healthcare professionals (DAHPs) that focused on emotional and relational processes inherent to treatment. We hypothesized that (a) following the course, DAHPs would report increased awareness and sense of competence in dealing with these processes; (b) an increased sense of competence would be associated with decreased burnout; (c) following the course, DAHPs would increase their reading and participation in seminars about emotional processes in therapy; and (d) DAHPs would report the course had positive effects on their work and that they use a more relationship-based treatment approach. Participants were 153 Israeli DAHPs. They reported their attitudes and sense of competence in coping with emotional and relational processes in treatment in three time points: before, upon completion, and at follow-up. At follow-up, participants also reported level of burnout and the extent they made changes in their work. They provided examples of these changes, which were qualitatively analyzed. Study hypotheses were supported. Results suggest participating in a relatively brief mental health course is associated with positive changes in DAHPs' attitudes, sense of competence, and professional approach toward a relationship-based treatment.

Adverse childhood experiences among early care and education teachers: Prevalence and associations with observed quality of classroom social and emotional climate

This study examines the prevalence of self-reported adverse childhood experiences (ACEs) among a sample of 349 early care and education teachers. Seventy-three percent of the sample reported experiencing at least one ACE and 22% reported experiencing 4 or more ACEs. Live observational assessments of the quality of the social and emotional climate in teacher's classrooms were conducted for a subsample of 58 teachers. Within this subsample, reporting a higher number of ACEs was associated with facilitating a lower quality social and emotional classroom climate. Individual ACEs were also examined. Teachers who reported experiencing incarceration of a family member, physical abuse, or emotional abuse were observed to facilitate a lower quality social and emotional classroom climate. This study provides preliminary insight into the prevalence of ACEs among members of the early care and education workforce. Further, it extends previous work examining the multi-generational impacts of ACEs within families by showing that ACEs may influence the care that is provided to children in childcare settings.