What is being done to ensure that ensure that public health nurses, early intervention specialists, home visitors, child care providers and early child care educators are trained in promoting mental health and positive social and emotional development?
What is mental illness?
A mental illness is a disease that causes mild to severe disturbances in thought and/or behavior, resulting in an inability to cope with life’s ordinary demands and routines.
There are more than 200 classified forms of mental illness. Some of the more common disorders are depression, bipolar disorder, dementia, schizophrenia and anxiety disorders. Symptoms may include changes in mood, personality, personal habits and/or social withdrawal.
Mental health problems may be related to excessive stress due to a particular situation or series of events. As with cancer, diabetes and heart disease, mental illnesses are often physical as well as emotional and psychological. Mental illnesses may be caused by a reaction to environmental stresses, genetic factors, biochemical imbalances, or a combination of these. With proper care and treatment many individuals learn to cope or recover from a mental illness or emotional disorder.
What are we doing in this area?
• Healthy Families and Early Head Start have strong professional training components.
• Head Start Performance Standards and guidelines require that programs have a written mental health plan. There is a referral process for children with behavior management issues.
• Head Start programs normally have a relationship with a mental health professional. Sometimes these individuals work with the programs to train staff. In past years programs had funding which enabled them to send staff for training.
• Cross system initiative to begin statewide screening of children entering the child welfare system to determine need for subsequent assessment and intervention. Initial 7 sites to begin July 1 and be statewide by 2005.
• Licensed child care providers by 2005 will have requirement for lead teachers to have minimum CDA credential. (Michelle will get details).
• IAITMH (Indiana Association for Infant and Toddler Mental Health) has sponsored a few training sessions.
• LENDlinks (training program at RCDC – Riley Child Development Center) focused on infant mental health.
• DYSON (community pediatrics grant) has small component on social-emotional and child development as part of training with medical residents in IU School of Medicine.
• ENRICH (Early Intervention Resources and Information Curriculum Handbook) training program is available through a partnership with IACCRR (Indiana Association for Child Care Resource and Referral) and RCDC.
• Success by Six (collaborative planning initiative focused on how to get kids “ready” for school); Allen County Step Ahead Council is looking at system of services and is including childhood mental health as a focus area.
• First Steps – Training on Infant Mental Health scheduled for fall 2004 regional Service Coordination meetings.
• Institute for Building Strong Families collaborative training effort for Head Start/Early Head Start, First Steps, and child care providers conference scheduled for September 13-14, 2004 to include topics on infant and toddler mental health.
What are the challenges?
• Physicians (pediatricians and family practice) do not seem to have training on mental health issues and do not screen/ask questions about these issues with parents. If they do have training it is not part of their licensure and requirements. Challenge is that parents feel frustration when doctors miss mental health issues in kids – some families leave the office sharing information about their children’s behaviors and when “ignored” may feel “crazy” themselves. Note that physicians are the gatekeepers for access to other services.
• Preservice programs face multiple demands for accreditation requirements.
• Professional licensure requirements do not include infant mental health/social-emotional development training.
• Patchwork is the current mode – available training regarding mental health issues for young children is not coordinated.
• Indiana ranks near the bottom of states’ access of federal dollars.
• EPSDT is not uniformly used.
• Medicaid is the only existing full insurance coverage offered – covers case management and mental health services.
• Traditional insurance coverage has limitations including life-time caps, limitations on mental health services, etc.
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• Finding needed service providers.
• Resistance of parents to mental health diagnoses.
• Focus on problem children who are acting out; need to focus on the environment and information for positive reinforcement of behaviors.
• Cultural differences in child rearing practices.
• Reduced training funds and more federal control over the type of training programs required/offered.