Origins and Purpose of Georgetown’s New Early Childhood Mental Health Consultation Study Read Comments | Post Your Own Comment
In very young children these behaviors can be severe enough to warrant their removal from their preschool programs, setting into motion a cascade of negative experiences. While much of this concern was initially fueled by anecdotal evidence from parents and early care and education providers, Gilliam (2005) released the first data documenting the extent of this problem nationwide. Surprisingly, most states were expelling preschool-aged children at rates that exceeded their school-aged populations. One promising statistic was that access to mental health consultation was found to be associated with lower rates of preschool expulsion (Gilliam & Shahar, 2006). State-funded pre-kindergarten programs that reported on-site access to a psychologist or social worker expelled 5.7 children per 1,000; occasional access to a mental health consultant was associated with a somewhat higher expulsion rate; and programs that lacked consultation expelled children in the highest rates (10.8 per 1,000). The Georgetown University Center for Child and Human Development (GUCCHD) has long been interested in exploring the supportive intervention of early childhood mental health consultation, and in May 1998, with funding from the Substance Abuse and Mental Health Services Administration, (SAMHSA), convened a Roundtable on Mental Health Consultation Approaches for Programs/Systems Working with Infants, Toddlers, and Preschoolers and their Families. Twenty-five public and private program administrators, practitioners, family members, and evaluators came together to share their state-of-the-art thinking and direct experience on promoting healthy development among our youngest members of society in early childhood settings by means of mental health consultation. A monograph, Early Childhood Mental Health Consultation (Cohen & Kaufmann, 2000) summarized the presentations, discussions and background materials from the Roundtable. This widely disseminated document and follow-up training guide has been used by states, programs and communities as a blue-print for developing mental health consultation initiatives across the country. As considerable investments of public and private funds were being used to develop mental health consultation programs across the country, GUCCHD and others became concerned about a lack of evaluation and research data available to inform the field. As states and communities expand their capacity to meet the mental health needs of young children and their caregivers, the need for accurate, data-driven information about effective strategies to deliver mental health consultation is growing. Motivated by a desire to assess the level of evidence for the effectiveness of mental health consultation, Eileen Brennan, Portland State University, Deborah Perry, GUCCHD, and their colleagues (Brennan et al., 2008, Perry et al., manuscript under review) completed an extensive review of published and unpublished literature. They concluded that while there is a growing body of evidence to suggest that mental health consultation is effective in building behavior and classroom management skills of early care and education staff and reducing the levels of problematic behavior in young children, there are gaps in the knowledge base. These gaps are fueled by a lack of consensus about:
To address the knowledge gaps listed above and provide data-driven guidance on building and implementing quality ECMHC programs, GUCCHD secured funding from the Annie E. Casey Foundation and the A.L. Mailman Family Foundation to examine the core features of effective consultation program and assess the extent to which consultation efforts are in place nationally. To achieve these goals, GUCCHD’s study includes three major components:
The study report is scheduled for release Summer 2009 and will be available on GUCCHD’s website: http://gucchd.georgetown.edu
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In recent years, there has been growing concern among many in the early care and education community that increasing numbers of very young children are manifesting behavior problems. The Center for Mental Health Services (2005) reports evidence for clinically significant emotional and behavioral disabilities among young children, with estimates in the general population ranging from 4 to 10%; these prevalence estimates are significantly higher for low-income children. Outcomes for young children who exhibit serious challenging behaviors that go without intervention are significantly compromised (Center for Evidence-based Practice, 2005). Early appearing behavior problems are associated with adolescent delinquency, school failure and drop out, and adult incarceration. Without appropriate identification and intervention by third grade, a large percentage of these children will continue to require costly, ongoing services (Dodge, 2003).
