By Christine Johnson-Staub

More than half of children under age 18 have been diagnosed with at least one mental health disorder, according to a new report by Child Trends and the Robert Wood Johnson Foundation. While the authors make the case for reforming health and mental health services to increase access for children and youth, they also present broader recommendations to support child wellness, emphasizing healthy child-adult relationships, along with positive routines and practices for children. Their approach has implications for services, family engagement and support, and professional development in early childhood settings.

• Serving children in high-quality child care settings that offer comprehensive services to families is important both to offer children consistent care and routines, and to identify children and families in need of support. High-quality early childhood programs ensure that young children access developmental screenings that may uncover potential mental health problems. According to early findings of the National Survey of Early Care and Education presented at the recent Head Start National Research Conference, almost all (97.9 percent) Head Start centers offer assistance with developmental screening, which helps identify mental health concerns. Nearly all (88.5 percent) public pre-kindergarten programs offer screening, as do 73.4 percent of private early childhood programs.
• Caring for children with family stress and potential mental health concerns, as well as related behavior challenges, is an urgent training need for the early childhood field. One approach to building the capacity of early childhood staff is the mental health consultation model. An increasing number of states offer programs serving young children some kind of mental health, health, or behavioral consultation, in which the consultant can provide training and guidance in identification of mental health concerns, referral to and coordination of follow-up diagnosis and treatment, and strategies to support the child’s development and learning. 
• Finally, the report suggests that two-generation approaches using effective family engagement strategies  provide parents with the skills they need to manage their children’s behavior and mental health needs, while also potentially identifying needs of the adult for mental health or other services. These types of two-generation approaches can be particularly successful in strengthening the capacity of both parents and children. Parent and child wellbeing are inextricably linked to one another, and challenges to either can interfere with family economic success and positive child outcomes.

Policymakers can support child wellness and increase access to mental health services by looking for opportunities to incorporate comprehensive services and related supports into their child care quality, professional development, and financing systems. Expanding access to high-quality programs like Early Head Start and Head Start can also make mental health services more available to those children who are most vulnerable.  While supporting child wellness and increasing access to mental health services is a challenge, high-quality child care and early education settings provide an opportunity to identify and serve young children at risk, while building and supporting the family’s capacity to meet their mental health needs.