Louisiana: Mental Health Consultation (MHC) Program
Dec 02, 2011 | Child Care and Early Education
Mental health consultations can help to equip child care providers who serve infants and toddlers with the tools and training needed to implement developmentally appropriate practices that foster healthy child development and support children with special needs. Research studies find that young children who are at high risk for developing social-emotional or psychological problems can be reliably identified as early as the first few years of life. Further studies indicate that early identification and treatment are effective in preventing risk factors from having a harmful impact on children's development and can reduce problems, such as delinquency and school failure, that may emerge later in childhood. Mental health consultations can also have positive impacts on child care providers themselves and have been associated with decreased staff stress and turnover rates as well as increased job satisfaction.
In July 2007, Louisiana's Department of Children and Family Services (DCFS) contracted with the Tulane Institute of Infant and Early Childhood Mental Health to launch a Mental Health Consultation (MHC) program for child care centers. Funded by the Child Care and Development Block Grant, the program's three main objectives are to:
- Promote the social and emotional health of young children,
- Support teachers' promotion of healthy child development within the classroom setting, and
- Refer for treatment or design interventions for young children exhibiting behavioral problems.
The MHC model focuses on both the individual child and child care program. Mental health consultants (MHCs) provide case consultation to address the specific needs of a child, while helping programs as a whole become better prepared on supporting children's social-emotional development. The model emphasizes developing collaborative relationships between MHCs and teachers/directors. MHCs provide training to teachers on developmentally appropriate practices in classroom settings. This includes five interactive meetings that are designed to meet state child care licensing requirements for continuing education credits. MHCs also work with teachers on strategies for working effectively with parents.
Child care centers are eligible to receive consultation services if they are participating in Quality Start, the state's quality rating and improvement system (QRIS). Participation is voluntary, incurs no cost for the center, and centers are free to terminate services at any time. Consultants are on-site at a center for one day every other week for six months (total of 12 visits). Consultation tools include:
- Classroom observations,
- In-class modeling,
- Individual meetings with teachers,
- Didactic group meetings,
- Meetings with families and parent education
- Referrals to outside services, and
- Design of specific interventions for challenging behaviors.
Links to Early Intervention (Part C and B)
Programs do not need parental permission to refer a child to Early Intervention (EI), but there is a recognition that nothing will likely occur unless the parent is involved. The state's MHC director is also working with the state's early intervention Part C director to formalize links between the two programs. One of these links would allow MHCs to conduct an EI assessment at the child care center, provided there is parental consent.
Evaluation of the MHC Program
The state recently completed an evaluation of the MHC program, assessing the level of impact on teacher confidence and competence in supporting children's social emotional development, including their ability to engage children and parents and manage children's behavior. Overall, evaluators found that the MHC model had promising effects on teachers across a wide range of centers. Most teachers reported that they had positive relationships with their MHC. In addition, teachers reported that after receiving MHC services, they were better prepared to support children's social emotional development. Teachers with less experience particularly benefitted from the program.
The MHCs themselves were highly trained and supervised. At the time of the evaluation, all twelve MHCs had a mental health master's degree or higher, were licensed (or working toward licensure) in the state, and had at least two years of clinical experience working with children and adults. Those who had not completed specialized training in infant mental health were required to attend a weekly, three hour training seminar (60 hours) through the Tulane University Institute of Infant and Early Childhood Mental Health. MHCs received reflective supervision twice a month in an individual format and monthly in a group format. Reflective supervision is an essential component of mental health consultation to support MHCs and maintain a high quality mental health consultant workforce. Each of the full-time MHCs carried a caseload of seven centers, and four half-time MHCs had four centers each.
Gail Kelso, Executive Director, Child Development & Early Learning Section
Louisiana Department of Children and Family Services
Allison Boothe, PhD
Geoffrey Nagle, PhD, LCSW, MPH
Institute of Infant and Early Childhood Mental Health
Tulane University School of Medicine
Department of Psychiatry and Behavioral Sciences
1440 Canal St., TB-52
New Orleans, LA 70112