What is the problem that needs to be addressed? Please describe how it is related to mental health.
Orange County lacks sufficient Infant and Early Childhood Mental Health (IECMH) specialists to address the needs of infants and toddlers with diagnosable mental health issues. It is estimated that only 5-6 licensed therapists in the entire County are certified to make a diagnosis based on the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-5) and provide a related evidence-based intervention. Locally, State-wide, and at the national level, various efforts have been initiated to develop the IECMH workforce. Many of these focus on non-clinical positions such as the SAMHSA IECMH Consultation program or the ZERO TO THREE Prenatal-to-Five Workforce Development Initiative implemented in Los Angeles County and other jurisdictions. To date, IECMH clinical certification programs have relied on a select group of universities that have chosen to have IECMH programs and corresponding certifications. Orange County currently lacks these resources, requiring an innovative approach to expand the capacity of IECMH clinical specialists on a Countywide basis.
Why is this a concern for Orange County? What can Orange County and other counties learn from this project?
At least 10,000 children a year in our County, aged zero to five, need a mental health intervention from a qualified licensed IECMH therapist. Obviously, this exceeds the current capacity to provide these services. Through a new public/community/hospital partnership approach to building IECMH workforce capacity, Orange County could serve as a model to other counties throughout California and the rest of the country. This includes testing new approaches to overcoming the double layer of stigma that comes with mental illness in general and mental illness in young children more specifically. This additional stigma has been a barrier to IECMH workforce development initiatives everywhere. Orange County’s ability to overcome this barrier in a new way would be beneficially to all other counties.
What is currently being done to resolve this problem in our county and throughout the United States? If applicable: Is it working; why or why not?
Very little is being done to resolve this workforce development problem in our County beyond the handful of clinical IECMH specialists encouraging others to receive their certification through word of mouth. At the national level, ZERO TO THREE has taken the lead in advancing the field through the development of the DC:0-5 and promotion of evidence-based IECMH clinical interventions such as Child Parent Psychotherapy (CPP). These national efforts have resulted in the creation of a new area of concentration within the mental health field, translating the most recent science into a clinical framework of practice tied to emerging policy changes at the federal and state levels. However, no effective mechanism has been created for expanding needed IECMH clinical workforce capacity at the local jurisdictional level.
What is new or different about this project idea? Please describe how this differs from what is already being done (Question 6). Please list any research that was done on this topic.
The project, which brings together HCA, community providers, and a hospital partner will be the first time that this type of integrated IECMH clinical workforce development initiative will be done in the country.
Research sources include:
- ZERO TO THREE (www.zerotothree.org/early-development/infant-and-early-childhood-mental-health)
- Center of Excellence for Infant and Early Childhood Mental Health Consultation (www.samhsa.gov/iecmhc)
- CHOC Children’s
- Children’s Bureau
- Early Childhood Mental Health Collaborative
- Children and Families Commission of Orange County
- First 5 LA
First 5 California
- First 5 Association of California
What is the project idea? Please describe how this project will operate.
Innovation funding would be used to implement a coordinated workforce development strategy with a participating hospital and community-based provider(s) to advance the development of the IECMH clinical workforce in Orange County. This will be done through the implementation of private sector matching awards to leverage MHSA dollars in paying for IECMH clinical training and capacity building for technical assistance for new IECMH clinical providers. The mechanism of recruitment and enrollment of early adopter private sector partners will have a catalytic effect of reducing IECMH stigma by creating a new set of influential “boosters” for early childhood mental health investment. This will simultaneously result in additional funding for IECMH clinical training and service capacity building.
Respondent skipped this question.