Mental Health
Use the key issues below as a guide to find related data, research or other resources in your work:
- Key Issue 1: Investing early in supporting the mental health of infants and young children creates benefits later in life. It can also help states avoid more costly interventions that often result when mental health challenges go unaddressed.
- Key Issue 2: Healthy beginnings for infants and toddlers start with culturally responsive pre- and postnatal care for expectant mothers.
- Key Issue 3: Early care and education programs can have a deep impact on the promotion of infant—and lifelong—mental health.
Materials from the following partners were used in the development of the guiding message points in this chapter:
Key Issue 1: Investment in early mental health
Key Issue 1: Investing early in supporting the mental health of infants and young children creates benefits later in life. It can also help states avoid more costly interventions that often result when mental health challenges go unaddressed.
Early experiences matter—a lot. In the first years of life, more than 1 million neural connections are formed every second. Babies’ earliest relationships and experiences shape the architecture of their brain, creating a foundation on which future development and learning unfolds. Babies who engage with responsive, consistent, nurturing caregivers and who are living in safe and economically secure environments are more likely to have strong emotional health—also referred to as infant and early childhood mental health (IECMH).
As they mature, their emotional health supports growth and well-being in other essential areas. These include physical development, cognitive skills, language and literacy, social skills, and even their approach to learning and readiness for school. When emotional health is compromised, so too is development across these other areas, leaving children more susceptible to poor overall health, poor educational performance and even criminal justice involvement over the course of their lives. Promoting the emotional health of infants and young children should be underscored as an essential ingredient for a bright future.
While positive early childhood experiences promote strong emotional health, negative experiences can adversely impact brain development, with serious lifelong consequences. When an infant or young child’s emotional health deteriorates significantly, they can, and do, experience mental health problems. Approximately 9.5%–14.2% of children birth to 5 years old experience emotional, relational or behavioral disturbance. Young children who live in families dealing with parental loss, substance abuse, mental illness or exposure to trauma are at heightened risk of developing IECMH disorders.
Because of the early onset of emotional and behavioral disorders, the federal government spent about $280 billion on mental health services in 2020. This impacts federal and state spending on health care, education, child welfare, criminal justice and economic productivity. A full continuum of services—from promotion to prevention to treatment—is needed to best support babies, young children and the significant adults in their lives.
Key Issue 2: Healthy beginnings start with prenatal care
Key Issue 2: Healthy beginnings for infants and toddlers start with culturally responsive pre- and postnatal care for expectant mothers.
Maternal depression before, during or after pregnancy is widespread in the United States and can have lasting negative effects on new parents and their young children. The stressors of poverty can multiply these risks. Prenatal care includes assessments and screenings for chronic diseases and behavioral health concerns, such as substance use or mental health disorders. Prenatal care also promotes healthy behaviors and breastfeeding, which reduces the likelihood of postpartum depression and accelerates recovery when it does occur. Prenatal care also can prevent pregnancy complications, low birth weight and preterm births.
Integral to addressing postpartum depression is an adequate amount of paid time off, which may help mothers to physically recover from childbirth and adjust to new caregiving and personal responsibilities. Paid family leave is proven to help new parents have more time to bond with children, develop positive caregiving skills and build the foundation for healthy attachment. And yet, just 16% of private industry employees have access to paid leave. Close to 1 in 4 mothers who are not eligible for paid leave return to work within 10 days of giving birth.
Parents with access to paid family leave may be less likely to experience depression and more likely to engage in healthy behaviors, such as stress management and exercise. Children may be more likely to experience positive health outcomes if their families have access to paid family leave.
Key Issue 3: Early care and education programs impact mental health
Key Issue 3: Early care and education programs can have a deep impact on the promotion of infant—and lifelong—mental health.
From the way teachers interact with infants during feeding and diapering to the way they engage parents in the care of their child, early care and education programs are continuously building and nurturing relationships that support the social emotional development of infants and their primary caregivers. Working closely with families can play a role in helping them understand the value of early, social emotional development. This includes outreach support such as home visits and family education programs. Home visitors connect families to needed health, child care and other services. They work with families to identify strategies for managing stress and social isolation and promote family emergency planning strategies.
Simultaneously, there is a need to design care and learning supports that build on families’ unique strengths and needs. Culturally and linguistically responsive practices in these spaces allow all parents and caregivers to be their children’s first and best teacher.
Supporting families helps to prevent child abuse and neglect, maternal depression and attachment challenges. Early Head Start and child care programs may supply more comprehensive training for providers to offer support to infants and toddlers with challenging behaviors. Other programs may employ social workers or mental health consultants to provide focused intervention.
Data/Proof Points
- ZERO TO THREE’s DC:0–5™ Manual (Version 2.0): In 2021, ZERO TO THREE released the latest version of its first-of-a-kind classification manual for diagnosing mental health and developmental disorders in infants and toddlers. By identifying and describing disorders as well as identifying effective intervention approaches, professionals have used this manual to help prevent, diagnose and treat mental health problems in PN-3. The Collaborative should use this manual as a resource for classifying mental health disorders and discussing solutions for PN-3. In addition to the manual, ZERO TO THREE released a policy resource for how the DC:0–5™ is being implemented in state policy and systems, improving access to mental health services and supports while also improving outcomes for children.
- How to use + resources to boost your message: ZERO TO THREE offers a resource page of infant and early childhood mental health clinicians. This directory provides resources for families and caregivers working with very young children who have experienced trauma. It also links them with specialized mental health professionals who understand the needs of very young children.
- How to use + resources to boost your message: ZERO TO THREE offers a resource page of infant and early childhood mental health clinicians. This directory provides resources for families and caregivers working with very young children who have experienced trauma. It also links them with specialized mental health professionals who understand the needs of very young children.
- ZERO TO THREE’s study on maternal mental health: ZERO TO THREE examines the need versus utilization of pregnant women's mental health services specifically for low-income women at higher risk for depression and PTSD. The findings show how women with lower-grade symptoms and women of color are less likely to receive mental health services. ZERO TO THREE offers potential solutions to improve access for pregnant women.
- How to use + resources to boost your message: ZERO TO THREE’s paper on improving mental health for moms and babies provides insight on tackling maternal depression. In essence, this paper discusses the impact of maternal depression on the social and emotional health of young children. This resource will help provide valuable perspective and proof points when crafting messaging surrounding maternal mental health.
- How to use + resources to boost your message: ZERO TO THREE’s paper on improving mental health for moms and babies provides insight on tackling maternal depression. In essence, this paper discusses the impact of maternal depression on the social and emotional health of young children. This resource will help provide valuable perspective and proof points when crafting messaging surrounding maternal mental health.
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Mayo Clinic Health System’s research on infants’ mental health: Discussions around mental health often focus on the experiences of adolescents and adults, leading many to believe that these are the only people in our community affected by emotional concerns. Unfortunately, many mental health concerns have roots that connect to challenges in infancy and early childhood. Early interventions for these developing minds are necessary to prevent future mental health disorders. The Mayo Clinic provides research and important data on how to mitigate these risks.
- How to use + resources to boost your message: Within this article, the Mayo Clinic outlines indicators of infant mental health concerns. Collaborative members should use this list of warning signs as a reference for messaging to parents and families of infants and toddlers.
- How to use + resources to boost your message: Within this article, the Mayo Clinic outlines indicators of infant mental health concerns. Collaborative members should use this list of warning signs as a reference for messaging to parents and families of infants and toddlers.
- Think Babies' Infant and Early Childhood Mental Health Resource List: Infants and toddlers need access to a full continuum of infant and early childhood mental health services. This annotated resource list includes a range of materials, such as policy briefs, fact sheets, websites and other tools to help stakeholders learn about the issue.
- How to use + resources to boost your message: Included in the list of resources from ZERO TO THREE is an infographic designed to help early childhood professionals talk about IECMH and address the critical importance of social and emotional development with stakeholders. It provides the definition of IECMH and illustrates where social and emotional development can be promoted.
Identified Launch Points/Escalation Moments for mental health awareness
- Mental Health Awareness Month: May is Mental Health Awareness Month and during this time, the resources listed above can be used to highlight the importance of maternal and childhood mental health to join the broader national conversation on mental health. Directly stating PN-3 when highlighting research in this field can help reframe the news cycle, which is frequently dominated by mental health issues of K-12 students and adults.
- How to use + resources to boost your message: ZERO TO THREE has put together a resource page for Mental Health Awareness Month. This series of resources can be helpful to uplift via social content as well as through talking points for interviews with the media.
