Skip to main content

Answering the SOS, Part II: Supporting Mental Health in the Very Young

November 1, 2022

Throughout the COVID-19 pandemic, 42% of families have reported increased levels of anxiety, depression, loneliness, stress and burnout, peaking in summer 2022. Early childhood educators have also suffered heightened emotional distress―at least 1 in 3 due to material hardship or hunger and over half due to workforce shortages.

Growing up in stressful environments can profoundly impact children’s academic achievement and long-term mental and physical health. Some policymakers are turning to evidence-based interventions and systems integration to promote resilience in adults and young children alike.

Rethinking Suspensions and Expulsions

Preschoolers are suspended and expelled three times more often than school-aged children, which can carry serious long-term consequences. Young children suspended or expelled have more negative attitudes toward school, experience greater academic failure and grade retention, are up to 10 times more likely to drop out of high school and have higher incarceration rates.

“Federal and state policies have resulted in an overall decrease in the use of suspensions and expulsions; however, significant racial, ethnic, age and gender disparities have remained constant since federal data were first collected in 2011-2012,” says Evandra Catherine, assistant professor and deputy director for the Children’s Equity Project at Arizona State University. Black children, for example, represent fewer than 20% of all preschoolers but nearly half of public preschool suspensions. Some states are responding to avoid these outcomes.

In place of suspensions and expulsions, jurisdictions are equipping early educators to better meet children’s social and emotional needs. Some states have enacted policies reducing suspensions and expulsions and providing supports. Oregon mandated technical assistance supporting children’s social and emotional development and inclusive program practices. It also enhanced community-based supports for families with a history of trauma, involvement in multiple support systems or intervention service needs. A pending Illinois measure would require early childhood programs to use resources including infant and early childhood mental health consultation.

The Child Care Technical Assistance Network, part of the U.S. Department of Health and Human Services, offers a tool with policy options promoting social and emotional development to help states build comprehensive strategies preventing expulsions.

Coordinating State Systems and Embedding Consultation Into Existing Programs

Infant and early childhood mental health is an emerging policy issue. Resources are unavailable in some states and often are disconnected from other systems where they do exist. Integrating consultation into coordinated state- and program-level efforts can effectively support early educators, children and families.

State-Level Coordination

Maximizing partnerships is one way to expand mental health services. At least 19 states and Washington, D.C., have coordinated statewide systems supporting early childhood initiatives. These have increased prekindergarten enrollment, expanded home visiting and aligned birth through age 20 education goals.

Illinois, for instance, encourages state entities to jointly develop and promote materials highlighting the role and value of mental health consultants. Materials should be easily accessible and written in providers’ and parents’ native languages. The state also urges collaborating with consultants, providing consultation-relevant data and promoting consultation database use. Alaska embedded services into existing quality rating and improvement systems to reduce suspensions and expulsions and increase inclusive early learning practices.

Program-Level Coordination

Head Start and Early Head Start integrate consultation by staffing mental health professionals, building strong partnerships with community agencies providing consultation and engaging private practitioners as consultants. Because Early Head Start serves infants and toddlers and Head Start serves preschoolers, the programs address social and emotional development concerns specific to each age group. For instance, Early Head Start consultants’ training may address excessive crying and attachment issues in children 3 and under before more intensive interventions are needed.

Outside licensed programs, families widely use friend, family and neighbor care. More than 5 million children were in nonparental relative care, and up to 2.8 million were in nonrelative home-based care in 2016. Policymakers can better support this population by expanding consultation to include this care.

Funding for Sustained Consultation Services

States can use COVID-19 and other federal funds to establish or expand consultation programs, coordinate consultation within community-based mental health systems and increase consultant capacity and expertise. Existing services covered by the federal Early and Periodic Screening, Diagnosis and Treatment program; Children’s Health Insurance Program; IDEA Part C; or maternal and child health programs can be leveraged to support collaboration with child welfare and child care systems and Early Head Start, Head Start, home visiting and other programs.

Some states allocated one-time and dedicated funds to consultation efforts. Utah established a grant program providing education regarding best practices for early childhood mental health support and interventions. And Illinois provided sustainable state funding to increase consultant availability, provide training and implementation support and coordinate consultation and additional resources.

Integrated systems and supports for early educators and families ultimately improve young children’s social and emotional development, which has positive long-term implications for everyone.

Melissa Mincic is a senior policy specialist in NCSL’s Children and Families Program.

  • Contact NCSL

  • For more information on this topic, use this form to reach NCSL staff.