Early Relational Health and Intervention

What’s needed:

  • Increase the awareness of physicians and other care providers of the importance of this for healthy family functioning
  • Change funding mechanisms to make this viable
  • Increase availability of referral resources
  • Integrate credentialing to insure the provision of quality services

By current estimates, at any given time, approximately 11% to 20% of children in the United States have a behavioral or emotional disorder, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Between 37% and 39% of children will have a behavioral or emotional disorder diagnosed by 16 years of age, regardless of geographic location in the United States.

From the Child Trends articles (cited below):

Many negative mental health issues, if addressed early, could be averted. For example, every year more than 400,000 infants are born to mothers who are depressed, which makes perinatal depression the most under-diagnosed obstetric complication in America. Postpartum depression leads to increased costs of medical care, inappropriate medical care, child abuse and neglect, discontinuation of breastfeeding, and family dysfunction and adversely affects early brain development. Pediatric practices, as medical homes, can establish a system to implement postpartum depression screening and to identify and use community resources for the treatment and referral of the depressed mother and support for the mother-child (dyad) relationship.

Early Relational Health Resources

Integration of Pediatrics with Mental Health Care

The Mount Sinai Parenting Center

Integrating the science of early childhood development into pediatric healthcare moments.

A pediatrician-led nonprofit based on Long Island, NY that's focused on improving outcomes for children prenatally through age 5 by fostering practice transformation and systems change.

American Academy of Pediatrics:

Watch and Learn How to Support Early Relational Health in Practice

Safe, stable, nurturing relationships (SSNR) are the solution to childhood adversity. Regardless of number of adverse childhood experiences (ACEs), adults with higher positive childhood experiences (PCE) have lower odds of depression and poor health outcomes after accounting for social health risks and adverse childhood experiences.1 Learn more by watching the two-part series on Early Relational Health.

Mental Health in Infants and Young Children

Mental health in infants and children is about how young children begin to organize their feelings and connect with other people. It includes their growing capacity to regulate and express their emotions and behavioral responses, to form secure relationships with others, and explore the environment in the context of their family, community, and cultural expectations.

Screening Technical Assistance and Resource Center

Includes foundational resources that can help you learn about the importance of screening, counseling, referral, and follow-up based on current recommendations for child development, perinatal depression, and social determinants of health.

Bright Futures

The primary goal of Bright Futures implementation is to support primary care practices (medical homes) in providing well-child and adolescent care according to Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. Settings for Bright Futures implementation include private practices, hospital-based or hospital-affiliated clinics, resident continuity clinics, school-based health centers, public health clinics, community health centers, Indian Health Service clinics, and other primary care facilities.

Zero to Three:

Healthy Steps- Partnering with Pediatrics

Almost all families take their babies to see a pediatric primary care provider. New parents and caregivers attend 12-13 well-child visits in a child's first three years—that's at least 12 opportunities to change a child's future.

We achieve improved outcomes for young children and families by bringing together the expertise of a child development expert, the HealthySteps Specialist, and the pediatric primary care provider.

Center for the Study of Social Policy:

DULCE

An innovative approach based in the pediatric care setting that proactively addresses social determinants of health, promotes the healthy development of infants, and provides support to their parents, all during the precious and critical first six months of life. DULCE does this by introducing a Family Specialist trained in child development, relational practice, and concrete support problem solving into the pediatric care team. Family Specialists attend well-child visits with families and providers. They get to know the families, provide peer support, and then work with the DULCE Interdisciplinary Team to connect families with resources and support.

National Institute for Children’s Health Quality

Pediatrics Supporting Parents Learning Community - Core Practices, Strategies, and Resources for Supporting Social Emotional Development in Pediatric Care

The Pediatric Integrated Care Resource Center (PIC-RC)

Designed to promote the integration of medical and behavioral/mental health services for children, adolescents, and their families by providing ready access to needed resources to interested professionals in different disciplines who are working in a variety of settings.

Integrated Behavioral Health Care as a means of addressing common behavioral health concerns within pediatric primary care

Screening Resources

Good policy recommendations for screening in these articles from Child Trends:

The following sites are from the Center for the Study of Social Policy:

The following are from the National Institute for Children’s Health Quality:

Following articles are from the American Academy of Pediatrics:

Perinatal Depression NIMH