State leaders in Minnesota are building an early childhood mental health system that connects evidence to practice, training, and policy.
Minnesota is investing in the development of local systems of care, promoting the use of screenings across settings, training mental health professionals and clinicians to use evidence-based assessments and interventions, and aligning Medicaid policies with proven practice so that services are reimbursable. The following are examples of how Minnesota is investing in early childhood mental health systems.
- Building Regional Systems of Care Infrastructure: Every county in the state and two tribal nations are covered by one of 20 grantees that are funded to create an infant and early childhood mental health system of care. The grants are used to strengthen infrastructure and support developmentally and culturally appropriate services to young children. Intensive training is provided to the grantee staff – both clinicians and supervisors – to ensure practices are aligned with the latest evidence and best practice. This investment will ultimately build capacity regionally and across the state to ensure all children under age five with mental health conditions, regardless of their insurance status, receive evidence-based mental health services from highly trained early childhood mental health professionals.
- Promoting the Use of Standardized Screening Tools: The state promotes the use of developmental and social emotional screenings for children in primary care clinics, early childhood programs, Head Start, schools, and child welfare. Screening for maternal depression is also supported.
- Providing Training on DC:0-3R: Since 2004, more than 1,150 mental health professionals have been trained in the use of DC:0-3R. Training is supplemented with ongoing monthly case consultation and supervision.
- Providing Training on Evidence-Based Interventions: The state provides training to mental health clinicians on evidence-based treatments including Attachment Bio-Behavioral Catch-up (ABC), the Incredible Years, Parent-Child Interactive Therapy (PCIT), and Trauma Informed Child-Parent Psychotherapy (TI-CPP). More than 300 clinicians have been trained in these interventions. Ongoing support and consultation is provided to ensure interventions are implemented with fidelity.
- Implementing Policies to Support Billing for Assessment and Services: In 2011, the state made changes to the administrative rule for mental health clinical services, guaranteeing that Medicaid covers an extended diagnostic assessment for children under age five and psychotherapy when performed by a mental health professional. The rule specifically recommends mental health clinicians use the DC:0-3R.
- Implementing Policies to Support Mental Health Consultation: The state supports mental health clinical care consultation by allowing a treating mental health professional or clinical trainee to bill Medicaid for providing consultation to other professionals who work with a child who is uninsured or underinsured. This is critical for ensuring communication across providers and systems. Further, state grants support mental health clinicians to work with child care and family child care providers to provide professional development related to mental health promotion.
- Measuring Outcomes: Mental health professionals who receive public reimbursement for services to children birth to age five must complete the Early Childhood Service Intensity Instrument, a tool for assessing intensity of services needed and developing comprehensive, integrated plans. This yields information helpful to families who may be making determinations about services, and the data helps providers and administrators focus on continuous improvement in the delivery of mental health services.
The Minnesota Department of Human Services, Children’s Mental Health Division website includes additional information on each of these aspects of the early childhood mental health system of care.