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North Carolina Advances Infant and Early Childhood Mental Health Assessment, Diagnosis and Treatment

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This article summarizes key themes from North Carolina’s role in a convening of states and jurisdictions centered around improving state policies supporting Infant and Early Childhood Mental Health assessment, diagnosis, and treatment.

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Children’s earliest experiences impact their brain formation and in turn, their social and emotional, physical, cognitive, communication, and sensory and motor skills development. Recognizing the tremendous opportunities and risks associated with this critical time, states are increasingly investing in promoting infant and early childhood mental health (IECMH), defined as the capacity of a child from birth to age five to experience, express and regulate emotions; form close, secure interpersonal relationships; and explore his/her environment and learn, all within the context of family and cultural expectations. ZERO TO THREE released two papers in 2018 and 2019 highlighting strategies states are employing to support children’s IECMH. Highlights from North Carolina include:

  • In a section describing how states are developing and disseminating resources to help providers use the DC:0–5TM (a diagnostic classification of mental health and developmental disorders of infancy and early childhood published by ZERO TO THREE) for eligibility determination, treatment planning, and billing purposes, North Carolina is highlighted for developing a state-specific DC:0–5 crosswalk and engaging stakeholders through a statewide IECMH summit. State leaders are currently supporting workforce training in DC:0–5 and exploring how to expand use of DC:0–5 and the crosswalk as well as seeking funding for infrastructure for the North Carolina Infant Mental Health Association.
  • In a section focused on increasing the number of IECMH providers with the support of IECMH associations and credentials, North Carolina’s work is described. North Carolina is building an infrastructure for the state infant mental health association to be able to provide a roster of certified providers. The state also undertook a workforce study to document the training needed by pediatricians, mental health providers, early intervention, and the early childhood community to identify and respond to social determinants of health.
  • In a section focused on maximizing reimbursement by Medicaid EPSDT, managed care, and accountable care organizations, North Carolina’s Medicaid work is highlighted. North Carolina changed Medicaid policy in 2001 to allow up to 16 mental health visits using non-specific V (now Z) codes. The state also provides a small payment incentive for completion of maternal depression screens. The state is working to identify resources for follow-up referrals, including to community-based nurses who can help connect families to resources. They are also referring to mental health professionals, with the primary care provider offering additional follow-up as appropriate.

Learn more about how North Carolina and other states are promoting IECMH in Advancing Infant and Early Childhood Mental Health: The Integration of DC:0–5™ Into State Policy and Systems and Exploring State Strategies for Financing Infant and Early Childhood Mental Health Assessment, Diagnosis, and Treatment.

North Carolina is one of twenty states and jurisdictions participating in ZERO TO THREE’s IECMH Financing Policy Project that supports states in improving IECMH policy and practice, with a focus on financing.


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