This article describes Tennessee’s efforts.
Tennessee is leveraging American Rescue Plan Act (ARPA) dollars to support expansion of infant and early childhood mental health (IECMH) consultation for home visitors. IECMH consultation in home visiting is one component of a larger effort in Tennessee to create a system of IECMH consultation.
Laying the Groundwork
Prior to ARPA, the Association of Infant Mental Health in Tennessee (AIMHiTN), guided by the Tennessee IECMH Financing & Policy Team, retained Consilience Group to develop an IECMH sustainability framework to advance statewide IECMH practice. That sustainability framework was developed based upon a literature scan, landscape analysis, and interviews with peer states, and identified five key domains critical to shaping a successful state level strategy:
- System integration
- Leadership development
- Workforce development
- Financial sustainability
Diversity, equity, and inclusion (DEI) is not included as a separate domain but rather is woven into the recommendations for each of the five domains, recognizing that DEI is essential to ensuring that any promotion, prevention, or intervention efforts are effective throughout diverse cultures and communities.
Based upon the recommendations of that report, the Consultation Coordinating Council was created to serve as an advisory group to create a shared IECMH vision, corresponding outcomes, and desired short- and long-term targets. The Council began meeting in January of 2022 and consists of representatives from child care resource and referral, local community health organizations, philanthropy, clinicians, Department of Mental Health and Substance Abuse Services, Department of Health, higher education institutions. The council is exploring strategies to increase representation and participation of families. ARPA funds are one of the funding sources supporting Council operations.
IECMH consultation was identified as a priority strategy in Tennessee based in part upon its potential as an intervention to reduce/prevent exclusionary practices like suspension and expulsion. The Council identified three primary focus areas for consultation: child care, home visiting, and pediatric care settings. ARPA funds are supporting consultation for home visitors while other funding sources are being leveraged to support implementation in early childhood education and pediatrics.
Developing and Implementing IECMH Consultation in Home Visiting
The IECMH consultation strategy for home visiting was informed by listening sessions with home visitors supported by ARPA funds and is being implemented by AIMHiTN, the Early Success Coalition at Porter Leath, and Allied Behavioral Health Solutions. Activities include:
- The creation of a warm line for home visitors to access clinicians in real time to receive support for emergent issues. Training for warm line staff includes an explicit focus on equity and cultural responsiveness.
- Targeted training for home visitors related to supporting social-emotional development.
- A streamlined pathway for referral to IECMH clinical treatment services when appropriate.
Tennessee faced a variety of challenges in the work to build a system of IECMH consultation, including the complexity of building a system from the ground up, getting everyone on the same page, and balancing the moving pieces of multiple funding streams. While there is still a long way to go, the success the state is experiencing today reflects the work that took place over many years to build shared commitment to IECMH and develop the partnerships necessary to move the work forward. This foundation built over time positioned Tennessee to move quickly when ARPA funds became available and leverage the opportunity to both respond to emergent needs and make progress in building a sustainable system.
The Department of Health expressed intent to continue funding the warm line beyond ARPA and the state is exploring the development of a warm line for early childhood educators modeled after the one created for home visitors, demonstrating that while financial stability remains a challenge with the end of ARPA, there is also will within the state to continue making progress.
Learn more about IECMH consultation in Tennessee HERE.
Additional ARPA Resources
Interested in learning more about how states are using ARPA to support babies? Visit our landing page to read the summary brief, States are Leveraging ARPA to Move the Needle for Infants and Toddlers, and the full series of state articles (featuring Alaska, Arizona, Colorado, Georgia, Minnesota, Tennessee, Washington and Wisconsin).