Colorado Advances Infant and Early Childhood Mental Health Assessment, Diagnosis and Treatment

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 Colorado include:

• In a section describing how states are promoting the use of DC:0-5™ (a diagnostic classification of mental health and developmental disorders of infancy and early childhood published by ZERO TO THREE), Colorado is highlighted for its professional development. Colorado has trained more than 150 professionals, including all early childhood mental health consultants across the state, so they understand IECMH disorders and can work collaboratively with clinicians providing services to children and families.
• In a section focused on IECMH consultation, Colorado is highlighted for having 34 state-funded IECMH consultation positions filled by 44 professionals. Approximately 20 additional mental health consultants are funded with philanthropic dollars. All consultants have access to trainings and resources, participate in learning collaborative activities, and use common tools to measure outcomes.
• In a section focused on maximizing reimbursement by Medicaid EPSDT (Early and Periodic Screening, Diagnostic, and Treatment), managed care, and accountable care organizations, Colorado’s accountable care system is highlighted. Colorado changed its accountable care system allowing for six episodic behavior health visits in either primary care or mental health settings without a qualifying mental health diagnosis. Legislative changes in 2018 resulted in three allowable maternal depression screenings during the infant’s first year of life.
• In a section focused on growing leadership outside of the government, Colorado’s work is highlighted. Colorado has a director-level state government position dedicated to IECMH within the Office of Early Childhood in the Department of Human Services. The role of the position is to institutionalize policy and practice around IECMH, create and execute an IECMH strategic plan, and provide internal and external IECMH expertise to state agencies and community-based organizations. Projects accomplished to date by the IECMH director include doubling the size of the IECMH consultation program from 17 to 34 state-funded, full-time equivalents; developing an IECMH training, reflective supervision and endorsement initiative for early intervention providers; and developing e-learning course material on understanding the impacts of implicit bias in child care.

Learn more about how Colorado 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.

Colorado 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.