The District of Columbia Advances Infant and Early Childhood Mental Health Assessment, Diagnosis and Treatment
This article summarizes key themes from The District of Columbia'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.
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 DC include:
In a section focused on maximizing reimbursement by Medicaid Early and Periodic Screening, Diagnostic, and Treatment (EPSDT), managed care, and accountable care organizations, the District of Columbia is highlighted. DC allows pediatric primary care providers to conduct a maternal depression screening as part of a well-child visit during the first year of the infant’s life. In addition, a major focus by the District of Columbia Collaborative for Mental Health in Pediatric Primary Care is to increase social-emotional and mental health screenings in well-child visits. A quality improvement learning collaborative worked with nearly every major provider practice to improve mental health screening, and the Department of Behavioral Health funded the DCMAP program (District of Columbia Mental Health Access in Pediatrics). DCMAP allows pediatricians to use a hotline to get immediate access to a team of child mental health professionals who are on call and can help with medication management questions, care coordination, and other issues. Currently, another learning collaborative with pediatric providers and early childhood providers is trying to determine how child development and social-emotional screening information could be shared among providers (e.g., medical and child care) to avoid duplication and to track referrals and follow-through rates.
In a section focused on integrating IECMH within primary care, home visiting, child care, early intervention, child welfare, and related fields, the District of Columbia’s work is highlighted for its inclusion of developmental and mental health screening in pediatric primary care. A challenge is connecting families to follow-up care when needed, as there is a lack of IECMH providers. A local collaborative is also piloting an effort to embed a mental health clinician into an obstetric practice at the largest delivery hospital that serves women who are at high risk of poor pregnancy outcomes, including maternal depression.
Learn more about how DC 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.
DC 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.