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Early Childhood Mental Health Consultation in Homeless Shelters: Qualities of a Trauma-Informed Consultation Practice

Livida Ondi, Kristin Reinsberg, Adriana Taranta, Amee Jaiswal, Andrea Scott, and Kadija Johnston

Abstract

This article describes the conceptual approach to, and practical aspects of, the Infant-Parent Program’s (IPP) decade-long experience providing early childhood mental health consultation in homeless shelters serving infants, young children, and their families. Illustrated by case examples, the authors discuss the characteristics of the consultant’s stance, practices, and role with parents and shelter providers developed in response to the need of mitigating the impact of trauma related to homelessness in young children.

The experience of homelessness, marked by sudden changes,threats to safety, unstable relationships, and layers of loss, is traumatic for both children and adults and can heighten the vulnerability of infants and young children (Grant et al., 2007). Families of color are at a higher risk due to the disproportionately high number impacted by homelessness (U.S. Department of Housing and Urban Development, 2017). The very process of competing for scarce housing resources can further expose these families to implicit bias and systemic discrimination. When adults are impacted by acute stressors and trauma, their capacity to attune and respond to the needs of young children may be compromised as their own need for internal regulation, safety, and protection can be at odds with their desire to meet those same needs for their child.

In providing shelter for homeless and traumatized families, it is a profound challenge to meet the variety, depth, and intensity of the needs. The focus on finding housing is necessarily prioritized over addressing mental and physical health issues, substance use/abuse, domestic violence, unemployment, discrimination, and other debilitating experiences. Meanwhile, the needs of infants and young children often recede to the background, or when attended to, their distress is typically understood and responded to as distinct from their caregiving circumstances. In their critical role of securing stable housing, shelter programs are placed in the untenable position of having to prioritize this goal over the myriad needs families are facing.

Nearly a decade and a half ago, aiming to mitigate the vulnerabilities homeless families face in the extreme housing shortage in San Francisco, the Infant–Parent Program (IPP) began providing early childhood mental health consultation (ECMHC) to homeless shelters. Bringing consultation, originally established for early childhood education sites, to shelter settings can enhance the staff’s capacity to integrate all members of the family into a more comprehensive housing plan; one in which adult’s and children’s concerns may be understood in the context of their relationship to one another. Consultants aim to help staff build empathy for parents and children, whose behaviors often reflect the immense stress and pressure they are experiencing, by supporting staff to consider and understand the needs of infants and young children and how they can provide containment, consistency, and safety during a time of significant upheaval.

Case examples highlight the ways that families and staff in homeless shelters can benefit from a relationship-focused, developmental, and trauma-informed approach to ECMHC. The examples begin by describing possible opportunities for the consultant to bring infants’ and young children’s needs to the forefront. The authors then outline the ways the consultants address the needs for self- and co-regulation during acute and ongoing crisis and set the stage for reflective exploration of the family’s needs and the staff’s own experience.

Photo: globalmoments/shutterstock

When adults are impacted by acute stressors and trauma, their capacity to attune and respond to the needs of young children may be compromised.

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