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Building Equitable and Effective Partnerships With Rural and Indigenous Communities

Lee Hinton, Erin Lucas, and Ekaterina Zoubak


Leadership in infant and early childhood mental health must take into consideration issues of diversity, historical context, power dynamics, and difference in worldview and experiences. This article describes the importance of equitable and effective partnerships with rural/remote, underserved, and Indigenous communities in the United States and Canada. It is important to build strong, foundational, respectful relationships rooted in humility, mutual learning, and trust. Effective leaders must also consider diverse concepts of children, childhood, and mental health as they are understood by different communities. All strategies, decisions, and activities that are brought into a community must be adapted in partnership with members of that community and also must be culturally grounded and aligned with the philosophies and practices of the community.

The first 6 years of life are critical for optimal development and future well-being (Cassidy & Shaver, 2016; Cozolini, 2017; De Bellis, Hooper, & Sapia, 2005; Grossmann, Grossman, & Waters, 2006; Hughes, 2009; Oppenheim & Goldstein, 2007; Perry, 2002, 2008). To thrive, children require nurturing care, including meeting health and nutritional needs; opportunities for learning and exploration as well as security, support, and safety; and responsive caregiving that fosters attachment (Black et al., 2017).

Infant and early childhood mental health (IECMH) prevention and intervention services, within the context of the caregiver relationship, provide opportunities to foster optimal child development (National Research Council & Institute of Medicine, 2000). Research has shown that these opportunities become even more effective through the provision of IECMH programming across sectors and through a variety of care, early intervention, health promotion, parent education, psychological and psychiatric, and early childhood education services (Anderson, Shinn, & Fullilove, 2003; Britto et al. 2017; Burton, Cohen, & Jain-Aghi, 2014; Leach & Yarker-Edgar, 2009; Meisels & Shonkoff, 2000).

Ideally, these integrated and cross-sectorial services would be available within the community where the family lives. Moreover, benefits can be gained when members of the community recognize and value the importance of these services and support families to access them. Consequently, this article focuses on situations in which access to resources and services has been compromised due to cultural, historical, and geographic inequities and/or a variety of differing perspectives about the importance of early childhood development and mental health.

Photo: Scott Prokop/shutterstock

Services in rural and remote communities are underfunded or inconsistently funded, resulting in a predominant focus on crisis intervention instead of prevention and early intervention.

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