220 likes | 350 Views
What Is an Infant Mental Health Intervention?. Focuses on infants and children 0-5 years of ageSeeks to optimize social and emotional development of young childrenIs a multi-disciplinary approach involving psychiatry, psychology, social work, and pediatrics. 2000 MCH Needs Assessment
E N D
1. Healthy Beginnings A Collaborative Infant Mental Health Intervention in a Public Health Clinic
2. What Is an Infant Mental Health Intervention? Focuses on infants and children 0-5 years of age
Seeks to optimize social and emotional development of young children
Is a multi-disciplinary approach involving psychiatry, psychology, social work, and pediatrics
3. 2000 MCH Needs Assessment #1 Priority = Mental Health Access
4.
5. 2000 MCH Needs Assessment Suicide and Homicide rates far exceed 2010 goal
Community surveys list substance abuse and homicide as primary concerns
Mental health access to services ranked #1 priority
Must begin in infancy to prevent adolescent problems
6. Collaborators Tulane Child Psychiatry Department
Children’s Bureau
LA Office of Public Health
Region I Office of Mental Health
Institute for Mental Hygiene
New Orleans Health Department
7. Collaborator Roles Tulane Child Psychiatry:
provides:
two part-time supervising psychologists
psychiatry fellow
senior psychiatry faculty supervision
one full-time clinic psychologist
(program director)
administers the HB grant from IMH
8. Collaborator Roles Children’s Bureau: provides two social workers and one case manager
LA Office of Public Health: funds Children’s Bureau social workers and NOHD MCH nurse coordinator
Region I Office of Mental Health: provides half time social worker
9. Collaborator Roles Institute for Mental Hygiene: provides funding through $125,000 grant to Tulane
New Orleans Health Department:
provides:
primary care (EPSDT) and WIC services
referrals to Healthy Beginnings Program
nursing and clerical support
physical space in Mary Buck Clinic (paid by grant)
10. Governance MOA written with help of facilitator and signed in fall of 2001
Operations Committee: senior representation for each organization; meets quarterly
Evaluation Committee: oversees research, data management, and program outcomes
Clinic Coordinating Committee: oversees clinic policies, forms, referrals, and feedback to providers
11. Clinic Operations Children with risks identified are invited to schedule an appointment with a HB social worker
An assessment is conducted over several visits and immediate and long-term treatment goals are formulated with the caretaker
A home visit is conducted as part of the assessment
Family is given choice of clinic or home for future sessions
12. Clinic Operations All assessment data is entered into the database
A caseworker links family with needed community social services
Interdisciplinary case conferences are held weekly with clinic and HB staff
Families are followed until goals are met or family is lost to follow-up
14. Achievements in First Two Years A 30 hour training was held for 3 clinic physicians and 33 nurses in identifying infant mental health problems
Facility was renovated to accommodate HB staff using grant funds
15. Achievements in First Two Years Undoing Racism workshop held
Over 143 children were served; 33 are still active
Assessment process was shortened
Collaborator relationships continue to develop
16. Demographics of Population Served
66% males; 34% females
Average age 24 months
Average income below $10,000
93% African American, 4.8% Caucasian, 1.6% Hispanic, .8% Pakistani Indian
17. Referral Concerns Physical aggression
Temper tantrums
Hyperactivity
Inattention
Developmental Delays
Anxiety disorders
Feeding disorders
Adjustment problems
Withdrawn behaviors
Childhood depression
Maternal depression (approximately 50%)
Domestic violence
Physical abuse
Parenting concerns
18. Assessment Tools Achenbach Child Behavior Checklist (CBCL) Ages 1 1/2 - 5
Infant Toddler Social Emotional Assessment (ITSEA) Competence Scale
Disturbances of Attachment Interview (DAI)
Parent-Child Interaction
19. Assessment Tools Beck Depression Inventory (BDI-II)
Parent Perception Interview
Partner Violence Inventory (PVI)
Omitted:
HOME inventory
Vineland
Maternal Self-Efficacy Scale
20. Lessons Learned Early mental health intervention is possible in a public health clinic with limited funding
Collaborative efforts can bring cost-effective, state of the art interventions
Communication between collaborators is key; cultural, professional, and institutional barriers need to be expected and addressed
21. Key Players Tulane: Paula Zeanah, PhD, MSN
Julie Larrieu,PhD
Shana Bellow, PhD
22. Key Players OMH: Guilda Butler, LCSW
Children’s Bureau: Ron McClain, LCSW, Letia Bailey, LCSW
OPH: Stacia Loveall, MSW, MPH