Health Affairs GrantWatch Blog on August 7, 2013.This article first appeared in the
by Whitney Gustin Connor
Early childhood mental health status affects the well-being of every family with young children. Estimates of the number of children suffering from serious mental health problems vary greatly depending on the study cited; national estimates range from 5 percent to 26 percent. Many more children, however, may have difficulties in the social and emotional realm that do not reach the level of “serious” but interfere with the child’s optimal development and ultimately affect their ability to be ready for school, their long-term health and their ability to achieve life-long success.
The emotional quality of the parent-child relationship in particular has a profound effect on young children’s mental health. Risk factors that can negatively impact the quality of these relationships and compromise children’s mental health include environmental factors, such as exposure to violence, chronic fear and stress, abuse and neglect, poverty, maternal depression, parental substance abuse, teenage parents and foster care; and biological factors, such as prematurity and low birthweight.
With shared grantmaking priorities in early childhood and prevention, Rose Community Foundation and Caring for Colorado Foundation recognized an opportunity to work together on an issue critical to young children’s life-long success and well-being: their social-emotional development or mental health. These two terms are often used interchangeably to describe the developing capacity of children ages birth to five years to form close and secure adult and peer relationships; experience, manage and express a full range of emotions; and explore the environment and learn.
Convening Philanthropic Leaders and Engaging Partners
Identifying a problem and then convening and mobilizing the appropriate community partners is a core operating principle of Rose Community Foundation. For many years, two of Rose Community Foundation’s program areas have supported young children’s mental health services in pediatric, K-12, early childhood education and home-based settings. In 2011, Rose Community Foundation’s senior program officer in Health and senior program officer in Child and Family Development began working together to more strategically address the issue. With support from the foundation and close relationships with other health and early childhood funders and stakeholders, the two programs were in a strong position to move forward collaboratively both within the foundation and in the broader community.
In November 2011, Rose Community Foundation’s Health and Child and Family Development Committees hosted an education session that included staff from other early childhood and health foundations and individual donors. (Each program has its own committee made up of community leaders and content experts who advise the program officers on grantmaking activities and approve individual grant requests.) This session featured an expert panel discussing the prevalence of child mental health issues, Colorado programs addressing children’s mental health, and policies influencing access to prevention and intervention services. The session resulted in Rose Community Foundation’s commitment to move forward on early childhood mental health, and a new partnership on the issue was solidified with the Caring for Colorado Foundation.
Learning the Landscape
Much work has been done in Colorado on early childhood and on mental health, but few programs or policies appeared to specifically address or support young children’s mental health.
To learn more, Rose Community Foundation and Caring for Colorado Foundation hired JFK Partners, a local consulting firm, to identify opportunities and barriers and develop recommendations around philanthropy’s potential role. The goal was to find ways that funders could address the unmet mental health needs of Colorado’s young children and their families in the areas of promotion of mental health, prevention of mental illness, and treatment of mental illness through effective programs and policy solutions. The resulting environmental scan report (PDF) included: (1) an extensive literature review; (2) an analysis of key informant interviews and focus groups — participants included representatives from other funders as well as community stakeholders; and (3) a summary of early childhood mental health service data on Colorado. The data provided an understanding of the current status of early childhood mental health and built upon Colorado’s Strategic Plan for Early Childhood Mental Health (Fall 2008).
Seven goal areas were presented in the 2013 report (PDF): Public Engagement, Professional/Workforce Development, Funding, Program Availability, Integrated System of Care, Child and Family Wellbeing and School Readiness. Finally, the report also included an appendix that mentioned “Philanthropic investment and partnerships in other states.”
In early 2013, potential community partners and funders attended JFK Partners’ presentation to a joint session of Rose Community Foundation’s Health and Child and Family Development Committees. Understanding the breadth of the issue, the two committees encouraged the program officers to continue working with other funders and to build upon existing successes.
Moving Forward with a Funders Learning Collaborative
Since that joint session, Rose Community Foundation and Caring for Colorado Foundation have reconvened Colorado’s early childhood and health foundations as a funders learning collaborative with a focus on systems-level change. The group’s shared vision is that all children are physically and emotionally healthy and safe, ready for school and life and able to reach their full potential.
The collaborative brings together different funder communities to develop a shared understanding of early childhood mental health and to create a common goal containing strategies to accommodate individual foundations’ own priorities. The first learning session highlighted Colorado’s new Office of Early Childhood and Help Me Grow, a national program that helps high-risk children and their families connect to necessary services. A subgroup of the collaborative recently began focusing on goals and strategies.
Rose Community Foundation and Caring for Colorado Foundation program officers have also reached out to public- and private-practice pediatricians, Medicaid leadership, policy makers and integrated care experts in the state, and they continue to learn from foundations across the country that have developed their own early childhood mental health initiatives, including Health Foundation for Western and Central New York, The Healthcare Foundation of New Jersey and The Children’s Fund of Connecticut.
Not surprisingly, the early childhood mental health collaboration has faced challenges. One early lesson was the importance of language, because not everyone recognizes the interchangeability of the terms “social-emotional development” and “early childhood mental health.” Other challenges include the continued stigma around mental health issues; the fact that many mental health programs and policies focus on adults; many educators’ exclusive focus on academics; the myriad funding needs in the area of early childhood mental health; and determining how to demonstrate impact on an issue that is difficult to measure. Rose Community Foundation and Caring for Colorado Foundation are well-positioned to take on these challenges with the strong support of these foundations’ leadership and the diverse coalition of funders that have become partners in promoting young children’s mental health.