Policy Pick: Improving Mental Health Care for Young Children

• Postpartum depression, which affects eight to 15 percent of new mothers, also hurts babies. It is associated with maternal drug or alcohol use and disrupts bonds between mother and child. Infants and toddlers of depressed mothers can develop serious emotional and attachment disorders (Onunaku, N., 2005).
• Preschoolers are expelled at a rate three times higher than children in K–12 programs nationwide (Gilliam, W.S., 2005). "About eight percent of all preschoolers (children aged 3–5 years) exhibit behavioral problems severe enough to warrant a psychiatric diagnosis"(Keenan, K., & Wakschlag, L.S., 2004).
• “Unidentified and untreated mental disorders can mean the loss of critical developmental years and can lead to youth suicide, school failure, and involvement with the juvenile justice and criminal justice systems” (NAMI, MHA, CHADD, CABF, FFFCMA, AACAP, 2007).
• Nearly seventy percent of children in foster care will experience a mental illness (Little Hoover Commission, 2001). As of July 1, 2007, more than 7,500 children age 5 and under were in foster care in L.A. County (UC Berkeley, 2007).
• Mental illness can be diagnosed in the early years of life. Depression and Post Traumatic Stress Disorder can be detected before one year of age (Luby, J., 2000 and Blank, M., 2007) and effectively treated through dyadic intervention with a qualified infant mental health practitioner.
• “Increasing services for children under the age of five would reduce the number of school-age children requiring mental health services for serious disorders” (ZERO TO THREE, 2007).
• Unlike most disabling physical diseases, mental illness begins very early in life. Half of all lifetime cases begin by age 14; three quarters have begun by age 24. Thus, mental disorders are really the chronic diseases of the young” (National Institute of Mental Health).

The facts speak for themselves: L.A. County should dedicate 75 percent of MHSA-Prevention and Early Intervention funds to 0-25 year olds, particularly on programs for children age 5 and under and their families or caregivers. Supporting effective programs to promote early childhood mental health, preventing the onset of mental illness in children and youth, and supporting early intervention in the earliest years of life is a high yield investment. It will reduce public costs and increase the quality of life for families and communities. Children will experience lifelong benefits and many will require less treatment in future years as a result.

For a schedule of upcoming meetings, see dmh.lacounty.gov. For more information or to get involved, contact Kate Sachnoff at ksachnoff@first5la.org, or Marc Davidson at mdavidson@first5la.org.

Updated 3/08

Full Citations

Onunaku, N. Improving Maternal and Infant Mental Health: on Maternal Depression. Los Angeles, CA: National Center and Early Childhood Health Policy at UCLA; 2005. Retrieved on January 28, 2008. Click here for report.

Gilliam, W.S. Prekindergarteners left behind: Expulsion rates in state prekindergarten programs (Abbreviated as Foundation for Child Development Policy Brief Series No. 3, May 2005). Retrieved January 28, 2008. Click here for report.

Keenan, K., & Wakschlag, L.S. (2004). Are oppositional defiant and conduct disorder symptoms normative behaviors in preschoolers? A comparison of referred and nonreferred children. American Journal of Psychiatry,161, 356–358 as cited in Gilliam, W. S. & Shahar, G. (2006). Preschool and Child Care Expulsion and Suspension: Rates and Predictors in One State. Infants & Young Children, Vol. 19, No. 3, pp. 228–245. retrieved January 3, 2008. Click here for report.

Coalition of mental health organizations including NAMI, MHA, CHADD, CABF, FFFCMA, AACAP. (2007). Improving the Mental Health & Well-being of America's Children. Retrieved January 3, 2008. Click here for report.

Little Hoover Commission. (2001). Young Hearts & Minds: Making a Commitment to Children’s Mental Health ER 04624; Retrieved January 3, 2008. Click here for report.

Needell, B., Webster, D., Armijo, M., Lee, S., Dawson, W., Magruder, J., Exel, M., Zimmerman, K., Simon, V., Putnam-Hornstein, E., Frerer, K., Ataie, Y., Atkinson, L., Blumberg, R., Henry, C., & Cuccaro-Alamin, S. (2007). Child Welfare Services Reports for California. Retrieved January 3, 2008. Click here for report.

UCLA Center for Healthier Children, Families and Communities and First 5 LA. (2007). Achieving Improvement in a System of Early Identification and Intervention in Los Angeles County. Retrieved January 18, 2008. Click here for report.

Glascoe, F.P. and Shapiro, H. (2004). Introduction to Developmental and Behavioral Screening. American Academy of Pediatrics: Section on Developmental and Behavioral Pediatrics. Retrieved January 3, 2008. Click here for report.

For Depression: Luby, J. (2000). Depression. In C. Zeanah (Ed). Handbook of Infant Mental Health (pp. 296-382). As cited in ZERO TO THREE. Infants and Toddlers and the California Mental Health Services Act. (Washington DC: ZERO TO THREE, July 9, 2007). Retrieved January 3, 2008. Click here for report.

For PTSD: Blank, M. (2007). Posttraumatic stress disorder in infants, toddlers, and preschoolers: Play therapy, psychoeducation, and family support are key when trauma affects children in the preverbal and early verbal years. BC Medical Journal.Vol. 49, No. 3, pp 133-138. Retrieved Jan 28, 2008. Click here for report.

ZERO TO THREE. Infants and Toddlers and the California Mental Health Services Act. (Washington DC: ZERO TO THREE, July 9, 2007). Retrieved January 3, 2008. Click here for report.

National Institute of Mental Health. (June 2005). Press Release: Mental Illness Exacts Heavy Toll, Beginning in Youth (National comorbidity survey replication [NCS-R]). Click here for report. The full study is available here.