Transforming Child and Family Mental Health in Washington, DC

Physical and mental health and well-being are core components of the two-generation approach that builds family well-being by intentionally and simultaneously working with children and the adults in their lives to move whole families toward educational success, economic security, and health and well-being.

Childhood trauma, for instance, has lasting health and social consequences. Similarly, economic supports, such as housing, and social capital, such as connections to one’s neighborhood and community, are important social determinants of health. The dynamics of local, state, and federal ecosystems are critical factors in identifying barriers and opportunities for increasing the health and well-being of children and families.

With the generous support of the Alexander and Margaret Stewart Trust; Children’s National Hospital, MedStar Georgetown University Hospital and Georgetown University Medical Center, and Ascend at the Aspen Institute co-hosted a four-part dialogue to inspire visionary change in mental health promotion, prevention, and treatment for children and families in the Nation’s Capital.

Over 10 months, the series engaged national leaders and region-wide stakeholders to build political will, knowledge, and relationships to rethink mental health systems in the region – highlighting the latest research and best policy and practices in the field of whole family-focused mental health.

Below are snapshots of takeaways from each conversation in the series.

1. Reimagining Mental Health Promotion, Prevention, and Treatment: New Models, Lessons Learned, and Opportunities for Innovation

Takeaways

• Focus on brain health: identify, convene, and organize key entities from all sectors that comprise your brain health system under a vision and an initiative structure
• Understand the system from the people experiencing it—family and community involvement is essential – “People First”
• Think in terms of a system of care instead of health care
• Continue conversation with a sense of urgency and understand the process requires patience
• Break down silos 
• Map the system
• Bring services to communities 

Resources

• Behavioral Health in the District of Columbia for Children, Youth, and their Families: Understanding the Current System
• Principles and Values to Guide Child and Adolescent Public Behavioral Health Care System Transformation in the District of Columbia
• 2019 Colorado Legislative Review
• Austin State Hospital Brain Health System Redesign

2. Advancing School-Based Mental Health: Policy, Practice, and Programs

As a continuation of conversations in the first two parts of this series – Olga Price, PhD., associate professor in the Department of Prevention and Community Health and director of the Center for Health and Health Care at George Washington University joined us for a conference call to follow up on her work designing a system dynamics approach to comprehensive school behavioral health in Washington, DC.

Local and national experts in school-based mental health addressed how school-based mental health programs can provide critical support to children and families living in communities impacted by high rates of violence. Topics included trauma-informed care, resilience, and building programs from a strength-based perspective.

Takeaways

• How can organizations and communities engage with schools to respond to increasing rates of violence and build a plan that strengthens partnerships
• Important to take trauma-informed approach
• Families, communities, and students should be engaged in a multi-disciplinary process focused on strength-based work

3. The Building Blocks of Sound Mental Health: Re-Imagining Systems of Care in Early Childhood

Leaders and experts driving meaningful cross-sector collaborations and systems change in early childhood behavioral health explored how in this early period of opportunity, we can learn from, build on, and support families’ inherent resilience for sound mental health development.

Takeways

• Early childhood is where brain health begins
• 2-gen approach and cross sector collaboration is important
• Braided funding is essential for high quality programming
• There are programmatic, policy, and funding opportunities in the increased understanding of the importance of mental, emotional and behavioral health, particularly in early childhood
• There is a gap between an understanding of the importance of early care and learning and integrated systems that address the social and emotional needs of infants and young children
• Family and community voice should authentically inform all stages of program and policy development, implementation, and evaluation
• Partnerships are essential – as are champions
• Education and training for teachers, administrators, and families are critical

Resources

• Flow of State and Federal Funds into the South Carolina Early Childhood State System

4. Stopping Behavioral Health and Substance Use Disorders Where They Start: Prevention and Treatment in Adolescence

Like all areas of behavioral health, prevention and early intervention for adolescent behavioral health and/or substance use disorders is critical. And, we know that times of crisis increase the prevalence of behavioral health disorders and substance use, making this conversation all the more urgent.

In this conversation local and national leaders shared how they are innovating to prevent, intervene, and be on the leading edge of behavioral health and substance use disorder prevention and treatment among adolescents and young adults.

Takeaways

• Age group of emerging adults faces rapid brain growth and new psychological and social challenges
• Social ramifications of COVID have profoundly affected this age group and there are serious concerns about the future
• More research is needed to better understand the strengths and vulnerabilities among this age group, especially among minority communities
• A developmentally specific approach is necessary—programs and interventions must be crafted in a way that is specific to the challenges of this age group
• It is important to work across professions and specialties in order to produce the best work
• Engagement, flexibility, and persistence is essential to successfully reach young people 
• It is vital to have an awareness of mental health in all places where young people are engaged—reducing stigma is critical if all of these systems are interfacing with young people
• Need to maintain a contextual understanding of how young people are living, i.e., events in Minneapolis and elsewhere, and their impact
• The most important tool we have is a culture in which youth voices are valued

Resources

• District of Columbia Department of Human Services Youth Services Division Supporting Our District Youth

Each conversation in this series was led and moderated by Lee Beers, MD, medical director, Municipal and Regional Affairs, Child Health Advocacy Institute at Children’s National Hospital and Matthew Biel, MD, MSc, division chief of Child and Adolescent Psychiatry and associate professor of Clinical Psychiatry and Pediatrics, Georgetown University School of Medicine.

Lee and Matt co-direct the Early Childhood Innovation Network – a local collaborative of health and education providers, community-based organizations, researchers, and advocates promoting resilience in families and children from pregnancy through age 5 in Washington, DC.