National Center for Effective Mental Halth Consultation
   

A Brief History of Influences on Mental Health Services in Head Start

From its inception, Head Start (1965) has recognized that social and emotional health are essential aspects of a child's development and a foundation for a child's capacity to recognize and regulate emotions, build relationships, learn, and succeed in school ( Hunter, A. and O'Brien, J., 2009). Initially described as "social competence", Head Start has always focused on promotion of both a child's and family's positive self-worth with respect for individual differences and belief in the ability of children and families to achieve social competence — positive self-esteem, self-confidence, and increased strength and ability to positively address life challenges and realize their full potentials. Over the years, there have been a number of influences that helped to focus on mental health services and mental health consultation in the Head Start and Early Head Start (HS/EHS) programs. Some of these are illustrated on the timeline below.

  1. Head Start established Included Psychological Services focused on intervention and treatment
  2. Performance Standards First Published
  3. Philosophy and services name change to Mental Health and prevention focus
  4. Review of HS Mental Health services effectiveness
  5. MH in Head Start: A Wellness Approach published
  6. Early Head Start Established
  7. Lessons from the Field published
  8. Revised Performance Standards implemented
  9. Infant MentalHealth Forum HS Training Guides published
  10. EHS Mental Health Initiative Pathways to Prevention
  11. Center for Social Emotional Foundations of Early Learning
  12. Head Start Child Social/ Emotional Outcomes Framework The Family Connections Project
  13. Center for Early Childhood Mental Health Consultation

Significant Influences on Mental Health Services in Head Start

  • Program Requirements/Performance Standards: All Head Start and Early Head Start (HS/EHS) programs strive to meet the program requirements described in the Head Start Program Performance Standards. The Program Performance Standards, first published in 1972, provide a foundation on which programs build their comprehensive program, including mental health services and mental health consultation. Mental health services are intended to support the social and emotional health of children, families, and staff through diverse strategies such as screening, assessment, and referral for specialized services; involving and educating families and staff, offering mental health consultation, and building linkages with community partners.
    The creation of the Early Head Start program and the Revised Performance Standards (1998) strengthened the cross-service area integration of mental health services within HS/EHS with specific attention to the inclusion of infant and family mental health, a focus on maternal depression, the emphasis on mental wellness of staff, and serving children with disabilities. The revised standards also included an expanded description of mental health consultation; specifying requirements to provide consultation, the qualifications for the consultant, and a schedule for consultation services. There are now more than 40 standards related to promoting and supporting mental health (Brown, 2009). Most recently, the Improving Head Start for School Readiness Act of 2007 continues to uphold Head Start and Early Head Start's commitment to the social and emotional well-being of young children, their families, and staff. Although revisions to program regulations may occur, the current Head Start and Early Head Start Performance Standards remain in effect until further notice from the Office of Head Start (Brown, 2009).
  • Reviews, Research, and Publications: Within the Head Start and Early Head Start community, periodic reviews, research and publications have focused on the perception and understanding of children's mental health, mental health services delivery approaches, mental health consultation, integration of mental health services in HS/EHS programs, and the impact on children, families, and staff. Many of these resources have informed new thinking, helped to establish a framework for child social/emotional development outcomes, and influenced models of practice in all areas of mental health (classroom curriculum, screening and assessment, intervention, etc.). Some have focused on how to make mental health services and mental health consultation more effective (Borg & Irwin, 2002; ZERO TO THREE, 2001; Green et al, 2003; Yoshikawa & Knitzer, 1997).
  • The Science of Child Development: Within and outside of Head Start and Early Head Start, the science of child development contributed new understanding of infant and early childhood brain development, behavior, mental health, and learning (National Research Council and Institute of Medicine, 2000). The new understanding stimulated efforts to more clearly define infant and early childhood mental health and design HS/EHS program services, including mental health services, accordingly. The outcomes of the Infant Mental Health Forum helped Early Head Start programs turn their attention to services and supports that would promote infants' and toddlers' ability to experience, regulate, and express emotions, form close and secure interpersonal relationships, explore the environment and learn in the context of family, community, and cultural expectations. (Stark et al, 2002) Likewise, Head Start programs focused their attention on the preschoolers' growth in recognizing and regulating emotions, the capacity for social interaction and relationship building, curiosity, initiative, resilience, and school readiness.
  • Training and Technical Assistance Resources: A diverse collection of guides, staff development materials (training guides), other publications, and specialized technical assistance (centers and supports) have helped programs, staff, and families have a better understanding of mental health and its important role in child development, family support, staff wellness, and program effectiveness. These resources help Head Start and Early Head Start programs design mental health services within their program, integrate mental health consultation, and address the three levels of mental health services: promotion of healthy social and emotional development in daily interactions, prevention of behavioral difficulties for those children at risk, and intervention for children exhibiting persistent behavioral difficulties. Technical assistance has also brought research to practice and a focus on identifying and measuring child and family social and emotional outcomes.

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