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Lamprey Health Care (LHC) – New Hampshire's (NH) first federally qualified community health center and the oversight agency for the Southern NH Area Health Education Center (SNHAHEC) that focuses on health professions education – is partnering with the Center for Trauma-Responsive Practice Change (CTRPC) to implement NEST – the NH Early Childhood and Family Mental Health System of Treatment (NEST) project. CTRPC provides expert training and consultation in trauma-responsive practices/systems for human service and state agencies throughout NH. With funding from SAMHSA's Infant and Early Childhood Mental Health Services (IECMH) initiative, LHC and CTRPC will expand access to age-appropriate, evidence-based IECMH interventions among NH children exposed to Adverse Childhood Experiences (ACEs) and their caregivers (Goal 1), achieved through the following objectives: increase the number of trained Child-Parent Psychotherapy (CPP) providers by 50% for a total of 180 CPP providers; increase the number of CPP providers who receive specialized training in working with immigrant families/POC and children and families exposed to SUD, for a total of 60 CPP providers; provide CPP to at least 200 children aged 0-6 with exposure to ACEs; and increase utilization of CPP among immigrant/refugee families by engaging cultural brokers to connect 15 families to services. LHC and CTRPC also aim to improve the capacity of early care and education programs and child- and family-serving professionals to provide trauma-informed, culturally responsive services to young children exposed to ACEs (Goal 2) through the following objectives: educate and consult with at least 500 professionals/providers throughout NH about the impact of trauma on children and families and available interventions, including CPP; and decrease the CPP intake time to less than 30 days by developing and implementing an expedited screening and referral system in partnership with the state's SAMHSA-funded System of Care (SoC) for Children's Behavioral Health. LHC and CTRPC will strengthen and sustain NH's IECMH infrastructure at the state and local levels (Goal 3) through the following objectives: increase NH's CPP trainer pool by 50% by conducting a CPP apprentice training program that will result in 3 certified CPP trainers in NH, create and implement an NH CPP Network database to track provider availability, referrals, service delivery, and outcomes; and develop a sustainability plan that identifies public and private funders and advocates to perpetuate CPP training, trauma-informed care, and IECMH delivery. LHC and CRTPC will serve 250 individuals each year for a total of 1,250 individuals, including children and families who receive screening and referrals for CPP and those who receive CPP. LHC and CRTPC will train 175 individuals per year for a total of 875 individuals, including early care and education providers who receive consultation, child and family-serving professionals who receive training, and mental health clinicians who participate in the CPP learning communities. LHC and CRRPC will partner with the following organizations to implement NEST: Amoskeag Health's Training and Technical Assistance Center for ACE Response Team teams throughout NH; Boston Medical Center Child Witness to Violence Project to provide training on diversity, equity, and inclusion; Boston University School of Social Work that will provide training in SUD-informed CPP interventions; Center for Program Design & Evaluation at Dartmouth that will provide mixed-methods evaluation services; Preschool Technical Assistance Network that will engage early childhood care providers and child- and family-serving professionals for consultation; and the NH Dept. of Health & Human Services that oversees the state's child welfare agency, the Division of Behavioral Health (DBH) that funds the SoC, and is developing the Child Behavioral Health Resource Center that will incorporate CPP Provider Network information.

CPNJ’s IECMH Program will fill the gap in service for direct behavioral health services as well as address the need for greater training within densely populated northern NJ in order to address the lack of early identification and appropriate intervention by child and family-serving professionals for infants and children under 12 years old who are at risk of, showing early signs of, or having been diagnosed with a mental illness, including a serious emotional disturbance (SED) as well as children with a history of in-utero exposure to substances that may impact development. With the goal of improving access to behavioral health services for children under 12, the CPNJ IECMH project will provide evidence-based age-appropriate screening, assessment and intervention services to at least 700 of children under 12 at risk of, showing early signs of, or having been diagnosed with a mental illness, including a serious emotional disturbance (SED) including children with a history of in-utero exposure to substances that may impact development. Additionally, we will seek to have 90% of children under age of 12 receive initial services within 10 days of inquiry. By the end of the project, CPNJ will provide multigenerational team-based services that promote positive care-giving relationships for 700 families and other caregivers of infants and children with or at high risk for mental illness. With the goal of building workforce capacity (training and consultations) among early care and education programs and service providers, CPNJ will provide infant and early childhood mental health training to at least 100 child and family-serving professionals including direct support for integration of infant and early childhood mental health assessment across their diverse disciplines and roles. CPNJ will provide 100 outreach and community engagement to child and family-serving professionals in order to promote community education and prevention. CPNJ will provide 50 trainings and consultations to other disciplines and organizations such as schools, care providers engaged with the target population. CPNJ will provide 50 specialized trainings and consultations over the lifetime of the grant period to mental health clinicians providing treatment in infant and child and early childhood mental health. The goal is to train 700 individuals in the course of the grant. Finally, CPNJ will implement plans for sustainability to ensure delivery of services once federal funding ends. By the end of the project period, training on Infant and Early Childhood mental health will be fully integrated as a requirement in CPNJ’s annual training for all clinicians working with this population. By the end of the year 2 a sustainability plan will be completed in order to maintain committed staffing level to provide ongoing direct behavioral health services and trainings within the catchment area. CPNJ will adopt the evidence-based approach to IECMHC through the Center of Excellence for Infant and Early Childhood Mental Health Consultation and the IECMHC Toolbox. CPNJ will utilize the organizational expertise and success as a SAMHSA Funded CCBHC and Bergen Trauma and Training Center, as well as expand the workforce dedicated to and trained in infant and early childhood mental health. CPNJ has a commitment from numerous community partners to ensure success implementation of the IECMH Project.

The Baystate Behavioral Health Center for Young Children and Families (CYCAF) at Baystate Health has the overarching goal of addressing critical gaps in services for infants and young children ages 0-5, prioritizing Latino children, who show early signs of or who have been diagnosed with mental illness including serious emotional disturbance (SED) and/or symptoms that may be indicative of developing SED, including children with a history of in-utero exposure to substances and their caregivers. CYCAF will achieve this goal in the following overlapping phases: 1. Increasing access to assessments and evidenced based practices (EBP) for treatment of early childhood mental health concerns for children 0-5 y/o and their caregivers by providing trauma informed mental health assessments (350 assessments over the course of the project), multigenerational evidenced-based therapy (250 children and families served over the course of the project) and access to a peer navigator with lived experience to help engagement, coordination of services and provide short term follow up (serving 375 families over the course of the project). 2. Providing specialized IECMH consultation to early childhood educational programs including direct care workers (50 group consultations a year using reflective supervision to improve engagement and decrease burnout in staff, 500 children served though on-demand classroom consultation) and building the capacity of infant and early child-serving service systems (CSSS) to identify, respond effectively to, and prevent mental illness in children 0-5y/o who are at risk for or have been diagnosed with mental illness and their caregivers by providing training in the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC-0-5), Collaborative Problem Solving, and special topics related to the target population (890 CSSS professionals trained over the course of the project). 3. Strengthening IECMH competence in the mental health workforce at all stages of career in order to promote sustainability by providing training in the following EBPs: Parent-Child Psychotherapy, Collaborative Problem Solving, Mothering from the Inside Out, as well as DC 0-5 for clinical professionals (122 mental health providers trained in the course of the grant) and incorporating IECHM didactics in mental health higher educational levels (psychiatry residents and fellows, psychology and social work students) and creating CYCAF rotations for two child psychiatry fellows and two psychology doctoral students a year in order to promote interest and increase competency early in their careers. Thus, CYCAF will address critical gaps in services for infants and young children with behavioral health needs with the ultimate goal to achieve better long-term outcomes for children and caregivers by identifying, and intervening with, children at an early age in order to prevent the development of SED.

The Center for Autism and Early Childhood Mental Health at Montclair State University and the YCS Institute for Infant and Preschool Mental Health) propose the Clinical Formation Initiative in Infant and Early Childhood Mental Health to the Department of Health and Human Services, Substance Abuse and Mental Health Services Administration for consideration in the FY22 Infant and Early Childhood Mental Health funding opportunity announcement (SM-22-006). The purpose of the Clinical Formation Initiative in Infant and Early Childhood Mental Health (CFI) is to saturate communities with a quality promotional and preventative support system which centralizes early relational health and to ensure equitable access to an infant and early childhood mental health treatment workforce who are competent, confident and capable to ameliorate relational and emotional concerns for children aged birth to 12, so as to ensure family well-being in the most formative years of life and reduce future severe emotional disturbance. The target population of the Clinical Formation Initiative will be infants, children and their families, aged from pregnancy through 12 years, and the workforce that provides family support services and clinical treatment services to these families, in the counties of Essex, Hudson and Passaic in New Jersey. Goals of the Clinical Formation Initiative in Infant and Early Childhood Mental Health include: (1) To improve outcomes for children from birth up to 12 years of age at risk of developing or being diagnosed with a relational disruption, emotional disturbance and/or developmental concerns; (2) To improve the professional competency of the multidisciplinary early relational health workforce to provide promotion, prevention and treatment services to children and families from pregnancy through age 12 years (3) To evaluate the implementation and impact of the program for replication and sustainability in additional counties. To meet these goals, the CFI will engage in five activities: (1) Provision of culturally and developmentally appropriate promotion, prevention, early intervention, and treatment services to the pregnancy through age 12 population; (2) provide the short-term, external model of Infant and Early Childhood Mental Health Consultation already operating in New Jersey, known as SEFI Support; (3) provide training to the promotional and preventative child and family-serving professional community, also known as the early relational health workforce including the original 21-hour curriculum, Keeping Babies and Children in Mind, which has been operating in our state since 2012; (4) provide specialized training and supervision for mental health clinicians in infant and early childhood mental health, including specific training in promising and evidence-based practices and models for prevention, early intervention, and treatment, with particular focus on children experiencing trauma or other adverse childhood experiences including specific training in evidence-based models of intervention that address trauma (Child-Parent Psychotherapy and Attachment, Regulation and Competency), and (5) the development of Sustainability Plan and replication plan for the future. We anticipate that over 400 more families will be served in clinical practice, over 500 multidisciplinary professionals will experience training in IECMH promotion and prevention, over 20 programs per year will benefit from IECMH Consultation and at least 60 clinicians within the Children's System of Care will learn clinical practice that addresses the birth through age 6 population.

This project will serve children ages 0-5, and their parent or caregiver, who are enrolled in an early childhood program with Children’s Home & Aid. The project will be implemented in two phases. In phase 1, the project will focus on two large Head Start-funded early childhood care and education centers operated by Children’s Home & Aid. These are the Mitzi Freidheim Englewood Child & Family Center, which serves 164 children and their families and is located in the southside Chicago neighborhood of Englewood, and the Marletta Darnall Schaumburg child & Family Center, which serves 136 children and their families and is located in the suburb of Schaumburg. In phase 2, the project will expand to a larger group of early childhood and home visiting programs operated by Children’s Home & Aid statewide. This includes Head Start and Early Head Start programs serving 700 children and their families, and early childhood home visiting programs serving 600 infants and young children and their families. Each location provides priority enrollment to children considered at-risk, including children of adolescent parents, victims of child abuse and/or neglect, and children from very low-income households. Our programs prioritize services to families involved in the child welfare system, including youth in foster care who are pregnant and parenting and families with an indicated case of abuse and neglect where the children remain in their parents’ care. The Bright Future project will provide screening, assessment and evidence-based treatment to 120 individuals annually; will provide infant and mental health consultation to support families in center-based early childhood programs; will provide cohort-based professional development to 30 early childhood professionals annually; will deliver 4 trainings per year on the impact of trauma and young children’s symptoms of trauma to child and family-serving professionals reaching 50 staff per year and 250 staff over the life of the project; and will provide training and clinical supervision to 2 graduate interns per year and 10 interns over the life of the project.

The Loyola Center for Counseling & Education (LCCE) is applying for funding to support the proposed project Increasing Access for Early Childhood Mental Health Care Services. The LCCE is housed within the College of Nursing & Health at Loyola University New Orleans. Since its inception in 2019, LCCE has been committed to providing effective mental health counseling services on a sliding scale to underserved families, couples, groups, and individuals at every stage of life. In tandem with clinical services, LCCE supervises exemplary training for graduate students in Loyola University’s Department of Counseling. With support from the Infant and Early Childhood Mental Health Program, the LCCE aims to improve outcomes for children from birth up to 12 years of age by developing, maintaining, or enhancing infant and early childhood mental health promotion, intervention, and treatment services. Providing access to these services to this target population will be addressing a significant need in our community. The target population for this project includes children up to age 12 in need of access to mental health care who are unable to access these services with a provider that bills Medicaid or private insurance. There is a significant lack of available providers in the eight parishes of the Greater New Orleans area and the majority are either not taking new patients or do not accept Medicaid clients. The target population will be low-income and mirror the demographics of the Greater New Orleans area: White alone not Hispanice: 43%; African American: 33%; Hispanic: 11%; Asian, Pacific Islander not Hispanic: 3%; and Two or More Races: 4%. With grant funding, the LCCE will accomplish the following goals and measurable objectives: Program Goals: 1. Provide an additional access point for children of the Greater New Orleans area in need of mental health care services who are unable to secure treatment from other sources Measurable Objective: Serve 220 children up to age 12 over 5 years 2.Provide children with access to comprehensive screening and evidence-based therapies Measurable Objective:100% of clients will receive a risk & needs assessment at in-take and access to evidence-based Trauma-Informed Care and Child Centered Play Therapy 3.Create a community of early childhood educators and care providers equipped to recognize children in need of mental healthcare services Measurable Objective:Establish 20 partnerships with early care and education programs, child and family-serving professionals over five years to provide educational and training outreach services and provide 2 workshops per year 4. Provide specialized training for mental health clinicians in infant and early childhood mental health, including specific training in promising and evidence-based practices and models for prevention, early intervention, and treatment Measurable Objective: 52 graduate students will be trained and certified to use evidence-based Trauma-Informed Care and Child Centered Play Therapy over five years The proposed project will also collect all SAMHSA required data and program specific data, create a QI plan, and work with a Lead Evaluator who will monitor the effectiveness and quality of the services provided and the progress towards meeting the project goals and deliverables.

Project Connect will complement and enhance existing mental health services within Head Start/Early Head Start (HS/EHS) centers; helping to address the serious gaps in multi-generational prevention, intervention, and treatment for children ages 0-12 and their families in Mercer County, New Jersey. Services will help meet a critical need in Mercer County, which has high rates of crime and poverty and other factors associated with child and parental stress; and where there is a shortage of multi-generational mental health treatment, especially for children ages 0-12. A skilled research team from the Brazelton Touchpoints Center will evaluate. Through a continuum of primary and tertiary services, Project Connect will provide intensive mental health consultation and professional development for HS/EHS programs, staff, and families, building systems-level capacity to support the healthy development of children. HS/EHS parents will strengthen the nurturing practices they use. Community-wide education will be offered for families and child-serving professionals and faith-based organizations, with the aim of building community knowledge and skills for relational, trauma-informed preventive practices. Finally, evidence-based, family-focused therapies will be delivered to enhance the functioning of children and families with significant mental health needs, filling infrastructure gaps. All activities will increase provider and parent awareness and ability to respond to children’s mental health and trauma via developmentally appropriate, culturally sensitive interventions. CHSofNJ will train and support a team of Clinicians certified to deliver Trauma-Focused Cognitive Behavioral Therapy and Theraplay, two evidence-based modalities, proven effective for the target population. Treatment for children and parents/caregivers will be complemented by evidence-based mental health consultation in five Head Start/Early Head Start centers, professional development and parent education opportunities. Project Connect has four goals: (1) Engage parents as partners in developing a sustainable approach to promoting protective factors and responding to the mental health needs and priorities of their families; (2) Reduce the need for intensive clinical interventions among children ages 0-12 years; (3) Improve access to evidence-based assessment, treatment and intervention services through delivery of multi-generational counseling for children ages 0-12 and their families to fill the serious gaps in the system of care, increase resilience in response to trauma and ACES, and improve mental health outcomes; and (4) Increase efficacy among the mental health and related workforce to maintain consistent, caring relationships with children ages 0-12. Eighteen objectives will guide assessment, such as, 75% of staff participating in the Family Connections IECMHC and PD Model will demonstrate increased competencies related to identifying and addressing children’s mental and behavioral health needs and use of developmentally appropriate, culturally sensitive, and trauma-informed social-emotional practices as measured by the Goal Achievement Scale; Improve child functioning, social skills and post-traumatic symptoms, as measured by the Child Behavior Checklist, and Child and Adolescent Trauma Screen for 75% who complete Theraplay and TF-CBT counseling; and 75% of Head Start/EHS staff will identify and describe one practice that resulted in improved observation/perception of child behavior in the classroom.

San Ysidro Health (SYHealth) requests funding to support its Infant and Early Childhood Mental Health (IECMH) Program in the South Region of San Diego County. As a Federally Qualified Health Center (FQHC), SYHealth specializes in providing care to uninsured and Medi-Cal (California’s Medicaid) populations. SYHealth’s proposed IECMH Program specifically addresses the need for expanded capacity and increased access to culturally proficient mental health services for the health center’s pediatric patients and their families. Specifically, SYHealth’s program directly addresses service gaps and systemic barriers, including: (1) extensive and long wait times for psychoeducational assessments and neuropsychological evaluations in children up to age 12, (2) limited community and safety-net resources in San Diego County’s South Region, and (3) lack of appropriate payment models within a FQHC setting to adequately sustain services. The IECMH Program is designed to serve the predominately Latinx pediatric patient population and their Spanish-speaking families of San Diego County’s South Region, with an emphasis on the impoverished border community of San Ysidro. The South Region is the only region of the county in which Latinx comprises the majority of the overall population; 61% of the South Region population is Latinx compared to 34% of the overall county population. The community of San Ysidro is federally designated as a Medically Underserved Area (MUA; ID 00346), Health Professional Shortage Area (HPSA) in primary care (ID 10699906J3), dental health (ID 606999066K), and mental health (7069990687). Health disparities are most commonly found among low-income families with histories of drug/alcohol/sexual abuse, domestic violence, food/shelter insecurities, premature births, etc., all of which are not uncommon in border region communities like San Ysidro. SYHealth’s proposed IECMH Program aims to achieve the following goals over the five year project period: Goal 1: Expand capacity to conduct psychoeducational assessments, neuropsychological evaluations, and increase capacity for therapy and psychiatric services for children up to age 12, resulting in a significant decrease in current service gaps and wait times. Goal 2: Increase access and linkages to culturally proficient pediatric behavioral health services for a predominately Latinx patient population. Goal 3: Educate and support parents and caregivers of children engaged in behavioral health services. Goal 4: Increase knowledge of awareness of school personnel, parents, and community members to recognize and appropriately respond to signs and symptoms of behavioral health difficulties. The proposed IECMH Program is designed to serve a minimum of 75 unduplicated pediatric patients each year, and train a minimum of 100 clinicians and community members each year.

The Chadwick Center for Children and Families at Rady Children’s Hospital, San Diego (RCHSD) is proposing the PATT project, which will improve the outcomes for children ages 0-5 and their families and expectant mothers using a trauma-informed, multi-tiered approach that includes the provision of direct clinical services while also improving the capacity of the infant and early childhood mental health (IECMH) workforce through specialized and general training and consultation to child and family serving professionals across San Diego County. The PATT project will coordinate closely across service systems to serve children ages 0-5 and their families and expectant mothers from a wide range of cultural and socioeconomic backgrounds who have been exposed to traumatic events, such as sexual abuse, physical abuse, exposure to domestic violence, and medical trauma. Specifically, treatment services will target children under age 5 with needs at the moderate to severe end of the mental health (MH) spectrum. Beyond direct clinical services, the PATT Project will support the building of work force knowledge, capability, and capacity in infant and early childhood MH throughout San Diego County. The PATT Project will accomplish the following six goals: (1) Provide specialized training for therapists on evidence-based practices specifically designed to support the social-emotional and trauma-related needs of infants and children ages 0-5 and perinatal mental health across San Diego County; (2) Provide specialized training for clinicians and supervisors on infant and early childhood mental health competencies; (3) Incorporate screening, assessment, and intervention practices designed to identify and support young children ages 0-5 and their caregivers in accessing the identified evidence-based practices with the priority age group of infants ages 0-2; (4) Create opportunities for infant & early childhood and education (ECE) providers, such as early intervention specialists & primary care providers, to develop greater expertise and knowledge in infant & early childhood MH that will result in increased screening & referrals from Primary Care Clinicians; (5) Implement a programmatic mental health consultation model to build capacities of ECE providers to improve their ability to identify, treat, and mitigate the impact of mental health problems among young children who have experienced trauma, and; (6) Develop and implement a strategic plan to sustain PATT program services beyond the funding period, ensuring that the training and services continue long into the future. A total of 90 unduplicated children and caregivers will be served through grant funds during the first year of the project, with that number increasing to 120 annually for a total of 570 children and caregivers receiving clinical services throughout the duration of the project. A total of 25 individuals will be trained during the first year of the project, with that number increasing up to 250 individuals annually, for a total of 1075 individuals receiving training throughout the duration of the project.

The Supporting Parenting Relationships through Outreach, Understanding & Therapy (SPROUT) Initiative will improve the capacity of 500 family and child-serving processionals annually (2,500 over five years) to strengthen infant and early childhood mental health by providing virtual and in-person training to apply emerging concepts in mental health to their practice. Training will encompass four sectors—early intervention, child welfare, home visitation, and early childhood education—and provide a common framework for supporting young children and their caregivers. The initiative will also provide direct evidence-based/informed clinical services to 250 young children (50 per year) identified as high risk by their nurse home visitor for developing Serious Emotional Disturbance through universal screening and specialized mental health consultation. Young children (under 6 years) will be screened and referred from the Philadelphia Nurse-Family Partnership and the Mabel Morris Family Home Visit Program, a Parents as Teachers affiliate (collectively NFP/MM). Of the approximately 800 families served annually, the pregnant/postpartum persons (who mostly identify as female) are all low-income (250% federal poverty level); have a young child (between ages of zero to five); majority are under 25; and are first-time parents (100% of NFP). Most participants are Black or people of color. About 30% of the caregivers report a mental health diagnosis at intake. This population of parents and young children are underrepresented in mental health care, and this project will build on a successful community mental health collaboration begun in 2021 between the Joseph J. Peters Institute (JJPI) and the National Nurse-Led Care Consortium (NNCC) to address this disparity in services. JJPI is an organization with a mission to “restore hope with dignity” for individuals impacted by trauma and was one of the earliest organizations to offer Trauma-Focused Cognitive Behavior Therapy (TF-CBT). JJPI clinicians will provide direct mental health support to children and their caregivers and will also provide infant and early childhood mental health consultation to the nurse home visitors at NNCC. NNCC is a member-supported 501(c)(3) nonprofit that advances nurse-led care through policy development, training and technical assistance, and innovative programs to reduce health disparities and meet people's primary care and wellness needs. NFP/MM is its largest community program. This project harnesses the strength of NNCC’s home visiting and its training and technical assistance expertise. NNCC will provide direct service referrals and bring together mental health experts to strengthen the capacity of Philadelphia’s service providers to work with children and families. JJPI and NNCC will also collaborate with the Pennsylvania Office of Child Development and Early Learning (OCDEL), the Philadelphia Department of Behavioral Health and Intellectual disability Services (DBHiDS), the Philadelphia Department of Human Services (DHS) and the Philadelphia Department of Public Health Division of Maternal, Child and Family Health (MCFH) to engage the Philadelphia early childhood workforce programs under their oversight in the infant and early childhood mental health training and technical assistance opportunities. The training will be extended to OCDEL home visiting providers and childcare centers; staff of the DBHiDS Early Intervention Program; the home visiting programs that participate in MCFH centralized intake system; and DHS child welfare staff.

The Department of Mental Health and Substance Abuse Services (ODMHSAS) and Central Oklahoma Community Mental Health Center (COCMHC) in partnership with the Oklahoma Department of Health (OSDH) proposes Cleveland Co First Five (CCFF) Project to support access to Infant and Early Childhood Mental Health (I-ECMH) Services in response to the Funding Opportunity Announcement No. SM-22-006. The target population of CCFF is children birth to 6 years and their caregivers in Cleveland Co who need I-ECMH services. Primary focus is on infants and young children who are in out-of-home placement or at risk of removal due to abuse/neglect, as the high levels of toxic stress, substance use exposure, and trauma places them at risk of showing early signs of a mental health disorder, including the development of SED. CCFF proposes to : 1) increase the number of children ages 0 through 5 years and their caregivers receiving specialized treatment, 2) increase service coordination around court-involved cases braiding local resources for parent supports, mental health treatment, early intervention, case management and other parts of the local system of care to collaboratively develop service plans that reflect the mental health needs of the child, 3) increase the number of children 0-5 years receiving SOC Wraparound services by working with COCMHC to utilize the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-5) and the Early Childhood Services Intensity Instrument (ECSII) to determine level of care and linking Wraparound to the child service array across agencies who are supporting the child/caregivers, 4) promote IECMH outcomes through training, consultation, and support of other parts of the local Infant and Early Childhood System of Care including child welfare, early intervention, home visitation, and early care and education. Outcomes will include improved child/parent well-being, increased permanency, improved safety and greater systems collaboration. Grant funds will result in adding new I-ECMH professionals in the Cleveland County community to significantly increase capacity for serving children 0-5. The addition of an I-ECMH consultant will ensure reliable access for ECE providers to consultation services and support the addition of new I-ECMH trained consultants to expand access in Cleveland County and surrounding areas. The project proposes to provide intervention and consultation services to a total of 1500 children and adults, and train a total of 440 mental health and other community professionals in I-ECMH related topics to build capacity for supporting young children and their caregivers over the 5 year grant period.

PPEER in Alabama Abstract: The Alabama Department of Mental Health (ADMH) and the Alabama Department of Early Childhood Education (ADECE) will lead Promoting Early Experiences and Relationships in Alabama: A Team-Based Approach (PPEER) to expand existing children's mental health (CMH) services across the state. The project will create a cohesive and sustainable infrastructure that results in measurable outcomes for children birth-12 years who are at risk for, or diagnosed with mental illness (MI), including severe emotional disturbance (SED), and their families. Project strategies and interventions will enhance the current workforce making it more effective and and accessible in areas where CMH service are limited or do not exist. A full continuum of interventions will combine comprehensive wrap-around services to children and families involved in the state's child welfare system that are relationship focused, linguistically and culturally sensitive, evidence-based, and trauma-informed. These services will be provided by Children's Mental Health Teams (CMHTs) spanning across promotion, prevention, and intervention of MI/SED. The project will initially occur in three pilot counties, Jackson, Jefferson, and Mobile, and then expanding to other counties in years 3-5. The CMHTs for each county will consist of a regional Infant and Early Childhood Mental Health Consultant(IECMHC) from ADMH and at least one local mental health clinician trained in IECMH assessment, diagnosis, and treatment. For school-aged children, a school mental health service coordinator and a school-based mental health therapist will also be included on the CMHT. The CMHTs will collaborate across agencies and disciplines within target counties to coordinate integrative services leading to positive outcomes for infants, young children, and their families to alleviate, remediate, and decrease behavioral and social/emotional issues that interfere with healthy child development and parent/caregiving relationships. A Project Director (PD) will develop community collaborations for identification and response to referrals for services and engage in data management and support. The PD will also oversee community workforce development, increasing the number of mental health clinicians with IECMH expertise in mental health shortage areas. A Project Coordinator (PC) will be added in Year 3 to continue developing the existing community collaborations and training while the PD oversees expansion of the project to other counties and continues to provide administrative oversight. In the 3 initial counties the project will expand access to care for at least 25 children and families in Year 1, and 30 in Year 2. In Years 3-5 120 more children and families will be served in up to 3 additional counties identified through the needs assessment. In all, at least 175 children/families will receive coordinated and comprehensive support and mental health services over the grant's 5 years. At least 30 mental health clinicians across the state will be trained and rostered in Child-Parent Psychotherapy (CPP), with two additional cohorts starting in years 3-5. Adding at least 30 CPP-rostered clinical MH providers will help us achieve our infrastructure goal of families in all 67 counties having access to a CPP-rostered MH provider. Finally, the project will train at least 100 professionals across child and family-serving system agencies in evidence-based practices, thereby improving access to dynamic wraparound services for vulnerable children and families across the state.

Through this project, ECDA will improve outcomes for 60 low income infants and children ages 0 to 5 and their caregivers annually. particularly those who have experienced trauma, and those who are at risk of developing a mental illness or Serious Emotional Disturbance, through screening, intervention, and caregiver support. Through training and consulting, we will increase the capacity of 360 educators, mental health and social service providers, clinicians, pre-schools, and community agencies annually to understand and address social/emotional development, trauma's impact on development, and implicit bias and equity. This project will expand our footprint to Santa Clarita and Los Angeles County Service Planning Area 6/South Los Angeles, and introduce the new evidence-based treatment modality of Infant Massage.

Family Service seeks to embed the attributes of a trauma-informed, resilient community in the child welfare system by: 1) building systemic capacity and training Child Protective Services staff in resilience and trauma awareness, 2) establishing trauma-informed foster parent and kinship care provider networks, and 3) thoroughly infusing the child welfare system with the principles of trauma-informed practice, and the adoption of trauma-responsive policies. Project Name: Por Los Ninos Population to Be Served: Children ages birth to 12 years old who have been abused or neglected, are under the supervision of the child welfare system and are at significant risk of developing, show early signs of or have been diagnosed with a mental illness. Family Service’s experience with this population in San Antonio/Bexar County, Texas indicates three-quarters will be boys, 77% will be Hispanic, 96% will live in a low-income family, and 55% will live with a single parent. Strategies/Interventions: Por Los Ninos will advance behavioral health equity and fully address the impact of trauma consistently experienced by children who have been abused or neglected and are at heightened risk of lifetime psychiatric morbidity. Por Los Ninos’ direct treatment and capacity building resources will include: 1) specialized, trauma-informed treatment for children under the age of 12; 2) training to build the capacity of CPS staff to consistently identify and screen for mental health, ACEs and related impact among children under CPS supervision, and make appropriate referrals for direct treatment services; and 3) creating a trauma-informed foster care/kinship care provider network prepared to deliver specialized or intensive, trauma-informed foster care to children assessed as having early signs of psychiatric disorders. Goal: Provide the specialized, trauma-informed mental health promotion, intervention and treatment services needed to improve outcomes for children ages birth to 12 years of age who have experienced abuse, neglect and additional ACEs, and are under the supervision of the child welfare system. Objective 1. Build the capacity of Child Protective Services staff to identify, screen and direct into care children who have experienced multiple ACEs and have suspected mental health challenges. Objective 2. Provide early intervention and mental health treatment services to 625 children. Objective 3. Provide trauma-informed parenting training and support groups to increase the capacity and skills of 325 foster parents and kinship care providers to promote trauma-informed, healthy, safe, secure environments in which young children can learn and grow. Number of children to be served: 625 Number of child welfare system and other professionals to be trained: 425

Children’s proposes to implement Expanding the Continuum of Care: Improving Equitable Outcomes through Infant & Early Childhood Mental Health Consultations in Milwaukee, Racine and Kenosha counties in Southeastern Wisconsin. The goal is two-fold to: 1) build a robust Infant and Early Childhood Mental Health Consultation (IECMHC) program at Children’s, in order to; 2) build the capacity of other child and family serving professionals using culturally-responsive trauma informed strategies to extend the continuum of care to strengthen and support the healthy social and emotional development of young children. This project will build on Children’s robust Mental and Behavioral Health program to give child and family serving professionals and mental and behavioral health clinicians, direct access to mental health consultants that will empower them to effectively address mental health concerns early and access developmentally specific, culturally responsive and equitable mental health services for children in need. Additionally, the project will allow Children’s to expand mental and behavioral health services by increasing the settings and age groups who receive mental health consultation. We will target our expansion to providers and children served through our Early Childhood Mental Health program (61% White, 31% Black, 64% enrolled in Medicaid), children served through our Child Welfare programs (67% ages 0-11, 67% Black, 14% White, 14% Hispanic, 80% enrolled in Medicaid, elevated adverse childhood experiences, and mental and behavioral health concerns), our Home Visiting programs (100% ages 0-3, 59% Black, 28% Hispanic and 17% White) and to early care and education settings. By September 2027, Children’s will design and implement the necessary system structure and functions of a centralized IECMHC program (organizational reporting, financing, policies and procedures, etc.) that prioritizes health equity and sustainability. This work will increase access to a full range of infant and early childhood services and build workforce capacity for individuals serving children from birth to age 12 years by expanding IECMHC to multiple settings (e.g., child welfare, home visiting, early care and education and medical) and age groups (e.g., up to 12 years of age). We will further develop, maintain, and enhance existing infant and early childhood mental health promotion, screening, referral and treatment services currently offered through Children’s. During the five-year grant, we anticipate serving 1,401 unduplicated individuals with grant funds and training 1,086 unduplicated individuals. Annual unduplicated individuals served includes: 137 (Y1), 190 (Y2), 288 (Y3), 361 (Y4) and 425 (Y5). Annual unduplicated individuals trained includes: 81 (Y1), 157 (Y2), 234 (Y3), 278 (Y4) and 336 (Y5). Children’s is a leading provider of innovative, evidence-based mental and behavioral health services for kids and families. We are committed to addressing health inequities and improving health outcomes. We bring mental and behavioral health programming to racially and ethnically diverse neighborhoods in Wisconsin where many residents face discrimination and other socio-economic barriers. Services are provided regardless of a client’s ability to pay. We treat children and families together through dyadic treatment that is aimed at improving parenting, the parent-child relationship and the child’s behavior. We treat thousands of children with mental and behavioral health challenges through programs at our primary care and specialty care clinics, in schools and communities across the state and through our foster care and adoption programs. Yet a large treatment gap exists and children and families are not always able to get the mental health services they need.

The Community Health Center Inc. (CHC) will launch the Early Childhood Therapeutic Partnership (ECTP) project to expand and enhance existing mental health services for thousands of infants and children in underserved communities primarily in Lower Fairfield County while strengthening the clinical expertise of pediatric service providers nationally. Through CHC’s specialized pediatric mental health arm, the Child Guidance Center of Southern CT (CGC), the ECTP project will serve between 660-1350 children annually and over 4,100 in the first five years. Children served will be aged birth through 12 and primarily from BIPOC families in Lower Fairfield County, CT. They will receive an array of prevention, assessment, and intervention services to support their social emotional development and mental health. The direct service components of the ECTP project will include individual, group and family therapy, parent guidance, evidenced-based trauma treatments including Attachment, Self-Regulation and Competency (ARC), Child-Parent Psychotherapy (CPP), and Trauma Focused Cognitive Behavioral Therapy (TF-CBT), and psychiatric medication management services. Establishing a designated multi-disciplinary clinical assessment team to conduct comprehensive developmental evaluations (CDE) will shorten the 1-1.5 year current average wait time for CT families. Expanding an existing partnership between CGC and the Children’s Learning Center of Fairfield County (CLC) will increase access to mental health consultation (IECMHC) in state-subsidized preschools in Stamford CT. These direct service components of the ECTP project would become self-sustaining through fees for service. The education component of the ECTP project will strengthen the clinical expertise of the pediatric workforce serving vulnerable communities by training between 4-67 pediatric providers annually and a total of 182 providers nationally in the first five years. Through Learning Collaboratives, CHC’s learning management system, and Project ECHOs (Extension for Community Healthcare Outcomes), the ECTP project will bring CHC’s infant and early childhood mental health expertise to pediatric service providers across the country. CHC’s research, education, and policy arm, the Weitzman Institute, will lead these training components. The primary goals and measurable objectives of the ECTP project are: 1. Increase capacity, quality, and timely access to infant and early childhood assessment and intervention services by a) training additional clinicians to conduct CDEs, b) training at least 60 clinicians in CT in ARC, and c) training early pediatric mental health providers and educators from at least 8 communities nationally to develop, implement, and sustain preschool mental health assessment, intervention, and consultation services. 2. Increase CLC’s capacity to manage emotional/behavioral outbursts of young children so that a) 90% of CLC’s students will be in classrooms led by teachers with 1 year of Mirror IEMHC training, b) CLC will demonstrate a 50% decrease in behavioral incident reports and a 50% decrease in student expulsions, and c) evaluation of the Mirror Program will generate 1 manuscript published in a peer reviewed journal. 3. Individuals who receive ECTP mental health intervention services will experience increased functioning and decreased distress as demonstrated each year by a) 70% of children showing significant improvement on performance measures assessing changes in social-emotional functioning and behavior and b) 70% caregivers showing significant improvement on performance measures assessing parental stress.

Advancing Resources for Children (ARCh): Connecting NC’s Systems to Strengthen Infant and Early Childhood Mental Health Outcomes will improve infant and early childhood mental health (IECMH) outcomes of North Carolina (NC) children through advancing workforce capacity to increase access and meet their needs. Our population of focus will be children ages birth to 5 at significant risk of or experiencing mental health problems, including those with histories of trauma and/or a history of in-utero exposure to substances. Through the ARCh project, the Center for Child and Family Health and its state partners expect to serve a diverse population across NC (50% White, 22% African American, 18% Hispanic, 10% Other BIPOC). Strategies to be implemented include: age-appropriate assessment and intervention services, three evidencebased multigenerational interventions, IECMH consultation (IECMH-C), and training for childand family-serving individuals and mental health clinicians to increase equitable access to effective services. Goal 1 is to reduce unidentified and untreated IECMH disorders in NC by implementing age-appropriate screening and assessment and providing evidence-based multigenerational intervention services that promote IECMH wellbeing. Goal 1 objectives are to provide age-appropriate screening to 250 children (1a), diagnostic assessment (using the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, DC:0-5TM) to 60 children (1b), and multigenerational evidence-based practices (EBPs) to 142 children (1c), while improving symptoms of trauma, mental health, and/or parentchild interactions in 85% of children served (1d), and increasing equitable access to IECMH services with an increase of 40% in the number of counties with trained providers (1e). Goal 2 is to expand NC’s capacity to provide IECMH-C to multidisciplinary providers. Goal 2 objectives are to increase IECMH consultation across multidisciplinary providers statewide, including: conducting 20 trainings for psychiatric behavioral health consultants (2a), providing ongoing IECMH group consultation to 4 early childhood agencies (2b), and supporting IECMH-C delivery for NC’s early childhood education providers (2c). Goal 3 is to increase capacity of NC’s multidisciplinary child- and family-serving professionals to identify children’s mental, emotional, and behavioral issues and to collaborate with other providers to address them. Goal 3 objectives are to train 375 providers in IECMH (3a), 100 in screening (3b), 100 in Reflective Supervision and Consultation (RSC) (3c), 75 in DC:0-5TM (3e), and 40 in IECMH assessment best practices (3f), while increasing access to at least 125 providers with IECMH Endorsement® (3d), training 10 agency supervisors to support clinician assessments (3g), and training 250 pediatric providers in IECMH (3h). Goal 4 is to expand access to IECMH clinicians’ specialized training in evidence-based prevention, early intervention, and treatment practices to effectively treat and reduce IECMH disorders, with the objectives of training providers in three EBPs, including 30 providers in Attachment and Biobehavioral Catch-up (4a), 10 clinicians in ParentChild Interaction Therapy (4b), and 10 clinicians in Child Parent Psychotherapy (4c). Goal 5 is to develop a sustainability plan that ensures that IECMH services and workforce development can continue when federal funding ends, with the objectives of convening IECMH family advocacy groups (5a), reporting recommendations for sustaining ARCh goals and activities (5b), increasing trained supervisors’ knowledge and competence sustaining best practices by 85% in assessment (5c), RSC (5d), and EBP delivery (5e), and completing all grant requirements for data and outcome evaluation (5f). Taken together, these ARCh project activities will serve on average 82 unduplicated children and caregivers annually (412 individuals served across 5 years) while training 91 providers annually (455 individuals trained across 5 years) to ensure scalable and sustainable service delivery after project funding ends.

The University of Pittsburgh's Early Attachment & Relationships (PEAR) Project fills gaps in the existing early childhood mental health system of Allegheny County, Pennsylvania and expands the availability of evidence based IECMH treatment services. The Project supports children ages birth through five who are at significant risk of developing, or have been diagnosed with, a mental illness as well as their families, to strengthen caregiving relationships. In collaboration with UPMC Western Behavioral Health and its Theiss Center for Trauma and Early Childhood Behavioral Health (Theiss), the Project's overall goal is to improve outcomes for young children (birth through age 5) in Allegheny County, particularly those who are from racial/ethnic and low socioeconomic groups vulnerable to behavioral health disparities. This goal will be accomplished by 1) increasing access to evidence-based IECMH treatment services for children and caregivers, namely Parent-Child Interaction Therapy (PCIT), Theraplay, and Incredible Years; 2) filling gaps in the existing IECMH consultation system for higher-need children and families, through collaborative consultation with early childhood consultants, home visitors, and early care and education providers; 3) training clinicians in evidence-based, early childhood-specific mental health treatments (i.e., PCIT, Theraplay, and Incredible Years); 4) creating IECMH-specific professional development to help child and family-serving professionals increase their knowledge/skills related to children's mental, emotional, and behavioral health needs; and 5) increasing Reflective Supervision Consultation (RSC) capacity to better support members of the early childhood mental health workforce. The Project will achieve the following primary goals/objectives by the end of the grant project period: assess 300 children for difficulties related to behavior, social-emotional skills, and developmental/language functioning; refer 100% of those children in need of intervention to appropriate services; provide mental health consultation and support to 70 providers working with infants and young children; facilitate evidence-based IECMH treatment training for 50 clinicians; support 15 supervisors to develop and implement RSC skills; and provide IECMH-related training to 1,000 child and family-serving professionals relevant to their respective disciplines (70% of whom will report improved knowledge and practice changes as a result Project training). A total of 240 infants and young children in Western Pennsylvania will receive evidence based IECMH treatment through the Project (with those served gradually increasing throughout the project period - Year 1: 20; Year 2: 40; Year 3: 60; Year 4: 60; Year 5: 60). As a result of Project involvement, 75% of children across racial/ethnic and socioeconomic backgrounds will exhibit improved behavioral functioning; 60% will display improved social-emotional skills; and 50% will show improvements in developmental and language functioning (as measured through DECA and ASQ-3 assessments). Further, 60% of parents will report improved caregiver practices and child-caregiver interactions upon completion of Project treatment (as measured by the PSI-4-SF).

Allies for Every Child has been providing essential services to the most vulnerable children and families since 1987. This project will primarily serve young children (and their primary caregivers) from zero to five years old and their siblings (up to age 12), who are at risk of, show early signs, or have been diagnosed with mental illness, including serious emotional disturbance (SED) and who are at risk of, or are currently receiving services from Department of Children and Family Services (DCFS) located in Service Planning Areas 5, 6 and 8 in Los Angeles County. This project has two main goals: 1) Improve outcomes for children 0-12 years old, who are at risk of, showing early signs, or having been diagnosed with mental illness, including SED and who are at risk of, or are currently receiving services from DCFS and their primary caregivers and 2) Increase early childhood provider (educators, child welfare workers, clinicians, early interventionists) capacity to identify, understand and intervene when issues related to socio-emotional development and need for trauma responsive and culturally relevant practices present. The purpose of the project is to improve access to high quality mental health services for children 0-12 years old who often experience difficulties finding appropriate and qualified providers in a timely manner and to reduce disparities related to access to high quality, culturally responsive mental health services for underserved populations and communities in the Los Angeles Area. The project will serve low-income families, a high percentage of whom identify as Hispanic/Latino and Black/African American; and will focus on providing age-appropriate, evidence-based, culturally and linguistically appropriate, trauma-informed mental health promotion, prevention, early intervention and treatment services. These services will include screenings, psychotherapy, and early childhood mental health consultation to benefit children, families and educators in our catchment area and training for the multidisciplinary early childhood workforce in Los Angeles County. The measurable objectives of this project are: 1) 85% of children who engage in mental health services until a planned termination will demonstrate improvements in social-emotional functioning. 2) 85% of dyads/triads who engage in dyadic psychotherapy treatment until a planned termination will demonstrate improvements in child-caregiver relationship quality. 3) 85% of caregivers who engage in psychotherapy treatment until a planned termination will demonstrate improvements in nurturing parenting practices. 4) 85% of consultees who have completed at least 6 months of consultation services will report an increase in self-reported capacity/ability to understand and manage children's challenging behaviors. 5) By the end of the 5-year grant period, we will have trained 2,150 early childhood serving professionals on topics related to socio-emotional development, trauma-responsive practices, assessment and intervention and other relevant early childhood and mental health topics. 6) 85% of professionals trained will report an increase in knowledge of concepts relevant to work with young children. 7) By the end of the 5-year grant, we will have administered a total of 500 screenings, including developmental, Adverse Childhood Experiences, Benevolent Childhood Experiences, depression, anxiety and trauma screenings. Through this project we plan to serve 900 individuals through early childhood mental health consultation services; 140 individuals through mental health therapy services and 2150 early childhood serving professionals through training over a 5-year period.

The Ponca Tribe of Nebraska is pleased to submit a request for $449,632 to the Department of Health and Human Services - Substance Abuse and Mental Health Services Administration for the Infant and Early Childhood Mental Health Program funding opportunity. The Ponca Tribe of Nebraska, Ponca Health Services Infant and Early Childhood Mental Health (PHS-IECMH) project will improve outcomes for 544 Ponca tribal and other tribal children and adolescents from birth to age 12 with multigenerational evidence-based treatment and services including integrated care, mental health screening, therapy services, and preventative programs within the Ponca Tribe of Nebraska's fifteen-county service delivery area. This project will also train 143 Ponca Health Services and other community members to build service delivery capacity. Reestablished as a federally recognized tribe in 1990, the Ponca Tribe of Nebraska has approximately 4,200 members and its service delivery area (SDA) covers thirteen (13) counties in Eastern Nebraska, two (2) in Iowa, and one (1) in South Dakota. The Ponca IECMH project will focus on the American Indian and Alaska Native (AI/AN) population residing in this SDA. The Ponca Tribe of Nebraska's health care entity, Ponca Health Services (PHS), will implement this project. PHS aims to support healthy Ponca tribal and other tribal members children, adolescents, and families throughout its fifteen-county service delivery area. Integrating the foundational elements, priorities, and strategies of the National Tribal Behavioral Health Agenda, Ponca Health Services mission is to provide holistic, caring, family-centered, and culturally sensitive services through a quality clinical and educational approach. PHS offers integrated medical, dental, and behavioral health care throughout the lifespan for Ponca tribal and other tribal members. Many other services are offered by the Ponca Tribe including youth programming, social services, housing, culture education and preservation, and transportation. PHS-IECMH project goals include: 1) providing age-appropriate assessment and intervention services for children at risk of, showing early signs of, or having been diagnosed with a mental illness, including a serious emotional disturbance (SED); 2) providing infant and early childhood mental health consultation (IECMHC) to early care and education programs that work with children and families; 3) provide specialized training for mental health clinicians in infant and early childhood mental health, including specific training in promising and evidence-based practices and models for prevention, early intervention, and treatment; 4) providing training to child and family-serving professionals with expertise in infant and early childhood mental health with respect to appropriate and relevant integration with other disciplines; and 5) developing a sustainability plan to ensure that infant and early childhood mental health services and workforce development can continue when federal funding ends. Key PHS-IECMH project objectives include hiring child/adolescent therapists, expanding psychiatry availability, investing in training and tools for behavioral health and primary care staff, improving care integration, strengthening youth programming and parenting classes with evidence-based curriculum, and providing external trainings on working with Native American children and youth to care providers in Nebraska. This project will provide more impactful mental health promotion, prevention, early intervention, and treatment interventions to Ponca tribal and other tribal children and adolescents and improve service delivery through training.