Early Childhood Mental Health Consultants

The Need

The COVID-19 pandemic created a wide range of challenges for meeting the mental health needs of children and families. The Early Childhood Mental Health Consultation (ECMHC) program brings necessary resources into the environments where children and families are best served: family homes, health care providers, and early care and learning centers. ECMCHC has demonstrated improvement in reducing expulsions from learning environments, identifying early mental health concerns and developmental delays and providing adults with more effective tools to respond to behaviors they find challenging. 

The Strategy

Funds from the Child Care Development Fund (CCDF) Coronavirus Aid, Relief and Economic Security (CARES) Act grant were used from July 1, 2020, to June 30, 2021, to increase the workforce of the ECMHC program by 15 full-time equivalent (FTE) positions across the state, providing support to child care providers and families as children returned to early care and learning settings. In July 2021, the ECMHC program was awarded additional funding through the CCDF Coronavirus Response and Relief Supplemental Act (CRRSA) to maintain these positions and further expand the program by eight consultants, bringing the total contracted FTE to 53 (49 ECMH Consultants and 4 ECMH Supervisors). 

Twenty percent of the eight additional consultants’ time is dedicated to an innovative service delivery strategy, Statewide Brief Consultation. This specialized team coordinates with local ECMH Consultation teams to address waitlists and provide high quality, timely services across all 64 counties.

Get more information on Colorado's Early Childhood Mental Health Consultation Program (SaludMentalComienzaTemprano.com).

Key Outcomes and Learnings

Impact

Over 50 consultants provided services across 1,982 cases between July 1, 2023, and June 30, 2023, 22% of which were in rural counties. Consultees valued ECMH consultants’ support, experienced growth in their skills and saw changes in young children.

Retaining CARES-Funded Consultants and Filling Additional 8.0 FTE:

• Stimulus funding has allowed teams to retain qualified, trained and dedicated consultants.
• From July 1, 2022, to June 30, 2023, the ECMHC program supported 174 additional cases (98 child-focused, 42 classroom-focused, and 34 program-focused). This is equivalent to a 9% increase in total cases served during the fiscal year.
• Challenges to recruitment include local and national behavioral health workforce shortages, limited ECMHC career awareness, poorly articulated education and career pathways and lower compensation relative to other available behavioral health roles.
• Challenges to retention include available compensation, limited understanding of services within and among communities, service recipients and support agencies, as well as documentation requirements.
• Between July 1, 2023, and September 30, 2023, the ECMHC program supported 68 additional cases (35 child-focused cases, 14 classroom-focused and 19 program-focused). This is equivalent to a 5% increase in total cases served during this period.

Statewide Brief Consultation Pilot:

• 29 referrals have been received since July 1, 2022, of which 21 were identified as an appropriate fit for brief consultation and were served by this initiative. Through this innovative service delivery method, families and providers received high-quality, timely access to ECMHC services.
• Stimulus funding allowed Colorado to develop and implement a flexible structure to address the high demand for ECMHC services, increasing wait times and fluctuating local team capacity across all 64 counties.

Learning

ECMHC currently is evidence-informed, but not an evidence-based program. In recent years, CDEC has been creating a new model of program standards, training, delivery and evaluation. 100% of eligible ECMH consultants have been trained on the new model and are implementing it. CDEC will complete evaluation of the new model by 2026.

Filling the Additional 8.0 FTE:

• Similar to other early childhood sectors, recruiting and retaining a qualified workforce is a perennial challenge. Filling all eight positions took a full year after being awarded these stimulus funds. As of July 1, 2023, two stimulus-funded consultants have resigned, resulting in 1.0 FTE vacancy.
• Recruiting and retaining a qualified workforce impacts all 21 state-funded ECMHC teams across the state. ECMHC supervisors have articulated the need for additional support and resources related to recruitment and retention.

Statewide Brief Consultation Pilot:

• Engaging successfully in brief, virtual consultation services requires access to technology, Wi-Fi connectivity, and an understanding of the process and time commitment. Troubleshooting barriers to these services has been a priority for the statewide team and includes equipping sites with necessary tools, identifying methods to increase connectivity and creating tools to outline expectations clearly. 
• Developing a new team and service structure, as well as building awareness and buy-in, has taken time. As of July 2023, communications efforts have included the development of resources (flyers, request forms, and a brief video) and leveraging multiple channels to increase messaging to key stakeholders. 
• Demand for ECMH consultation continues to outpace capacity. Across all 64 counties, there are 40 to 60 waitlisted referrals at any given time. The Statewide Brief Consultation team is meeting the demand for statewide requests, highlighting that more adoption of statewide services is needed by local teams to manage and prioritize their waitlist.