1. 1 OSEP National Early Childhood Conference OSEP National Early Childhood Conference Washington, D.C. November 4, 2003 Gail F. Ritchie, M.S.W. Public Health Advisor Substance Abuse and Mental Health Services Administration Department of Health and Human Services

2. 2 Dr. William Foege What would happen to society if we knew how to promote positive mental health as well as to prevent, identify, and treat mental health conditions on a mass scale? + What would happen to the productivity of individuals, the happiness of families, the flourishing of potential, the cohesion of communities?

3. 3 Improving the Mental Health Service Delivery System President's New Freedom Commission on Mental Health Achieving the Promise: Transforming Mental Health Care in America (2003) http://www.mentalhealthcommisson.gov/reports/Fi nalReport/toc.html

4. Mental Health Status Continuum Mental Health Care Continuum Mental Health Continuum Primary PreventionTreatment and Enhancing Health:Primary Prevention:Early RecognitionTreatment and Rehabilitation: Promoting optimumAddressing risk factors and Intervention:Rehabilitation: mental health, e.g., jobvulnerable groups, Detecting a problemInterventions to satisfaction, resilience, e.g., coping skills foror illness at an earlyreduce symptoms of self-esteem, and people who are stage and increasingan illness, diminish social skills, improving un employed, home visitsaccess to effectivedisability, and improve access to income for families experiencingtreatmentquality of life separation or divorce Positive Mental Health:Mental Health Problem:Mental Disorder: High-level capacity of theDisruption in interactionsMedically diagnosable illness individual, group, andbetween individual, group,, that results in significant environment to interact &and environment,impairment of cognitive, to promote well-being,producing a diminishedaffective, or relational abilities optimal development, andstate of positive mental health use of mental abilities 4

5. The NIMH Committee’s Mental Health Interventions Spectrum 5 Pre-Intervention Basic & Clinical Sciences (Casualty, Risk Factors) Universal Selective Indicated Comorbidity Prevention Relapse Prevention Maintenance Treatment Acute Care PREVENTIONTREATMENT Generation III Prevention Treatment Generation II Prevention Generation I Prevention Disability Prevention

6. 6 Individual Factors Risk  Low IQ  Low birth weight  Difficult temperament Protective  Above average I.Q.  Social Competence  Positive temperament  Internal locus of control

7. 7 Family Factors Risk  Severe Marital Discord  Parental Mental Illness Protective  Child has close relationship with a parent or other caregiver who is warm, trustworthy, and supportive  For older children, supportive parents or other caregiver, good sibling relationships, and adequate rule setting by parents

8. 8 Community Factors Risk  Living in subsidized housing with high rate of community disorganization Protective  Community with well-organized after-school programs for children of working parents

9. 9 Promotion and Prevention Science is Getting Better and Better

10. 10 Prevention/ Early Intervention Grant Program "Teachers find themselves spending increasing amounts of time attending to students' aggressive, hyperactive and noncompliant behaviors in the classroom. If these behaviors are ignored, or if teachers give them negative attention, they will continue to increase leading to eventual school failure and antisocial behavior.“ Carolyn Webster-Stratton, M.S.N., M.P.H., Ph.D. Professor and Director of the Parenting Clinic University of Washington Seattle, Washington Developer of The Incredible Years programs www.incredibleyears.com www.incredibleyears.com SAMHSA Prevention/Early Intervention Grant Program Osborn School District, Phoenix, AZ Age: Kindergarten to 1st Grade

11. 11 Prevention/ Early Intervention Grant Program "Addressing emotional and behavioral problems in young children, even before they enter kindergarten, can pay off considerably down the road." Monroe County Office of Mental Health Rochester, NY SAMHSA Prevention/Early Intervention Grantee Primary Mental Health Project adopted for 4-year-old urban children who are at risk for developing mental health and school adjustment difficulties. Developers: 40-year history of research A. E. Cowen, Ph.D. Dirk Hightower, Ph.D. Other Colleagues University of Rochester, Rochester, New York http://www.childrensinstitute.net

12. 12 Science to Service SAMHSA's Mission: SAMHSA is the Federal agency charged with improving the quality and availability of prevention, treatment, and rehabilitative services in order to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illnesses. Cross-Cutting Principles: Science to Service/Evidence-Based Practice

13. Homelessness HIV/AIDS and Hepatitis Mental Health System Transformation Co-Occurring Disorders Science to Services/ Evidence-Based Practices Children & Families Strategic Prevention Framework SAMHSA Priorities: Programs & Principles Matrix Substance Abuse Treatment Capacity Seclusion & Restraint Aging Criminal Justice Disaster Readiness and Response Programs/Issues Cross-Cutting Principles A Life In The Community For Everyone Building Resilience & Facilitating Recovery Recovery/Reducing Stigma & Barriers to Services Community and Faith-Based Approaches Financing Strategies & Cost-effectiveness Workforce Development Collaboration with Public & Private Partners Cultural Competency/ Eliminating Disparities Trauma & Violence (e.g., Physical & Sexual Abuse) Rural & Other Specific Settings Data for Performance Measurement & Management 13

14. 14 Contact Information Gail F. Ritchie, M.S.W. Public Health Advisor Substance Abuse and Mental Health Services Administration Department of Health and Human Services 5600 Fishers Lane, Room 17C-05 Rockville, MD 20857 Tel: 301-443-1752 Email: gritchie@samhsa.gov

15. 15 Substance Abuse and Mental Health Services Administration Sampling of Activities Related to Young Children Pregnant and Postpartum Women (PPW) Grant. Comprehensive Residential Treatment Services for Pregnant and Postpartum Women and their infants and children. (CSAT)  4 million women give birth in the US each year and 221,000 (5.5%) use illicit drugs at sometime during pregnancy

16. 16 Substance Abuse and Mental Health Services Administration Sampling of Activities Related to Young Children National Center on Substance Abuse and Child Welfare, a service of SAMHSA/CSAT and the Administration on Children and Families (ACYF), and the Children’s Bureau’s Office on Child Abuse and Neglect FASD Center for Excellence http://fascenter.samhsa.gov  Fetal Alcohol Spectrum Disorders (FASD)-range of birth defects due to women drinking alcohol while pregnant.  Mission increase effectiveness of prevention and treatment options for fetal alcohol syndrome by providing national leadership

17. 17 Substance Abuse and Mental Health Services Administration Sampling of Activities Related to Young Children National Child Traumatic Stress Initiative (http://www.nctsnet.org)  To raise the standard of care and improve access to services for traumatized children, their families and communities throughout the United States.  Treatment centers from all over the United States have come together to form a new coalition, the National Child Traumatic Stress Network (NCTSN).

18. 18 Substance Abuse and Mental Health Services Administration Sampling of Activities Related to Young Children Alicia F. Lieberman, Ph.D. is Professor of Psychology at the UCSF Department of Psychiatry, Director of the Child Trauma Research Project, and Senior Psychologist at the Infant- Parent Program, San Francisco General Hospital.  Her major interests include toddler development, disorders of attachment, child-parent interventions with high risk families, and the effects of early trauma in the first years of life.

19. 19 Substance Abuse and Mental Health Services Administration Sampling of Activities Related to Young Children Joy D. Osofsky,Ph.D., Program Director, Department of Psychiatry, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA 70112; Charles H. Zeanah, M.D. is Professor of Psychiatry and Pediatrics and Executive Director of the Institute of Infant and Early Childhood Mental Health at the Tulane University School of Medicine in New Orleans. Dr. Betty Groves, Boston Medical Center. The hospital is the primary teaching affiliate for Boston University School of Medicine. Staring Early/Starting Smart (SESS) – www.health.org/promos/sess/ was designed to create and test a new model for providing integrated behavioral health services for young children and their families by way of a multi-year study of these grantees.