A Systematic Review of Infant Mental Health Services: Help-Seeking and Service Access of Moinority and Socially Excluded Groups (original) (raw)

Current delivery of infant mental health services: are infant mental health needs being met?

Australasian Psychiatry, 2005

Objective: To identify services supporting the well-being of infants and their families in an area of South Brisbane, Australia, highlight problems of accessing these services and recommend strategies to make them more readily available. Method: Semistructured interviews were conducted with staff from 18 service providers offering antenatal services, or programmes primarily focused on children under the age of 2 years and/or their families. The interview aimed to identify the precise nature of the services offered, problems encountered in providing those services, perceived gaps in services and potential strategies for improvement. Results: Services were diverse, provided by a range of different professionals, in varying locations (home, community, hospital) and with funding from various sources. The major findings were: (i) the fragmentation of services, lack of communication between them, and lack of continuity in services from one stage of family formation to another; (ii) the shortage of services working with the parents and infant together; and (iii) the difficulty of providing services for some at-risk populations. Conclusions: Recommendations included: (i) maintaining a range of different services networked through a centralized resource/referral centre; (ii) expanding joint mother-infant services and providing training for such services; and (iii) supporting outreach services for difficult to engage populations.

Construct validity of a service-setting based measure to identify mental health problems in infancy

PLOS ONE, 2019

Accumulating research document the needs of intervention towards mental health problems in early childhood. The general child health surveillance offers opportunities for early detection of mental health vulnerability, conditioned the availability of feasible and validated measures. The Copenhagen Infant Mental Health Questionnaire, CIMHQ, was developed to be feasible for community health nurses and comprehensive regarding the range of mental health problems seen in infancy. Previous testing of the CIMHQ has documented feasibility and face validity. The aim was to investigate the construct validity of the general population measure by using the Rasch measurement models, and to explore the differential functioning of the CIMHQ relative to a number of characteristics of the infants, local independence of items, and possible latent classes of infants. CIMHQ was tested in 2,973 infants from the general population, aged 9-10 months. The infants were assessed by community health nurses at home visits, in the period from March 2011 to December 2013. Rasch measurement models were used to investigate the construct validity of the CIMHQ. Analyses showed an overall construct valid scale of mental health problems, consisting of seven valid subscales of specific problems concerning eating, sleep, emotional reactions, attention, motor activity, communication, and language, respectively. The CIMHQ fitted a graphical loglinear Rasch model without differential item function. Analyses of local homogeneity identified two latent classes of infants. A simple model with almost no local dependency between items is proposed for infants with few problems, whereas a more complicated model characterizes infants with more problems. The measure CIMHQ differentiates between infants from the general population with few and more mental health problems, and between subgroups of problems that potentially can be targets of preventive intervention.

The Evidence Base for How and Why Infant and Early Childhood Mental Health Consultations Works

HS Dialog: The Research to Practice Journal for the Early Childhood Field

Infant and Early Childhood Mental Health Consultation (IECMHC) is an evidence-based service in which consultants build capacity for early childhood professionals and programs to promote the social-emotional development of infants and young children. This paper describes the current state of the evidence for IECMHC, mapping the evidence to a new theory of change from the Center of Excellence (CoE) for IECMHC. There is a substantial literature base regarding the effects of consultation on outcomes for infants and young children; yet the evidence for consultation’s specific mechanisms of change, moderators of impact, and reductions in disparities have been understudied. The authors identify gaps in the scholarly literature, articulate next steps for research, and conclude with a call to action for IECMHC researchers to expand rigorous studies to the range of settings in which IECMHC is implemented and to center social justice in the research questions, methods, and dissemination.

Characterizing Intervention Strategies Used in Community-Based Mental Health Care for Infants and Their Families

Administration and policy in mental health, 2018

Mental health interventions for infants typically target high-risk groups and can prevent long-term negative outcomes. Despite federal initiatives promoting early intervention, minimal research has examined usual care services for infants, which is important to improve routine care. The current study characterized usual care practices in infant mental health through the adaptation and administration of a provider survey. Providers (n = 126) reported using a wide range of intervention strategies and few intervention programs with varied evidence. Findings can inform future research to identify quality improvement targets of usual mental health care for high-risk infants and their families.

Early intervention service providers: what do they say about their infant mental health training needs?

Early Child Development and Care, 2005

Early intervention providers (957) were asked about their comfort level with and interest in training in infant mental health (IMH) topics including attachment, behavior and regulation/adaption, and whether they worked with families who needed information in these areas. Results indicated that providers continue to grow in understanding of these core IMH topics and that they continue to recognize the importance of training in these areas for themselves and families. Significant differences were found by provider type, level of experience and minority status. Both minority and less experienced providers were most interested in learning more about IMH topics.

A new measure for infant mental health screening: development and initial validation

BMC pediatrics, 2016

Mental health problems are a major public health challenges, and strategies of early prevention are needed. Effective prevention depends on feasible and validated measures of screening and intervention. Previous research has demonstrated potentials for infant mental health screening by community health nurses (CHN) in existing service settings in Denmark. This study was conducted to describe the development of a service setting based measure to screen for infant mental health problems, to investigate problems identified by the measure and assess the validity and feasibility in existing public health settings. Experts within the field developed a short, feasible and comprehensive measure. A consecutive sample of 2973 infants from 11 municipalities around the city of Copenhagen was screened at 9-10 months. Face validity and feasibility were evaluated among CHNs. Data on child and family factors and the results of screening were included in descriptive analyses. Exploratory factor anal...

Providing Continuity in Infant Mental Health Services for Medically Fragile Infants and Their Families

Journal of Clinical Psychology in Medical Settings

Having a baby who is prenatally or postnatally diagnosed with a medical condition places considerable stress on the parents, infants, and their developing relationship. Infant mental health (IMH) services offer an opportunity to address the challenges and support the parent-infant relationship. The present study outlined a continuum of care IMH program embedded within various medical settings of a large metropolitan children’s hospital. Applications of IMH principles within the fetal care center, neonatal intensive care unit, high risk infant follow-up clinic, and the patient’s home are described. Descriptive data about families served across settings and a case study are provided in order to illustrate the implementation of this unique IMH intervention model.

Phenomenology, psychopathology, and short-term therapeutic outcome of 102 infants aged 0 to 12 months consecutively referred to a community-based 0 to 3 mental health clinic

Tradition-a Journal of Orthodox Jewish Thought, 2010

Infants ages 0 to 1 year consecutively referred for psychiatric treatment during the year 2005 were followed, and variables associated with diagnosis and short-term outcome were assessed. Infants were evaluated using the Psychiatric Infant Navigator Chart and Evaluation that includes nosological diagnoses [Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, (DC 0–3), Zero to Three, 1994] as well as risk and protective factors, treatment procedure, and outcomes. Seventy-six percent of the infants had an Axis I diagnosis, with anxiety disorders and a mixed disorder of emotional expressiveness being the most frequent. Twenty-five percent had an Axis II diagnosis. Multiple correspondence analyses showed that two dimensions corresponding grossly to DC 0–3 Axes I and II emerged. They emphasized three clinical profiles characterized by (a) good infant functioning, parent's awareness of their own difficulties, and a good outcome; (b) moderate child symptoms, overinvolved relating, and a good/intermediate outcome; (c) severe child symptoms, underinvolved relating, and a less favorable short-term outcome, signaling the risk for developmental disorders. Among the associated risk factors were cumulative parental stress, maternal psychopathology, and family dysfunction. Clinical implications of these findings indicated that infants under the age of 1 year who are referred for mental health evaluation and intervention are a heterogeneous group in terms of both severity and prognosis. Clinicians should differentiate subgroups of young children to detect those infants at risk for persistent psychopathology.