Infant mental health and family support: Contributions of Early Head Start to an integrated model for community-based early childhood programs.

This paper analyzes the experiences of an Early Head Start (EHS) program in adopting and implementing an infant mental health (IMH) approach in its work with community families. Through qualitative methods (participant observation, qualitative interviews, and case studies), we examined the strategies used, and the challenges encountered, by program staff as they applied IMH principles in their home-visiting interventions with families whose lives involve significant economic, social, and psychological stressors. Our study identified four elements crucial to an effective IMH initiative: (1) teamwork, especially the use of transdisciplinary teams to review family cases, (2) reflective supervision, (3) development of an integrated and empathic understanding of the child's needs and the parent's challenges in meeting those needs, and (4) a dynamic ecological understanding of children, families, and communities in which psychosocial and socioeconomic factors are viewed as mutually important and interactive. We argue that each of these elements both builds on and enhances long-standing dimensions of this EHS program's family support approach, creating an innovative and integrated model of IMH and family support that could prove of value in many community-based programs serving children and families whose emotional health is affected by everyday experiences of economic and social inequality.