Expanding early childhood mental health consultation to new venues: Serving infants and young children in domestic violence and homeless shelters

Abstract

The number of infants and young children affected by homelessness and domestic violence is growing, and the effect of these experiences on children is wide-ranging. Early childhood mental health consultation (ECMHC) has expanded to these settings to help the adults attend to very young children whose needs are often obscured by families' crises. Recent research in ECMHC to childcare has cited the salience of the consultant-consultee relationship as the central contributor to positive change in caregiver's behavior and children's experience. This article explores the similarities and variations in the consultant's way of being that are necessary to expand this relationship-based ECMHC model to adult-focused settings. This has incorporated a combination of consultative shifts: expanded training, appreciation for families' survival priorities, attention to the effects of unavoidable adult decisions on children, increased tolerance for the affect this raises in parents and caseworkers, and greater efforts to create space for reflection and thinking. Caseworkers' attenuated contact with and limited prior knowledge about young children creates challenges in identifying and responding to concerns about children. The particular systemic and relational difficulties that emerge in shelters and that influence caseworkers' responsiveness to clients are explored.

Housing and Support Services with Homeless Mothers: Benefits to the Mother and Her Children

“…Indeed, housing likely reduces the stress among children inasmuch as it increases the sense of stability and safety. However, this study's findings suggest that intervening directly in the needs of these children can result in significant and powerful preventive effects, and has been recommended by others (Brinamen et al, 2012). …”

“…Children of homeless mothers are not routinely offered services by shelter or treatment programs (Brinamen et al 2012; Weinreb et al, 2007), even though studies document increased stress and mental health problems among homeless children (Park et al, 2012). It may be that providers assume that when the mother's mental health and substance use problems are treated, or homelessness is resolved, problems observed among their children will remit (Brinamen et al, 2012). In fact, Cooke et al (2004) found that children of substance users showed reduced internalizing and externalizing behaviors following the treatment of their substance use disordered parent, even though the children were not directly treated.…”

Parenting and child experiences in shelter: A qualitative study exploring the effect of homelessness on the parent–child relationship

“…We believe that the recommendation by Brinamen, Taranta, and Johnston () to expand early childhood mental health consultation (ECMHC) to homeless shelters is a promising approach to exploring how shelter environments can support infants and young children by promoting secure parent–child attachment. However, several mothers in our study were separated from their infant children, preferring to have kin care for their infants rather than bring them to shelter.…”

A Diagnosis of Denial: How Mental Health Classification Systems Have Struggled to Recognise Family Violence as a Serious Risk Factor in the Development of Mental Health Issues for Infants, Children, Adolescents and Adults

“…However, CAMHS is in a powerful position to not only champion the importance of the early identification of family violence, particularly in infancy [ 43 , 150 , 151 , 152 , 153 ], but to offer a therapeutic contribution to lives of the families they serve [ 151 , 154 , 155 , 156 , 157 , 158 , 159 , 160 ]. Furthermore, CAMHS has much to offer in how the prevalence and complexities of violence within families is thought about from a mental health perspective [ 49 , 161 , 162 , 163 , 164 , 165 ].…”