Mental Health Consultation to Home Visiting programs is an integrated service delivery approach designed to enhance the capacity of home visiting programs and their staff in the early identification of mental health issues that may affect the mother/father and their impact on the development of the young child. The home visiting staff receives ongoing support through group and individual consultation, direct brief intervention services and linkage to the treatment continuum if needed.
The Mental Health Consultant assists the home visiting staff to attend to the developmental and social emotional wellbeing of the child through observation and parent/child interactions. The Mental Health Consultation approach seeks to enhance home visiting programs with high quality mental health services and supports.
CA LAUNCH Approach
The CA LAUNCH model seeks to integrate maternal/paternal mental health stabilization, support, referrals and resources to families receiving services from Public Health home visiting programs where mental health concerns exist. The home visitors and consultant come together as a team to focus on mental health wellness, complex psychosocial needs and barriers to receiving mental health services.
Early childhood home visiting programs are voluntary, family-centered services that match new and expectant parents with trained and caring professionals (nurses, child development specialists, early interventionists, and/or case managers) who provide ongoing, one-on-one support during pregnancy and a child’s first years of life. Home visitors provide parent education, mental health and developmental screenings, lactation support and respond to critical needs. They work one-on-one with mothers and fathers to improve their parenting skills, strengthen their support and coping capacities, and promote the infant’s healthy development, emphasizing that parents are a child’s first and most influential teacher. The essential goal of early childhood home visiting is to strengthen the parent-child relationship since it plays such a critical role in children’s healthy development and in ensuring school readiness – a strong predictor of success later in life – especially for children who are growing up in environments where there are high levels of adversity.
The original LAUNCH Program in California was in Alameda County. Following its successes, CA LAUNCH has expanded to three additional counties in California: Fresno, Nevada, and San Francisco. The expansion counties are building the infrastructure across systems (Community based organizations, Public Health home visiting programs, Mental Health agencies and Early Childhood Systems) to integrate and coordinate mental health supports to home visiting programs and their staff.
Model Elements for Mental Health Consultation
The Mental Health Consultation and Supports model focuses on the health and well-being of the child in the context of the dyadic relationship with the primary caregiver. This model takes into account a two- generation approach that focuses on the whole family. Clinicians will provide a range of consultative intervention strategies, training and supports to home visitors integrating a reflective practice approach. Some of the topics to be infused into the consultative approach are the impact of stress and trauma on families with young children, vicarious trauma for individuals and providers, brief interventions for clients in their homes, parent-child interaction and relationships and how to facilitate warm hand-offs for mental health services and supports.
More Mental Health Consultation in Home Visiting Resources
Alameda County Public Health Department’s Mental Wellness Team named the Blue Skies Mental Wellness Team. The Blue Skies Team provides mental health consultation, support and clinical interventions to the Maternal, Paternal, Child and Adolescent Health Unit’s Home Visiting and Family Support Programs.
Alameda County Public Health Department’s (ACPHD) Blue Skies Mental Wellness Team Video Clip. The ACPHD model is one approach to illustrate how mental health consultation in home visiting can be successful.
Below are the job descriptions of the positions on the Alameda County Public Health Department’s Mental Wellness Team called Blue Skies:
The Supervising Behavioral Health Clinician provides management, team leadership and clinical oversight of the team and its staff. This person should hold a unique ability to work well with others, possess strong organizational skills, create and support multidisciplinary team approaches and provide reflective and clinical supervision. The position/staff should have awareness of community mental health resources, wellness promotion capacity and possess abilities to triage case work along with manage multiple task supporting and sustaining mental health service delivery. Click here for the job description.
The Behavioral Health Clinician II provides psychiatric clinical and case management services, conduct evaluations and assessments; provides crisis management, ongoing counseling, treatment and intervention for perinatal clients in early childhood mental health continuum and conducts individual, group and psychotherapy; training in-services and provides consultation to referring programs. This licensed clinician should possess team service delivery ability, knowledge of collaboration efforts and home visiting therapy case work experience. Click here for the job description.
Perinatal Mood Disorder Therapist– position provides psychiatric clinical office based or home visiting therapy to evaluate and assess clients, provides ongoing counseling, treatment and interventions for perinatal clients experiencing perinatal mood disorders and other emotional concerns. Has ability to manage complex case presentations providing individual therapy and consultation to referring programs. This licensed therapist can support medical medication advocacy, parenting and crisis interventions and therapeutic practices to support perinatal clients. Click here for the job description.
Mental Wellness Team Referral Form
Here is an example of the Mental Wellness Team Referral Form. This form is used by a case manager, home visitor, or direct service provider who would like to refer a family to a mental health provider or to speak to the Team Leader for consultation.
CA Project LAUNCH Program Support 4 ways to participate
Below was the plan and the deliverables for the TA Team during the grant cycle. If you are thinking about starting up a mental health consultation team, this is one example of activities provided for expansion sites for technical assistance and consultation.
- Monthly Reflective Community of Practice Supports
- One hour of Reflective Consultation
- Zoom/In person Case Conference Trainings (2 per site per year)
- Training session with Project LAUNCH Expansion grantees (TBA)
Click here to view the entire PDF.
Depression in Mothers: More than the Blues
A Toolkit for Family Service Providers
This toolkit contains strategies and information to help providers work with mothers who may be depressed. Facts about depression, signs of more serious depression, activities, and resources are included.
Citation: Substance Abuse and Mental Health Services Administration. Depression in Mothers: More than the Blues –A Toolkit for Family Service Providers. HHS Publication No. (SMA) 14-4878. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
Additional Resources for Mothers with Depression and Service Providers
New Paper on Early Childhood Mental Health Consultation
Early Childhood Mental Health Consultation: Policies and Practices to Foster the Social-Emotional Development of Young Children, a new paper from ZERO TO THREE, offers an overview of early childhood mental health consultation (ECMHC), current issues in the field, and possible future directions. It provides a snapshot of current programs across the nation, underscoring the variability of how ECMHC programs are funded, managed, implemented and staffed. A list of guiding questions is provided for states to consider in designing and creating their ECMHC program.
Secondary Trauma and Child Welfare Staff: Guidance for Supervisors and Administrators
Child Welfare has the mission of promoting child safety, wellbeing, and permanence through the provision of child-focused, family-based practice. As part of their day-to-day work, child welfare staff interact with people who have experienced trauma, and frequently multiple traumas, over the course of years and often over the course of generations.
Click here to view the entire PDF.
Mental Health Consultation in Home Visiting Evaluation Resources
The following evaluation tools may be useful in measuring the impact of mental consultation on home visiting program staff members.
Bride Secondary Traumatic Stress Scale (STSS, 2004)
The Bride Secondary Traumatic Stress Scale, (STSS, 2004) is a 17-item self-report survey recommended by the National Child Traumatic Stress Network. The STSS has been described as filling a need for a reliable and valid instrument specifically designed to measure the negative effects of work practice with traumatized populations.
Professional Quality of Life Scale (ProQOL-5)
The Professional Quality of Life Scale (ProQOL-5, 2009) is a 30-item self-report survey recommended by the National Child Traumatic Stress Network. It will be used in the upcoming local evaluation (2017-2019) of California LAUNCH expansion counties that are implementing the LAUNCH model of mental health consultation and supports within home visiting programs. It is designed to measure positive and negative aspects of work life, and includes sub-scales for compassion satisfaction, secondary traumatic stress, and burnout. More information at www.proqol.org.