The Hillsborough County Early Childhood Council has called upon Dr. Jennifer Marshall and her research team to evaluate the county’s Infant Mental Health Uniting Grant. Marshall, a research assistant professor in the Department of Community and Family Health at the USF College of Public Health, has a long relationship with the council.

“I have worked with the Early Childhood Council for about 12 years,” she said, “so I have relationships with them from doing other projects and sitting on the council. They have just gotten funding from the Children’s Board to unite Hillsborough County agencies in improving the effectiveness, awareness, knowledge and capacity of infant mental health practice. So, they’re bringing together all the major agencies in the community: Child Welfare, Early Childhood Education, Parent Education, all the agencies that work with young children and families.”

Marshall’s research team is comprised of two MPH students, Jerchelle Jean-Poix and Amber Patterson. Both are full-time students. Jean-Poix, whose concentration is epidemiology, is also a full-time health department employee, and Patterson, whose specialization is maternal and child health with a certificate in epidemiology, doubles as a full-time mother.

“They’re just superstars,” Marshall said. “These students are always looking to get involved in research. These are two double full-timers who are in really challenging programs and developing a very ambitious evaluation, too, outside of all those other hours.”

Those other hours mean weekly meetings are after hours, two to three hours every Tuesday night, Marshall said, then copious e-mails, texts and phone calls over the ensuing week.

The one-year grant is fairly complex, she said, partly because of the sheer number of agencies involved, and the grant’s complexity naturally leads to a complex methodology.

“We’re using diffusions of innovation theory to see how organizations and individuals perceive the infant mental health interventions,” she explained, “how they incorporate that into their daily practice, and whether their readiness for that increases over the year.

“This united effort of the community partners is working to increase readiness and then adoption of this infant mental health practice by raising awareness through a social marketing campaign, as well as raising knowledge, skills and effectiveness via several evidence-based trainings that are going to be held. Also, they’re working as a system-level collaborative to address sustainability.”

That has to do with how mental health services are funded and how staffs are trained, and training starts with perception and definition, and Marshall acknowledges that the key term is not widely known: Just what is infant mental health?

“Sometimes people think of mental health,” she said, “and they think in terms of not necessarily mental social and emotional wellness, but instead they think of illness – they think of children who have social and emotional problems and need some type of therapy or intervention.”

Examples, she said, are families and children who have been in high-stress situations, have been in the child welfare system, or have been exposed to trauma or violence and are evincing social or emotional challenges.

“But that’s not only what infant mental health is,” Marshall said. “It’s also promoting responsive caregiving, promoting attachment, promoting knowledge of child development so that parents and children can form bonds and relationships that promote healthy social and emotional development. So, we’re looking to raise awareness that infant mental health is really social and emotional wellness for children from birth to age 3.

“The idea is that the community agencies and the staff that work in those agencies can support child social and emotional development and know how to do that. They’re trained to do that, but also they’re trained to recognize when there’s something going wrong, to be able to know how and when to intervene. So this also involves training mental health professionals who might traditionally provide services to school-aged children, teenagers and adults, and wouldn’t necessarily know what to do with a 2-year-old whose showing major signs of distress, or that 2-year-old’s parents, for example.”

So for the next year, Marshall and her research team are busy analyzing everything from training participant and organizational staff surveys to audio recordings of community meetings. Their goal is to use that year’s investment on making a lasting systemic impact.

“The evaluation is focused on the organizational level, so that it’s more sustainable and has a broader reach,” she said. “It’s not just training parents or a handful of providers. The effort is really to engrain this in the organizational structure.”

 

Story by David Brothers, College of Public Health. Photo courtesy of Dr. Jennifer Marshall.