Carefully twisting many fibers will create a strong and cohesive cordage to support Hawai‘i’s youngest keiki 

Imagine early care and education, health care providers, and private foundations weaving a safety net to support the mental health of Hawai‘i’s youngest keiki and families. Hawai‘i’s Integrated Infant and Early Childhood Behavioral Health Plan (IECBH) is convening diverse stakeholders to create a systems-level vision of aligned strategies between and across departments and agencies to ensure infant and early childhood mental health principles and practices are integrated in their work. Recently, ★ 30 leaders came together to discuss how they could realize the IECBH vision, and how - in turn - woven together - these collaborations will support their own organizational goals.

Alignment of key resources strengthens our ability to respond to the many challenges confronting the systems of support for early childhood.

As Cecilia Sakata of Hawai’i Island Community Health Center (HICHC) notes, young children spend significantly more time with family, friends, and in early care and learning settings than they do with health care providers. By collaborating, health care providers can leverage the insights of early care and education providers, as well as families, to create a robust safety net. This ensures that keiki at risk are screened for developmental delays, referred for critical services, and receive the necessary interventions quickly.

Currently, ★ 33 medical providers from the HICHC have agreed to align their screening efforts by using one standard screening tool to ensure that children receive the support they need. To date, ★ over 2,500 keiki ages 0-5 on Hawai’i Island have engaged in this improved care path. Improving alignment also allows for collaboration in other meaningful ways. For example, the information garnered can be shared back to the community. This valuable loop can help early care and learning providers tailor their curriculum to the needs of the keiki in their communities, all the way down to zip code-specific interventions. This approach is a step in the right direction for equity in health and education. This is a good example of integration and alignments to weave and tighten the cordage.

Many different fibers need to be woven into the support structure IECBH partners are envisioning.

Establishing and coordinating dependable funding mechanisms is a key to sustaining efforts. The IECMH Finance Policy Project (FPP) is untangling the finance puzzle to build a coordinated finance pattern to ensure sustainability of efforts. The big in-person IECBH gathering demonstrated the value of bringing together a wide spectrum of perspectives for robust discussion with exciting input from managed care organizations, MedQuest, DOH, DOE, and others. 

Another essential fiber in the cordage is the training of professionals in infant and early childhood mental health (IECMH). The Association for Infant Mental Health Hawai‘i (AIM HI) continues to be a lead training entity across the state offering workforce development through the Promising Minds initiative, other grants, and now the Pediatric Mental Health Care Access Grant. 

The IECBH convening of cross-sector leaders was an opportunity to champion systems-level strategies and there is great interest to keep this momentum going. The post-meeting survey showed 100% of participants felt it was worth their time with 93% stating that gathering in person to have these conversations was the most important aspect. Event participants appreciated the opportunity to identify and recognize small and large action steps in the weaving process of integrating Infant and Early Childhood Mental Health into various aspects of the Early Childhood system. All fibers count!

All fibers count!