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St. Joseph's focuses community on mental health in early childhood

By RENEE STOVSKY

St. Joseph's Hospital in Chippewa Falls, Wis., believes that one of the most effective ways a community can ensure its future well-being is to focus on providing a socially and emotionally healthy environment for its youngest members.

That's why its Chippewa Health Improvement Partnership, or CHIP, sponsored a summit last fall for area educators, doctors, child care workers and therapists to discuss current trends in infant and early childhood mental health. Since then, it also has spearheaded the formation of two action teams — one geared to professionals, the other to the general public — to educate Chippewa County, Wis., population 63,000, on the importance of providing a nurturing network for babies.

"Infant mental health is synonymous with social and emotional growth in very young children," says CHIP Director Rhonda Brown, a clinical social worker who is regional director of community health development for St. Joseph's parent, Hospital Sisters Health System in Western Wisconsin. "It involves skills such as self-confidence, curiosity, persistence, trust, motivation and self-control — all of which affect learning, growth and success throughout life."

Children ride the seesaw at River Source Family Center in Chippewa Falls, Wis. The center works to prevent child abuse and neglect and to strrengthen familes by providing parent education in the areas of nurturing and attachment, positive parenting and knowledge of child development.

Brain development
Before organizing the Chippewa Falls summit, Brown and a few of her cohorts attended a meeting in Madison, Wis., organized by the Wisconsin Alliance for Infant Mental Health. There they learned about research, such as the Behavioral Risk Factor Survey sponsored by the National Alliance of Children's Trust and Prevention Funds in 2010, showing that adverse childhood experiences can affect the architecture of the developing brain of infants. That, in turn, can profoundly impact biological, cognitive, social and emotional functioning. Adverse childhood experiences include physical or emotional abuse, or mental illness in the home.

"Between 9.5 percent and 14.2 percent of infants exposed to a non-nurturing environment manifest mental health issues themselves, ranging from depression and anxiety to hyperactivity and post-traumatic stress disorder," says Brown. "Scientists are learning that chronic exposure to (adverse childhood experiences) can change development at the brain stem. Chemical and hormonal reactions to stress and trauma, such as increases in cortisol levels, can actually damage the hippocampus — which is responsible for memory functions — and result in smaller-sized brains."

Brown explains that CHIP, which identifies and analyzes community health gaps and prioritizes responses, has been aware for years that access to mental health services needed to be improved in Chippewa Falls. Until now, though, it has been concentrating its efforts mainly on bettering access to mental health services for adolescent and adult populations.

"Our suicide rates are disturbingly high here, due mainly to a combination of easy availability of firearms, high rates of substance abuse, a weak economy, the rural nature of the area and bad weather," says Brown.

While CHIP continues to work to fill the gaps in the community's support systems, she says, it wants to emphasize its new initiative to target the very young.

"We've been concentrating on problematic teenage issues like bullying, underage drinking, kids getting into trouble with the law," she says. "After attending the meeting in Madison, we've come to realize that adolescence may be late in the game to address significant problems."

Adverse childhood experiences
Joy LaMartina, a healthy community specialist at CHIP who is leading the action team geared to educating the general public on infant mental health, says the issue is of the utmost importance to the entire community — not just families that are already in the social services system.

"According to the 2010 census data, 11.6 percent of Chippewa County families are in poverty. Many of them face unemployment, lack of transportation, alcohol and drug problems and so on, putting young children in the home at higher risk of abuse," says LaMartina, a speech pathologist and former program director at a local family resource center. "But even the kids of middle-class, two-parent families can have exposure to (adverse childhood experiences) due to the stressful pace of our modern, multitasking life."

Brown emphasizes that a child's exposure to one adverse childhood experience may not have a profound affect on development or emotional health, but the greater the number of risk factors, the recurrent nature of them and the age at which a child is harmed by them can determine the damage to lifelong learning capacity.

Building resilience
In addition to alerting community members to potential threats to infant mental health, CHIP is spreading the word about referral networks and protective factors that parents, schools, social and health workers or other professionals can promote or provide to ensure a child's well-being and help build resilience. Among them:

• Good nutrition, healthy sleep habits and medical care.
• Healthy peer relationships for children in day care settings and early childhood programs.
• Teaching children what is appropriate behavior, providing examples of good social skills and building on their ability to trust.
• Teaching techniques for self-calming that can be coping mechanisms for children exposed to chronic stress.
• Making certain children have safe, stable, nurturing relationships around them.
• Promoting caring relationships with extended family members.

"I see parents, for example, on their cell phones when their child is trying to talk to them," she says. "It's so important to stop, look and listen to your child. If you want to build a relationship, you need to have eye contact, show that you care, encourage your child and teach them what you want to see in their behavior."

Part of her action group's mission, LaMartina says, is to develop not only awareness of the issue of infant mental health but also an education campaign. Brainstorming sessions to date among her team of 14 — which includes parents, grandparents, teachers, nurses, school representatives and a pediatric therapist — include the possibilities of producing brochures, podcasts, PowerPoints and even phone apps to reach the community at large.

"Both of our action groups are committed to meet for one year, and then we hope to come together again to talk about our progress and keep the initiative going forward," says Brown. "As the primary host of CHIP since 1994, St. Joseph's is always looking to give back to the community and help those who are underserved and underprivileged. This is a perfect fit for our mission; it provides services beyond the walls of our hospital by helping kids through contact with parents and professionals."

Childhood traumas can do lasting damage

What, exactly, are the adverse childhood experiences researchers have identified that, especially if recurrent, can contribute to trauma to young children? There are eight, says Rhonda Brown, regional director of community health development for Hospital Sisters Health System in Western Wisconsin:

• Physical abuse
• Emotional abuse
• Sexual abuse
• An alcoholic or drug abuser in the household
• An incarcerated household member or missing parent
• A household member that is chronically depressed, mentally ill, institutionalized or suicidal
• Violence between adults in the home
• Parental separation or divorce