Unmet Needs of Young Children with Social-Emotional Concerns and Their Families: A Needs Assessment in Alameda County, CA

This needs assessment sought to identify early childhood mental health system gaps and priorities for the San Francisco Bay Area’s Alameda County by understanding what families need most and what the concerns of family members, mental health providers, and key partners are.  We conducted focus groups with families and providers, community forums with all partners in the early childhood mental health system of care, key stakeholder interviews, and analyzed data from children currently enrolled in county mental health services.

            Fourth major needs emerged. First, families have unmet basic needs, including extreme poverty, unstable housing, lack of affordable childcare, transportation issues, and language barriers. In particular, half of families whose children receive mental health services noted that their primary reason for unemployment was because they could not find affordable, quality childcare. Second, families experience stress as they care for their children and as many are also exposed to neighborhood and domestic violence. Third, parents seek emotional, informational, and financial support. For example, one parent said, “For years, my son had these behaviors that I didn’t realize were related to mental health issues because, you know, I was told that he was this bad kid and I’m a bad parent.” Fourth, the system is fragmented such that families sometimes fall through the cracks.  There is limited collaboration and communication across the different institutions that serve children, including, for example, medical providers and schools.  Insurance reimbursement policies also limit individuals’ service options. 

            These findings have several implications for practice.  The early childhood mental health system of care should partner with social services providers and others to help meet families’ basic needs that affect the quality of life of them and their children.  Similarly, mental health providers can partner with public safety officers to identify ways to improve neighborhood and family safety.  Providers can also make the early childhood mental health system of care more family-friendly; Alameda County has already implemented integrated family partners into agencies. Family partners are individuals who have experience with their own children and/or family members going through the mental health system and are trained to be a point of support in helping families navigate the system.  In addition to family partners acting as liaisons across the system, encouraging providers from diverse child-serving agencies to communicate, collaborate, and share information (including intake assessments and treatment plans) could increase the system of care’s efficiency in addition to making it more child-centered and family-friendly.