§ 27-38.2-6. Infant and early childhood mental wellness task force.
(a) The general assembly hereby finds that:
(1) Infant and early childhood mental health is defined by Zero to Three as "the developing
capacity of the child from birth to five (5) years of age to: form close and secure
adult and peer relationships, experience, manage and express a full range of emotions,
and explore the environment and learn — all in the context of family, community and
culture.�
(2) Significant mental health challenges can and do occur in babies and young children.
Epidemiological studies show a sixteen percent (16%) to eighteen percent (18%) prevalence
rate of mental health disorders in children between age one and age six (6). Evidence
shows that many mental health challenges occurring in the first years of life persist
and increase the risk of problems related to early learning and development in all
areas, and to serious long-term health and mental health challenges and poor educational
and economic outcomes.
(3) Young children respond to and process emotional experiences and traumatic events in
ways that are very different from adults and older children. Consequently, identifying
and addressing mental health challenges in early childhood requires special skills
and knowledge. Promoting responsive and nurturing parent/caregiver-child relationships
is particularly important for babies and young children.
(4) It is essential to treat young children's mental health challenges in the context
of their relationships within families, homes, and communities. The emotional well-being
of young children is directly tied to the functioning of their parents/caregivers
and the families in which they live. Thus, successful mental health treatment for
young children involves working to build and strengthen consistent, supportive relationships
within their families and community. Identifying and treating mental health challenges
of parents and caregivers, especially maternal depression which is a common condition
and can negatively impact child development, is also needed. When relationships are
reliably responsive and supportive and stress is reduced, young children can thrive.
(5) Diagnostic Classification of Mental Health and Developmental Disorders of Infancy
and Early Childhood (DC: 0-5) is the only recommended diagnosis system for children
under age six (6). DC: 0-5 is a system of classification of mental health and developmental
disorders for infants and toddlers.
(6) Evidence-based and evidence-informed parent-child dyadic therapies exist that focus
on the powerful influence of the parent/caregiver-child relationship to positively
impact a child's trajectory. Evidence-based interventions aimed at mental health challenges
are more effective when implemented during early childhood rather than school age.
It is a misconception that young children will grow out of their difficulties or simply
forget early traumatic experiences.
(7) In Rhode Island, approximately fifty percent (50%) of infants and young children have
Medicaid health coverage which covers screening, evaluation, diagnosis, and treatment
for children's mental health needs starting at birth. Data from 2018 indicate that
less than eight percent (8%) of the Medicaid population under age six (6) received
any mental health services.
(8) According to the National Center for Children in Poverty, at least twenty-one (21)
states have adopted research-informed infant/early childhood mental health state policies
and scaled initiatives. Medicaid policy in at least thirteen (13) states and the District
of Columbia recommends or requires the use of the developmentally-appropriate DC:
0-5 system for the diagnosis of children under age six (6), and at least twelve (12)
states require providers to use an evidence-based dyadic treatment model for children
under age six (6).
(b) The executive office of health and human services shall establish a task force to
develop a plan to improve promotion of social and emotional well-being of young children
as well as screening, assessment, diagnosis, and treatment of mental health challenges
for children from birth through age five (5) with Medicaid coverage.
(c) The planning task force shall include representation from the RI Association for Infant
Mental Health and representatives from pediatric health care, mental health care,
child psychiatry, child welfare, early intervention, family home visiting, early care
and education, advocacy organizations, Medicaid managed care organizations, Medicaid
accountable entities, families with young children, and other stakeholders as needed.
(d) The plan established in accordance with this section shall include strategies to:
(1) Promote use of developmentally appropriate screening, assessment, diagnosis, and evidence-based
and evidence-informed parent-child dyadic therapies for children from birth through
age five (5).
(2) Identify mental health promotion and prevention-related parenting support programs,
particularly evidence-based or evidence-informed parent-child programs supporting
social and emotional well-being.
(3) Allow for effective screening, evaluation, and treatment over multiple visits with
a qualified practitioner in a variety of settings, including in children's homes,
at childcare and early learning programs, in schools, and in clinical and other professional
settings.
(4) Establish a registry of trained infant/early childhood mental health professionals
that can be a resource across health care, education, and human service settings.
(5) Strengthen infant and early childhood mental health skills, knowledge, and practices
of all providers who work with young children (birth through age five (5)) in health
care, mental health care, early childhood, and child welfare service sectors.
(6) Address and respond to the intergenerational effects of racism, economic insecurity,
and toxic stress that influence the health and mental health of parents/caregivers,
babies, and young children.
(e) The task force shall submit a plan to the governor and general assembly on or before
June 30, 2023.