It is also the case that infants and very young children can experience mental health challenges. Indeed, according to the Centers for Disease Control and Prevention, one in six children aged 2-8 have a diagnosable mental health condition. In Rhode Island, the number of young children enrolled in Medicaid presenting with Serious Emotional Disturbance has grown from 10 percent in 2017 to 22 percent in 2024. Many young children across the state are experiencing significant mental health challenges that interfere with their development, relationships, and learning.
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In these uncertain times, more parents than ever are stressed. From struggling to find child care, to financial pressures, to housing instability, parenting can be stressful. And that stress can impact young children’s brain development and mental health. According to the Harvard Center on the Developing Child, “Early experiences affect the development of brain architecture, which provides the foundation for all future learning, behavior, and health. Just as a weak foundation compromises the quality and strength of a house, adverse experiences early in life can impair brain architecture, with negative effects lasting into adulthood.”
In addition, the providers who serve families with young children are also stressed given limited resources and workforce shortages. Taken together, we need to focus on providing parents, families, and providers with the tools they need to promote infant and early childhood mental health, and to identify and address infant and early childhood mental health challenges.
Fortunately, Rhode Island has recognized this need and is making strides implementing a system to support children, families, and providers. In 2022, the General Assembly passed legislation to establish an Infant Early Childhood Task Force, which issued an Infant Early Childhood Mental Health Plan in 2023. That plan called for increased training and support for clinicians and other allied professionals, to improve infant and early childhood mental health along a continuum of promotion, prevention and intervention.
An exciting development is a collaborative project led by the Rhode Island Association for Infant Mental Health to build the capacity of mental health clinicians and allied professionals who already work with children younger than 6 to become familiar with the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, a nationally recognized framework for the assessment of mental health challenges in young children. A growing number of states encourage, recommend, or require the use of this framework to help ensure that young children’s mental health needs are understood and responsive therapies are provided. With grant funding, Rhode Island Association for Infant Mental Health will offer a series of trainings designed to introduce this framework to Rhode Island’s infant and family workforce, to enhance early intervention strategies.
This learning opportunity is designed to benefit Rhode Island professionals who are directly involved in the developmental and mental health evaluation, diagnosis, and treatment of children from birth to 5 years of age, as well as those who serve young children and families in non-psychiatric settings such as early care and education, family home visiting, and early intervention.
Another important program that the General Assembly has recently supported is the Pediatric Psychiatry Resource Network, which provides Rhode Island’s pediatric primary care providers with free behavioral health telephone consultations, direct patient care, and training and education services. This program has proven highly valuable to pediatricians, who continue to see high numbers of young children experiencing mental health challenges.
The mental health crisis impacting Rhode Island’s young children is a complex and difficult issue that will take time to improve. Fortunately, Rhode Island is leading the way through a combination of coordinated planning, training, and tools that support clinicians and families with young children.
It is best for babies when those providers who bear witness to a family’s deep struggles are supported with specialized training and support, so they are prepared to work alongside families and lift up their strengths. Babies remind us every day that it is our relationships that matter. And when all the grown-ups work together and collaborate across programs, agencies, roles, departments, our babies notice, and thrive.
As we look forward to the 2026 legislative session, it is critical that Governor Dan McKee and the General Assembly continue these efforts and investments that are making a real difference in the lives of our state’s youngest children and their families.
Susan Dickstein is an adjunct associate professor in the Brown Medical School, in the Departments of Psychiatry and Human Behavior and Pediatrics, and executive director of the Rhode Island Association for Infant Mental Health. Alana DiMario is a state senator representing District 36 (Narragansett, North Kingstown, New Shoreham) and a licensed mental health counselor.