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Understanding Mental Health Consultation in Head Start Programs

Use this resource to learn more about mental health consultation and how to find a consultant who meets your Head Start program’s unique needs.

What is mental health consultation?

Mental health consultation (MHC) is a prevention-based approach that pairs a mental health consultant with adults who work with infants and young children in the different settings where they learn and grow (e.g., child care programs, preschool, early intervention, and their home. MHC offers caregivers ways to support children’s healthy social and emotional development.

Explore these resources to learn more about MHC:

Three types of MHC include the following types of support:

  • Child- or family-centered consultation helps caregivers support a specific child or family.
  • Classroom consultation supports all children in a class. For example, the consultant and teachers may discuss routines in the classroom or how to help children talk about emotions.
  • Programmatic consultation supports everyone in the program. For example, the consultant may review the discipline policy, staff wellness activities, or social and emotional curricula.

The mental health consultant also improves family and community engagement. They help build community partnerships for more access to mental health resources and services.

What is MHC in Head Start programs?

Head Start programs have a unique and important role in early childhood mental health. MHC is a key part of Head Start programs’ multi-disciplinary approach to health and well-being. It supports promotion, prevention, early intervention, and referrals to community partners.

The Head Start Program Performance Standards (the Performance Standards) describe the role of MHC and service requirements. Head Start programs must offer MHC services at least once a month. Programs can help consultants partner with other staff for a coordinated approach. Programs should review MHC services every year to make sure they meet the program’s needs. Learn more at Supports for mental health and well-being 45 CFR §1302.45(a)(3)(4), (b)(1-6.

How can MHC support your program’s unique needs?

All Head Start programs must meet the Performance Standards, but each program has unique strengths and needs. Each Head Start program should choose a consultant based on the needs of the community it serves. Programs may hire or contract with a consultant. They may also write a memorandum of agreement with an agency for consultation. Use the questions below to help find the best MHC services for your staff, children, and families. You can also use the questions to assess your current MHC services.

What is unique about your program and community?

Each Head Start program is in a unique community. It is important to find a consultant who has experience and skills that match the needs of the program. Ask potential or current consultants or agencies about their experience working with the populations you serve. For example, in some communities many people speak a language other than English. Ideally, a consultant speaks the languages or dialects of the community. Other traits unique to your program or community might include:

  • Trends in family goals set during the Family Partnership Process
  • Recent changes in the program, such as serving more infants and toddlers
  • Challenges like high rates of violence, crime, or substance use disorders
  • Recent major events like a natural disaster
  • New populations arriving, such as refugees or immigrants
  • An increase in behavioral concerns
  • Organizational challenges in the program
  • Loss of a staff member

Choosing a consultant with the right experience helps create an approach to promoting mental health that works well for the whole program.

How can you find out if a mental health consultant can meet your program’s needs?

When interviewing a consultant or talking with your consultant, describe your program’s unique needs. Then ask what training and experience they have in these areas. You might say, “Many of our staff are concerned about children’s behavior. What has your experience been in this area?” or “Our community has recently had some deaths due to substance use. What experience do you have supporting staff on this topic?” Very rarely will a single consultant have experience related to every need. Focus on the program’s top needs to find a consultant who is the best match. Think about hiring several people for the program’s different needs. Programs can also offer consultants training on specific topics.

What is your program’s vision for MHC?

Create a program-wide vision for MHC by making sure everyone understands your program’s:

  • Definition of mental health
  • General approach to promoting mental health
  • Roles for all staff, consultants, and administrators in caring for mental health
  • Goals for MHC
  • Support for children and families who need mental health services

A shared vision helps make sure staff are all working toward the same goal. Words like mental health can mean different things to different people. Create shared definitions for key terms like behavioral health and social and emotional development. It is important that your shared definition is prevention based, holistic, and focused on wellness.

How do you find a mental health consultant?

Finding a consultant who meets the needs of your program can be hard. Follow these tips for how to find the right consultant:

  • Talk to other programs serving young children in your area. Local Head Start programs, home visiting programs, and early childhood programs may have ideas.
  • Connect with other programs on MyPeers. It is a great place to post your questions. MyPeers has communities with Head Start staff from across the country. It offers communities for MHC, mental health, and the Pyramid Model (a framework of evidence-based practices for promoting young children’s healthy social and emotional development).
  • Use your Region’s health or mental health specialist as a source of information. Your state Head Start Collaboration Director may know about community agencies that offer mental health services.
  • Talk to local organizations that offer mental health services. If the organization is unfamiliar with MHC, explain the role and ask if they can offer support. Consider contacting these organizations:
    • Local mental health clinics
    • Your state or Tribal mental health agency
    • Universities with graduate programs in behavioral health professions, including social work, psychology, psychiatry, or counseling
    • Your state’s infant mental health association
  • Ask local health care providers where they refer children and adults for mental health services. Pediatricians, community health clinics, and hospitals likely have local partnerships.
  • Think about offering telehealth (virtual) consultation. In-person services are best, but virtual support may work well until you can find someone for in-person services.
  • Learn about resources from national organizations. Find out if these organizations can post your request for a consultant on their website or email lists. National organizations to connect with include:

When you find a consultant, what is the best way to use MHC?

Resources to help you implement MHC:

These resources can help before and during your partnership with a mental health consultant.

Create clear policies and procedures for MHC. Use these questions to guide your partnership with a consultant:

  • How will your consultant help create and carry out policies and procedures? Policies and procedures should promote a multi-disciplinary approach to mental health for the whole program.
  • How do you make sure families understand what MHC is and how to use it?
  • How does your program get caregivers’ consent for MHC?
  • Who in your program will supervise the consultant and oversee how they carry out MHC?
  • What specific activities will the consultant do?
  • What is the process for deciding what the consultant will work on first?
  • How will your program decide if MHC is taking place often enough to meet your needs?
  • What are the steps for evaluating MHC? How will you measure how well the services work for staff and families?
  • How do you make referrals for mental health treatment services?
  • How will the consultant help you build partnerships with community mental health agencies?
  • How will you keep records of MHC services? Who will have access to the records?
  • How will you get Program Information Report (PIR) data on MHC?

Some consultants and agencies may have answers to these questions. If not, this is an opportunity to set up clear policies and procedures with the consultant you hire. Adapt MHC records, policies, and services to meet your program’s needs. Review the policies and procedures at least once a year to make sure they meet the needs of program leaders, staff, and families.

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