Upstream Upper Valley

Increasing early childhood mental health and trauma awareness among community health and service providers.

Population to be served and need

The proposed 3-year Upstream project will target health providers (for example, pediatricians, nurses, and adult addiction providers) and service providers (for example, police, fire, and emergency services; military/National Guard members; child advocates; child-care/pre-school staff; and homeless shelters) serving children ages 0 to 6 years and their families. The catchment area encompasses three primarily rural counties across New Hampshire and Vermont known as the “Upper Valley.” The population is largely Caucasian, and many towns suffer from higher than average poverty and unemployment levels. The targeted counties are in the midst of a devastating opioid crisis with some of the highest overdose death rates and infants born addicted to opioids in the country.

Numerous service sectors have observed an unprecedented increase in early childhood neglect and trauma and subsequent mental health needs of young children. For example, the number of children entering foster care has risen 30% since 2012, mostly accounted for by infants and young children. Health, community, and service providers are overwhelmed by the influx of needs in this population and are unfamiliar with how to identify mental health needs in young children. Yet early intervention is key to preventing the long-term effects of adversity during this rapid period of brain development and growth.

Strategies/evidence-based practices

The Upstream project will provide evidence-based mental health and trauma training and consultation to health, community, and service professionals serving young children and families across the Upper Valley. We will use standardized, evidence-based curricula focused on identifying signs of trauma, neglect, and mental health symptoms in children ages 0 to 6 years and de-escalation strategies for dysregulated individuals; as well as processes and tools to facilitate referrals to partnering mental health agencies providing evidence-based psychotherapy to this population in our community.

Trainees will also have access to the Upstream consultation program connecting them with 1 of 3 local early childhood expert mental health clinicians via in-person and phone consultation to assist with the identification of children in need and linkage to treatment.

Goals and measurable objectives

Our goal is to increase the capacity for health, community, and service professionals to identify trauma and mental health needs in young children and link families to needed services. Our primary objectives are to:

  • Provide six full-day and three 2-hour sequenced in-person trainings (54 total training hours; 18 annually) to 300 professionals (100 annually) spanning numerous disciplines across the Upper Valley
  • Provide ongoing in-person or phone consultation through county-based early childhood experts
  • Increase the number of referrals from the trained professionals to the partnering mental health agencies