The first five years of life mark a critical time for childhood development. Early experiences and relationships with caregivers shape the architecture of a developing brain and lay the foundation for mental health across an individual’s life.
The American Academy of Pediatrics has recently released a clinical report, (published in the September edition of Pediatrics), endorsing preventive pediatric screenings for mental health, emotional, and behavioral concerns and offering providers additional clinical guidance to support their practice.
However, these endorsements can only have value if there are the providers available to deliver them. The need for these mental health roles has never been greater.
Despite the recognized importance of mental health in early years, the mental and behavioral health needs of infants, toddlers, and young children are often overlooked.
California has started to increase investment and launch initiatives in mental health for older children, but state and local governments are yet to do more to ensure we meet the mental health needs of California’s youngest, particularly as recent changes in mental and behavioral health funding through Proposition 1 and the Mental Health Services Act may soon impact the availability of community-based prevention and early intervention services.
First Five Center for Children’s Policy issued a report last year highlighting a concerning mental health provider workforce shortage impacting the nation and our state.
Some key findings highlighted in the report:
This shortage is particularly acute for providers serving specific sub-populations of California children, such as children in Medi-Cal, infant and toddlers, and for providers that are culturally and linguistically relevant for the diverse population of children in the state. First Five Center for Children’s Policy’s Brief proposes several key recommendations for state leaders which aim to address the critical shortage of IECMH providers, improve access to mental health services for families with young children, and reduce the inequitable impacts of the current system.
Subsequent data released by the California Department of Health Care Access and Information further emphasized these findings, explaining that in 2025, all 58 counties are projected to face a shortage across all behavioral health roles examined, and that the challenges facing mental health workforce supply and demand are projected to persist through to 2033.
In order to meet these needs, Safe & Sound works to build the system of care for children and families in San Francisco and beyond in a number of different ways.
Often, in the absence of a mental health provider, peer support is essential. Safe & Sound, as the backbone agency of the Family Services Alliance (FSA), is piloting ways to increase the number of family support providers that are reflective of their community and able to offer this peer support. By partnering with Community Health Worker training programs we can ensure that experienced community members get valuable training in peer support and then are placed within trusted Family Resource Centers. They could then undertake tasks such as mental health screenings that could be an early indicator of mental health issues requiring further support, navigation to resources and mental health education.
Where mental health providers are available, the FSA is working to strengthen the connections between these providers and family support services so that a family’s holistic needs can be met. Without access to basic needs such as shelter or food, it is difficult for a family to address trauma, anxiety or depression in therapy, lessening the value of mental health support. Safe & Sound and the FSA work to ensure that families’ basic needs are provided for both directly, and by increasing connections and advocating for more resources for families.
The Center for Youth Wellness, a program of Safe & Sound, works with pediatric clinics nationwide to support the introduction and implementation of ACEs screenings, and to ensure that children who have a high ACEs score are referred to Enhanced Care Management where they can receive a high level of case management.
And finally, Safe & Sound’s clinical care team based at both of our San Francisco locations provided 1,068 therapy sessions in 2024 for children and caregivers in our community. Through therapeutic play, our clinicians support families to have the tools they need to thrive.