Pre-K providers on the front line of dealing with growing mental health needs

Damaris Alvarado-Rodriguez, owner of three Children's Playhouse early childhood education centers, thought it best to do away with statistics in her presentation to tell the story of a growing problem.

She had enrolled a 4-year-old preschooler into her day-care center. The first day of school the father, who seemed fine, dropped off the child. He participated in all the rituals that parents do to ensure a good handoff of a new student to a teacher.

"And then the father went home and committed suicide," Alvarado-Rodriguez said.

Alvarado-Rodriguez was one of the panelists at the Children First's Racial Equity Early Childhood Provider Council conference, where the organization released its latest policy brief: Priorities of Early Childhood Providers in Pennsylvania.

Children First, a youth advocacy organization for Southeast Pennsylvania, gathered early learning providers on July 27, to present its findings and discuss the report's most pressing concerns, including funding, staffing shortages, and the steadily increasing mental health needs for the pre-K set.

The declining mental health of young children

"It's at pandemic level," said Abiguel McMillan, who owns Abiguel's Beloved Family Child Care in East Mount Airy.

McMillan, who has owned her child care business for six years, said almost all of the children at her center now enter with an individualized educational plan (IEP), a written support plan for children with special needs.

"There's a crisis, and almost every child I see—more than 50% of the classroom—has special needs."

According to the U.S. Department of Health and Human Services, one in five young people experience mental health-altering problems during their school years, including stress, anxiety, bullying, family problems, and depression. Self-injurious behaviors are on the rise, too.

Unis Bey is the owner of Grays Ferry Early Learning Academy and the chair of the council's Racial Equity Subcommittee, which consists of 50 members representing a variety of programs all advocating for equitable access.

Since COVID-19 began, Bey said, she has noticed that children are demonstrating significantly more delays, especially in speech. Other behaviors she has witnessed are severe aggression toward adults, including hitting, biting, and spitting; self-injurious behavior where a child will throw themselves on the floor or smack themselves; and constant screaming as a way to cope with sensory overload.

She said early childhood providers need more help, but the current mental health system for getting pre-school-aged children evaluated is slow, fragmented, complex, and difficult for a parent to navigate. "When you talk about the system—the way the system is right now is inequitable. How many children in Philadelphia County are waiting for help? Over 10,000—more than any other county."

One awful solution: Suspensions and expulsions

McMillan decided the only way to meet the demands of her children was to invest in more training to help her cope. She is also limiting the children she enrolls who exhibit challenging behaviors.

When a grandmother brought her 5-year-old grandchild to the enrollment interview, McMillan spent time with the child but had to reject the application. "I said [to myself], ' just can't,'" said McMillan, the sole teacher at her family childcare center. During that initial meeting, the child, who had already been kicked out of several pre-K schools, was demonstrating challenging behaviors. "He was aggressive and [used some] profanity," McMillan recalled.

Research shows that suspension or expulsion from pre-K leads to children who are more likely to deal with academic failure, grade retention, have negative attitudes regarding school and ultimately drop out. With 42% of the suspensions and expulsions nationwide being Black boys, it also has become a racial equity issue.

Bey said she has been in the field 16 years, including six as an owner, and she hasn't expelled a child. Instead, she rolls up her sleeve to help. "I actually go into the classroom to help the teacher," Bey said. But she acknowledges that early childhood teachers are not special education specialists. "We are not speech therapists. We are not occupational therapists."

Upending an archaic mental health system

Instead of pushing children out, the Children First's subcommittee is recommending more funding for specialized teacher training, for adapting their centers to create inclusive environments, and for implementing rapid interventions.

"Just as $100 million was allocated for mental health funding for K-12 schools, we recommend equal funding for children in early childhood programs who are experiencing mental health challenges," the report notes.

Bey said one additional recommendation is to foster a collaborative partnership among all the stakeholders to find the best ways to deal with challenging behaviors.

Alvarado-Rodriguez said the mental health system for young children is out of step with what modern providers need. "[The mental health system] is archaic and like a puzzle that we need to throw the pieces up in the air and start rebuilding," Alvarado-Rodriguez said.

Alvarado-Rodriguez continued her story to make her point in her presentation.

After the father's death, the child, who is now in kindergarten, was beset by emotional problems that the staff dealt with daily as best they could. But resources and support for the child, the teachers, and family were in short supply and waits were long.

"We failed that child although I provided as much as I possibly could. By we, I mean the city, the state, everybody," she said. "This is not pointing fingers, this is about working collaboratively with city, state, and federal organization to ensure children, families, and teachers have the resources to meet the needs of every child."

In the meantime, Alvarado-Rodriguez and her staff are still haunted by the memory. "I pray for the child every day."

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