Integrating mental health services into primary care

Through play, children learn. Play teaches them how to process information, express themselves, self-regulate, and concentrate among its many other functions.

Photo by Rajesh Rajput on Unsplash

Early in her psychology studies, Laura Harford, PsyD, Licensed Clinical Psychologist and HealthySteps Specialist with the Mother and Child Integrated Mental Health Program (MAC-IMP) at NewYork-Presbyterian Columbia University Irving Medical Center became fascinated by the role that play plays curatively. 

“When you’re working with very young children therapeutically, it becomes nearly impossible to treat the child without addressing the parents’ needs as well,” Harford begins. 

Using play as a parental teaching tool and providing the parent with strategies and support, can promote more secure attachments and facilitate communication and understanding between a parent child dyad.

Photo by Larry Crayton on Unsplash

Play can increase parents’ understanding of their children’s needs and help them to feel more confident overall, Harford continues.  

Healthy Steps is part of the Zero To Three program designed to support new families around bonding, child development, and parenting concerns. 

More specifically, Zero to Three supports parents with practical resources, professionals with knowledge and tools that help them support healthy early development and policymakers in advancing comprehensive and coherent policies which support and strengthen families, caregivers and infant toddler professionals. 

The Healthy Steps model has identified five outcomes important to healthy child development and family well-being which include:

  • Breastfeeding
  • Child social-emotional development
  • Early childhood obesity
  • Maternal depression and 
  • Well-child visits.

As such, Harford was encouraged to complete the Lactation Counselor Training Course (LCTC) to help fulfill these priority outcome areas. 

Infant feeding can affect parental mental health, and the reverse is true too. 

Harford explains that if a mother is feeding her child “well” (“well” in quotes because this definition varies from individual to individual and family to family), she will likely feel more confident in her parenting abilities overall. If the child is not feeding “well”, feelings of anxiety and failure may creep into the picture. 

A mother who  presents with mental health issues may be less responsive to her child’s feeding cues in particular, contributing to a potentially fussy and irritable infant or to an infant who fails to thrive, Harford goes on.  

While breastfeeding can be preventative against perinatal mood disorders, support isn’t always easy to come by.   

 “There is no shortage of lactation specialists at [NewYork-Presbyterian Columbia University Irving Medical Center], but I wanted to be a more direct resource to ensure that any mother who is enrolled in my program and needs help can access support,” Harford explains.  

Harford works solely with individuals who receive Medicaid; as such, these families are often up against systemic barriers that challenge their ability to access health services. 

In the instance of virtual support, access to technology can be a barrier. Harford shares that as healthcare services shifted virtually as a result of the pandemic, their institution had various initiatives to support patients in maintaining connection to clinical care. 

Sometimes cost is prohibitory. Generally, navigating mental health care systems can be overwhelming and sustaining the effort to initiate services can be exhausting. 

That’s why Columbia University Irving Medical Center is working to provide these services directly through primary care, Harford says. 

Integrating health services allows for better continuity of care. 

“If there is one provider that the family trusts, then they will readily engage with the next they come across when these direct connections are made,” Harford explains.

There’s more time and energy available to facilitate those invaluable moments of play and connection between parents and their children when health services are integrated and the stressors of seeking out help are eliminated.

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