Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce Final Report

Transcription

1 Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce Final Report Prepared for the Department of Education, Employment and Workplace Relations September, 2012

2 Report prepared by: Karen Stafford, Nicole Edwards & Alexandra Logatchova Program Manager: Gavin Hazel Hunter Institute of Mental Health Hunter New England Local Health District PO Box 833, Newcastle NSW and Community Services and Health Industry Skills Council PO Box H61 Australia Square NSW Suggested Citation: Hunter Institute of Mental Health and Community Services & Health Industry Skills Council. (2012). Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce. Final Report. Department of Education, Employment and Workplace Relations. Canberra, ACT: Commonwealth of Australia. This project was funded by the Commonwealth Government through the Department of Education, Employment and Workplace Relations.

3 Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce Contents Executive Summary 1 1 Introduction 3 2 Project Stages and Objectives 3 3 Defining Early Childhood Mental Health and Wellbeing 3.1 Objectives for Stage One Sector Context and Background Developing a Shared Understanding The Mental Health Consensus Statement 13 4 Early Childhood Teacher Education 4.1 Higher Education Sector Context Preliminary Program Analysis Further Data Collection and Consultation Structure and Content of Programs Additional Consultation Findings Conclusions 46 5 Vocational Education and Training: Children s Services 5.1 Competency Mapping Exercise Online Surveys Literature Review Conclusion 89 6 Professional Development Opportunities 6.1 Sources of Information Workforce Engagement in Professional Development Inclusion of Mental Health in Professional Development Mental Health Specific Resources and Programs Conclusions Further Consultation and Emerging Themes 7.1 Stage Three Subject Matter Expert Group Emerging Themes and Principles Domains of Practice by Work Role Recommendations References 117

4 Abbreviations ACECQA Australian Children s Education and Care Quality Authority ACER Australian Council for Educational Research AITSL Australian Institute for Teaching and School Leadership AQF Australian Qualifications Framework CHC08 Community Services and Health Training Package (2008) CBT Competency Based Training COAG Council of Australian Governments COPMI Children of Parents with a Mental Illness CS&HISC Community Services and Health Industry Skills Council DEEWR Department of Education, Employment and Workplace Relations ECA Early Childhood Australia ECD Early Childhood Development ECEC Early Childhood Education and Care ECTARC Early Childhood Training and Resource Centre EYLF Early Years Learning Framework FDC Family Day Care HE Higher Education HELP Higher Education Loan Program HIMH Hunter Institute of Mental Health IPSP Inclusion and Professional Support Program ITAB Industry Training Advisory Body LDC Long Day Care MOU Memorandum of Understanding NQF National Quality Framework NQS National Quality Standard NUHEPs Non-University Higher Education Providers OC Occasional Care OECD Organisation for Economic Co-Operation and Development OOSH Outside of School Hours RTO Registered Training Organisation SEEDS Social and Emotional Early Development Strategy SNAICC Secretariat of National Aboriginal and Islander Child Care TAFE Technical and Further Education VET Vocational Education and Training

5 Executive Summary There is growing awareness of the importance of early brain development and life experiences in influencing children s social and emotional development and their mental health. Childhood developmental influences can have important consequences for mental health and wellbeing, which often reach into adolescence and adulthood. Mental health and wellbeing also have the potential to influence other outcomes throughout life, such as physical health, learning, vocational opportunities and community participation. For many Australian families, early childhood educators play an essential role in enhancing children s development and supporting those with additional needs. By providing high quality services that support optimal development and mental health, early childhood educators also help to promote positive longer-term outcomes for both individuals and communities. What knowledge and skills can educators integrate into their practice, to most effectively support children s mental health and wellbeing? This project, an initiative of the Department of Education, Employment and Workplace Relations, explored this issue by drawing on research, policy, expert opinion and consultation. Other objectives for this project were to examine the inclusion of mental health related material in current training and professional development and to identify opportunities to enhance workforce capacity. One item for specific consideration was the potential development of a national set of competencies or professional practices for the early childhood workforce, relating specifically to children s mental health and wellbeing. For the purposes of this project, early childhood mental health and wellbeing was defined in terms of the capacity of a young child within the context of his or her development, family, environment and culture to participate in the physical and social environment, develop a secure sense of self, understand and regulate emotions and behaviour, form healthy and secure relationships and interact appropriately with others. This project adopted the view that mental health is related to capacity and wellbeing, and is not interchangeable with the term mental illness. Mental health encompasses people s social, emotional and psychological wellbeing, which can be reflected in their thoughts, feelings and behaviour. In the early years, mental health is primarily related to promoting children s best possible physical, cognitive, social and emotional development and responding to particular challenges that may arise for some children and families. Based on an analysis of policy, research and expert opinion, and working in consultation with representatives from both the early childhood and mental health sectors, this project identified five key domains of practice relating to children s mental health and wellbeing, with several elements of knowledge or skill relevant to each domain. The domains were: the environment; child development; early intervention; partnerships; and professional practice. Using this framework, the project then examined the extent of such material in current training and professional development and consulted widely with stakeholders to identify ways forward. Throughout the consultation, there was wide support for the importance of early childhood mental health and wellbeing. There was also an appreciation of and a commitment to the continued role of early childhood educators in promoting positive development and wellbeing. It was clear, however, that there is a lack of consensus on concepts and language relating to mental health, along with uncertainty about how best to support children s mental health and wellbeing, particularly when there are significant developmental or mental health challenges. Much of what early childhood educators already do and aspire to do in their practice can be seen as contributing to mental health outcomes, but the links to mental health are not always explicitly understood or articulated, either in practice or in training and development. In broad terms, many people were supportive of the potential value of defining core knowledge and skills relating to the promotion of early childhood mental health and wellbeing, as this could serve as a guide for the workforce in regard to practice and professional development. However, rather than establishing these as a distinct set of competencies which could be Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 1

6 viewed as imposing additional requirements on a workforce that is already undergoing extensive reform most participants suggested other approaches that could promote a focus on mental health in service provision and could be used over time to build workforce capacity. A staged approach has been envisioned, including the definition of key concepts, an outline of relevant workforce knowledge and skills, and the promotion of such material throughout the sector to promote a common language and understanding. This material should be linked with current initiatives relating to quality service provision and promoted as an integral part of quality practice, rather than an additional requirement. It would act as a guide for educators and services and could be used to help identify training and professional development needs relating to children s mental health and wellbeing. Follow-up strategies are recommended to ensure that the concepts and skills underpinning children s mental health become formally integrated into early childhood practice and training such as through VET competencies, professional standards for early childhood teachers, accreditation systems for training programs, and processes relating to service quality and regulation. While the first stage could lay the groundwork for common language and understanding, which would certainly be beneficial, the second stage would help to promote accountability and sustainability over the longer term. During both stages, acknowledging the mental health needs of educators themselves could be important in gaining support for the issue. Strategies for educators self-care and for creating supportive workplaces may help to ensure that educators are better able to support children and families. It was also noted that while there are some high-quality, evidence-based training and professional development resources or programs available for this workforce, these are not necessarily universally used or widely accessed and there are barriers to educators participating in formal professional development. It was suggested that promoting and supporting the use of existing quality materials and enhancing access to training and professional development could be important strategies in building workforce capacity in relation to children s mental health and wellbeing. This report has generated a series of recommendations for consideration by the Australian Government, grouped into six areas of action, as follows: Promote mental health literacy in the early childhood education and care sector Enhance mental health content in early childhood vocational education and training Enhance mental health content in early childhood teacher education programs Support access to professional development about children s mental health Specify children s mental health as a priority issue in formal systems and processes Promote the mental health and wellbeing of all children, young people and educators. These action areas and the specific recommendations which have been developed for each are seen as a set of mutually-reinforcing activities, forming the basis for a potential integrated strategy to enhancing workforce capacity. Ultimately, supporting workforce capacity in regard to children s mental health has considerable long-term potential to promote positive wellbeing and learning outcomes for individuals and for communities. Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 2

7 1. Introduction There is growing awareness of the importance of early brain development and life experiences in influencing children s social and emotional development and their mental health and wellbeing. Early influences on development and wellbeing can have far-reaching consequences for mental health outcomes in childhood, adolescence and adulthood. Positive relationships and experiences in early childhood tend to support positive, productive outcomes for the future, for both individuals and communities. Early identification of mental health difficulties, and referral of children and families to early intervention services, can also be associated with better developmental and mental health outcomes. As many children and families in Australia access formal Early Childhood Education and Care (ECEC) services, the early childhood workforce is well placed to support the development of resilience and wellbeing in children and to work in partnership with families to facilitate early identification and intervention when there is an emerging risk of mental health difficulties. This project was an initiative of the Department of Education, Employment and Workplace Relations (DEEWR), under the broader Council of Australian Governments (COAG) agenda for improving access to and quality of ECEC. The aim of the project was to explore the potential for development of national mental health and wellbeing competencies or professional practices relevant to the ECEC workforce, and to examine the current inclusion of such practices in training and professional development, as a step toward promoting greater workforce capacity in regard to children s mental health. The project was implemented by the Hunter Institute of Mental Health (HIMH) and the Community Services and Health Industry Skills Council (CS&HISC), with some elements being conducted independently and some tasks and analyses being performed in partnership. The work was undertaken from October 2011 to May The importance of the ECEC workforce in promoting quality services and positive outcomes for children is recognised and articulated in the national early childhood policy agenda, including the National Early Childhood Development Strategy (Commonwealth of Australia, 2009a) and the National Quality Framework for Early Childhood Education and Care (NQF). The NQF and its components, such as the Early Years Learning Framework (COAG, 2009), are key policy and action documents informing this work. Links to key documents and further information are available at This project also drew upon expert opinion from the ECEC sector and tertiary education providers and on an ongoing analysis by HIMH of research and theoretical publications in the field of mental health promotion and prevention in children. Some of this analysis had been undertaken by the HIMH in the context of other project work in recent years exploring the promotion of children s mental health and wellbeing within educational settings. 2. Project Stages and Objectives The overall aim of this work was to build the capacity of the ECEC workforce to support the development of children, in particular, children s mental health and wellbeing. The project sought to identify key ECEC workforce knowledge and skills which are believed to support children s positive development, mental health and wellbeing, according to the available research literature and expert opinion. The coverage of these skills and topics was then broadly considered in current early childhood qualifications across the Vocational Education and Training (VET) sector and the Higher Education (HE) sector. Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 3

8 Drawing on this research and consultation, and engaging other key stakeholders, the project team then examined the potential for development of a national set of mental health and wellbeing competencies or professional practices to guide the training and development of the ECEC workforce. The project can be conceptualised as including four stages, as outlined in Table 2.1. This table shows specific objectives within each stage of the work. Table 2.1 Project Stages and Objectives Stages Stage 1: Research Project Objectives by Stage Development of a Memorandum of Understanding between the project partners as a guide to collaboration during project planning, implementation, analysis and reporting. Development of a shared understanding of mental health and wellbeing and identification of ECEC workforce knowledge and practices believed to be associated with improved childhood mental health, drawing on research and expert opinion. Stage 2: Consultation with training providers & scan of other professional development opportunities Consultation on the inclusion of mental health related knowledge and practices in Early Childhood HE qualifications and training. Topics included current training, gaps, opportunities for enhancement, uptake of relevant training resources, and discussion of potential national competencies or practices. Consultation on the inclusion of mental health related knowledge and practices in Children s Services VET qualifications and training. Topics included current competencies and training, gaps, opportunities for enhancement, uptake of relevant training resources, and discussion of potential national competencies or practices. Identification and scoping of training and professional development for the ECEC workforce, specific to the topics of mental health related knowledge and practice. Stage 3: Validation and Options Development Stage 4: Recommendations and Report Consultation and discussion with a key stakeholder group, through a face to face meeting, drawing on findings from Stage 1 and 2. Generation of options for the development and implementation of a nationally-consistent set of competencies or professional practices, for use in VET and HE training. Drafting and finalisation of recommendations emerging from the project, pertaining to the potential for development and implementation of national competencies or professional practices intended to build the capacity of the ECEC workforce to support children s mental health. Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 4

9 3. Defining Early Childhood Mental Health and Wellbeing 3.1 Objectives for Stage One A key goal of Stage One was the development of a shared understanding of early childhood mental health which would inform the project partners in completing the remainder of the work. This was essential because the organisations would be consulting with different stakeholders in Stage Two, then coming together to co-facilitate further discussion with others in Stage Three and working in partnership to develop recommendations in Stage Four. The Higher Education (HE) and Vocational Education and Training (VET) sectors differ markedly in their teaching and learning approaches, assessment practices and in the way workforce requirements are conceptualised and articulated, such as in workforce competencies or in broader professional standards and graduate attributes. This necessitated the use of slightly different consultation methods for each sector. In addition, individuals have different understandings of the term mental health and varying ideas about its relationship to the early childhood domain. As such, it was important from the outset to be able to prompt stakeholders with practical examples of relevant content areas and professional practices, to facilitate consultation. In developing a shared understanding of early childhood mental health for this project, it was important to try to articulate specific workforce knowledge and skills that are considered essential to promoting early childhood mental health. Furthermore, it was necessary in the course of this project to bring together information about how these issues are conceptualised and applied in the sector, how they are represented in training and development, and what is suggested by theory and research as being best practice for supporting children s mental health. Developing a common understanding and some shared language for use throughout the project was an important first step in this work. HIMH took the lead for working with the CS&HISC and other stakeholders to develop a shared understanding of early childhood mental health and relevant workforce practices. HIMH was able to build on its ongoing analysis of policy, theory and research on the mental health of children and young people, a central element of the Institute s work over the past decade. HIMH also drew on previous consultations and ongoing partnerships in the early childhood sector, VET and the university sector, relating specifically to educators contributions to the mental health of children and young people. Much of this work has been undertaken previously in the context of other projects on children s mental health in educational settings, such as Response Ability ( and Foundations ( It was helpful for the project partners in this initiative to be able to build upon this existing knowledge base, as the objectives and timeframe for the current initiative precluded undertaking a full systematic literature review prior to consultation with relevant stakeholders. 3.2 Sector Context and Background Mental Health Mental health is a positive capacity relating to the social and emotional wellbeing of individuals and communities. It is a concept that is culturally defined and tends to relate generally to the enjoyment of life, the ability to cope with stressors and sadness, the fulfilment of goals and potential, and one s sense of connection to others. It is inclusive of people s thoughts, emotions, social functioning and the overall coherence or purpose in their lives (Hunter Institute of Mental Health, 2010a). Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 5

10 Mental health is an integral part of a person s overall health and wellbeing and is not dependent simply on the absence of a mental illness or a disability. Rather, mental health is fluid and can be influenced by a variety of biological, psychological and social factors. These may be internal to the person (e.g. genetic make-up) or external, relating to something in a person s environment or life situation (Hunter Institute of Mental Health, 2010a). Improving mental health outcomes at the population level requires not only a focus on intervention and treatment when mental health problems or illness occur (which is largely the province of state and territory governments and private health service providers) but also on the promotion of mental health and where possible the prevention of disorders (which is influenced or undertaken by a range of stakeholders). Promotion and prevention includes an emphasis on creating environments and community conditions supportive of mental health, which requires a whole-of-government, cross-sectoral approach. It can also involve creating specific initiatives for certain sites or sectors. Such approaches occur at multiple levels, such as local, state or territory initiatives, national programs, or policy reform. Diverse agencies may have a common interest in certain sites or population groups, such as the early years, particularly because early life experiences have the potential to influence a number of longer-term outcomes in education, health and mental health. At the national level there are two key documents that shape current policy and action throughout Australia in regard to mental health: the National Mental Health Policy 2008 (Commonwealth of Australia, 2009b) and the Fourth National Mental Health Plan (Commonwealth of Australia, 2009c). The National Mental Health Policy provides a strategic framework to support improved mental health outcomes among individuals at risk of or experiencing mental health problems or illness. It aims to: Promote the mental health and wellbeing of the Australian community and where possible, prevent the development of mental health problems and mental illness Reduce the impact of mental health problems and mental illness, including the effects of stigma on individuals, families and community Promote recovery from mental health problems and mental illness Assure the rights of people with mental health problems and mental illness and enable them to participate meaningfully in society. The Fourth National Mental Health Plan sets a specific agenda for collaborative action in mental health across Australia. The Fourth National Mental Health Plan has a number of priority areas under which specific outcomes and actions are detailed, including: Social inclusion and recovery Prevention and early intervention Service access, coordination and continuity of care Quality improvement and innovation; and Accountability measuring and reporting on progress. Children are a particular focus of the Fourth National Mental Health Plan under the area of prevention and early intervention, as follows: Working with schools, workplaces and communities to deliver programs to improve mental health literacy and enhance resilience; Implementing targeted prevention and early intervention programs for children and their families through partnership with generalist services such as maternal and child health services, schools, and mental health specialist services; and Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 6

11 Expanding the level and range of support for families and carers of people with mental health problems, including recognition of the risk experienced by children of a parent with a mental illness. As a result of these policy areas of promotion and prevention, and the growing recognition of the importance of childhood development and life experiences in influencing later outcomes, there are several existing initiatives in Australia which are relevant to the issue of mental health and wellbeing in early childhood. Some specific programs of interest will be highlighted in section 3.2.3, which explores the intersection of the mental health and the ECEC sectors Early Childhood Education and Care Early childhood education and care has become an important focus of policy and action in many countries, owing to a growing body of research relating to the social and economic benefits of high-quality ECEC services (e.g. OECD, 2006). There is increasing awareness of the importance of early brain development and life experiences in influencing social and emotional development and impacting on learning and wellbeing later in life. The ECEC workforce in Australia has traditionally included personnel with varying levels of experience and qualification working across a diverse range of settings. Early childhood educators include all practitioners who work directly with children from birth to age eight across various settings and services, such as early childhood teachers and other staff who may work in the school sector, Long Day Care (LDC), preschool, Outside of School Hours (OOSH) services, Family Day Care (FDC) or Occasional Care (OC) services. In Australia, ECEC services have previously been regulated through a combination of federal and state or territory bodies. As a result of differences in governance and funding arrangements across these organisations, there were also differences in various service characteristics, including variation in some features now known to be important to service quality and children s outcomes, such as child-to-staff ratios and the level of training among staff (ECA, 2011). This situation is changing as part of a process of ECEC reform currently underway throughout the country. In 2009, the Council of Australian Governments (COAG) introduced Investing in the Early Years: A National Early Childhood Development Strategy (Commonwealth of Australia, 2009a). Through this strategy, the Australian Government aims to improve the health, safety, early learning and wellbeing of all children, and to better support disadvantaged children and reduce inequalities. The strategy aims to give all children a positive start in life to help them develop to their fullest potential through a number of priority areas of reform, which focus on: Strengthening universal maternal, child and family health services Supporting vulnerable children Engaging parents and community in understanding the importance of early childhood development (ECD) Improving early childhood infrastructure Strengthening the workforce across ECD and family support services Building better information and a solid evidence base. As part of this strategy, the NQF came into effect in January 2012 and applies to preschools and most LDC, FDC and OOSH services. This facilitates a unified national approach to regulation and service quality, in place of previously separate licensing and quality assurance processes. The National Quality Standard for Early Childhood Education and Care (NQS) requires services to achieve national targets for educator-to-child ratios, staff qualifications, and the measurement of service provision against national indicators of quality. Changes to the required educator-to-staff ratios and levels of staff training will come in from 2012 to Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 7

12 Another key element of the reforms under the NQF is the use of approved curriculum or learning frameworks across diverse services. Two national frameworks have been developed for use under the NQF and in addition several state and territory specific frameworks have also been approved. The national frameworks are: Belonging, Being and Becoming, the Early Years Learning Framework (COAG, 2009; for birth to five and to support the transition to school) and the document My Time, Our Place: Framework for School Age Care (DEEWR, 2011). These frameworks acknowledge the important contributions of play and leisure to children s learning and development and also have a strong emphasis on a number of elements relevant to mental health such as: feeling safe, secure and supported; developing autonomy, interdependence, resilience and a sense of agency; developing a confident self-identity; developing a sense of belonging to groups and communities; responding to diversity with respect; developing social and emotional wellbeing; becoming confident learners and problem-solvers; and communicating effectively with others. The frameworks recognise the interdependence of children s learning outcomes and their wellbeing and provide guidance for educators in optimising children s learning and development. Under the NQF, each state and territory government is responsible for legislation under which child care services are licensed. However an independent national statutory body, the Australian Children s Education and Care Quality Authority (ACECQA), will work with state and territory bodies to guide and support the implementation of the NQF in their jurisdiction and to monitor how services are meeting the new requirements of the NQS. ACECQA will also have a role in providing education and raising awareness about relevant quality issues and early childhood reforms across the sector and the community. One outcome of the NQF and NQS is that over the next several years many services will need to increase their staff-to-child ratios and there will be a greater requirement for staff to have VET or HE qualifications, or to be working toward these. There is therefore pressure on training providers to offer a range of accredited courses to meet the demand for Certificate III, Diploma or teaching qualifications, or upgrades to current qualifications, and to incorporate an awareness of policy reforms, quality processes and curriculum frameworks into their teaching Intersection of the Mental Health and the ECEC sectors Public and private service providers of many different types work in collaboration with the ECEC sector at times, in the course of their service provision for children and families. Such work could include a focus on treatment and intervention for children and families, or initiatives designed to promote wellbeing more broadly in a group or a particular setting. When intervention and support is required in relation to children s mental health and their social and emotional development, a number of professions may be engaged, from a variety of agencies or sources such as psychologists, psychiatrists, paediatricians, occupational therapists, social workers, nurses, case workers and welfare workers, etc. HIMH has previously completed a comprehensive report outlining the support available for childhood mental health and parenting-related issues in each state and territory (Hunter Institute of Mental Health, 2007; Hunter Institute of Mental Health, 2010b). In addition to ongoing, case-by-case contact between the mental health and early childhood sectors, there are a number of specific programs that operate wholly or partly in the early childhood context and deal with issues relevant to children s mental health. Many of these are based on a health promotion model and aim to build workforce capacity to support children s mental health and wellbeing. Others are derived more from recognition of the needs of particular children or population groups in some domain of mental health, or in related areas such as children s behaviour and development. Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 8

13 Existing National Programs: KidsMatter Early Childhood ( An initiative of the Australian Government Department of Health and Ageing which provides a framework for implementation of evidence-based mental health promotion, prevention and early intervention strategies in long day care and preschool. There are online resources for educators and families, with some professional development and support for pilot services engaged with the program. It is implemented and evaluated by Early Childhood Australia (ECA), the Australian Psychological Society and beyondblue. Response Ability ( This program provides evidence-based multi-media teaching resources to universities, TAFE institutes and private registered training organisations to support the preparation of educators, including early childhood educators and primary and secondary school teachers. The program aims to enhance workforce capacity to contribute to mental health promotion, prevention and early intervention. This is an initiative of the Australian Government Department of Health and Ageing, implemented by the Hunter Institute of Mental Health (HIMH). Children of Parents with a Mental Illness (COPMI) initiative ( This program, also an initiative of the Department of Health and Ageing, recognises that children whose parents are affected by mental illness are at an increased risk for mental health problems and disorders. It provides a range of evidence-based resources for children, families, and for professionals who work with families. Online and print resources are provided and these include a brochure for the ECEC workforce. The program is implemented by the Australian Infant Child, Adolescent and Family Mental Health Association. Child & Adolescent Trauma, Loss & Grief Network ( This is an online network and information portal hosted and implemented by the Australian National University, with funding from the Australian Government Department of Health and Ageing. It provides resources for parents, professionals, and others who care for or work with children and adolescents with a history of trauma, loss or grief, as these children and young people have an increased risk of mental health problems and disorders. The web site features a specific resource hub for schools and educators. Existing State or Regional Programs: Social and Emotional Early Development Strategy (SEEDS) ( Implemented by Queensland Health, this initiative is designed to enhance the social and emotional wellbeing of children through building capacity in the ECEC workforce. It has provided information materials and some professional support to ECEC services in Queensland. Foundations ( This is a magazine-style resource produced by HIMH and distributed to children's services staff in the Hunter, Mudgee and Taree areas of New South Wales, with funding from Xstrata Coal NSW. Developed with local practitioners, it presents accessible theory, practical ideas and suggestions for team professional development. The publication is also available online for free download and is widely promoted to the sector, for example in ECA s WebWatch e-bulletin. Some government or non-government agencies invest in specific programs, funded positions or research collaborations at their local level, which could include partnership with ECEC services. For example, there are designated mental health promotion officers in some states (such as Queensland, Victoria and parts of New South Wales) who may be working with their Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 9

14 local community in a variety of ways. There are also some research groups conducting studies on mental health and wellbeing issues in the context of ECEC services (for example, research by Dr Elise Davis, University of Melbourne, and colleagues). It is not possible to capture all such activities in depth here, as they vary considerably from region to region, but it is important to be aware that in addition to large-scale programs, there may be other activities taking place at the local or regional level at various sites throughout Australia. 3.3 Developing a Shared Understanding Building on previous research and other competency frameworks To analyse the training and professional development of the ECEC workforce in regard to early childhood mental health, it was necessary to develop a shared conceptual framework for the partner organisations to use with multiple stakeholders. It was important to articulate a working definition of early childhood mental health for this project and to generate a list of evidencebased workforce practices and knowledge relating to early childhood mental health. HIMH took the lead for this element, drawing on its previous project work in early childhood mental health, including the development of multi-media educational resources for teacher education and vocational education and training, and the partnerships already established with ECEC services and tertiary educators. HIMH had previously published some reviews of policy, theory and research (Kay-Lambkin et al., 2007; Hunter Institute of Mental Health, 2010), so it was mainly necessary to further consider any material that might have been published more recently or might be considered additionally relevant to this particular project. In considering additional material, it was noted that there have been some Australian and international attempts to identify workforce practices or competencies relating to early childhood development and/or mental health. These have focused on a composite workforce which may include people from several professions working across multiple settings, rather than relating solely to early childhood education. Such frameworks have not sought to capture discipline-specific knowledge, but to articulate certain core dispositions, knowledge or skills that are applicable to various professionals working with young children. They appear mainly to include early childhood educators, teachers, nurses and allied health professionals. Three such documents were included in the literature review and examined in greater detail. None had precisely the same parameters as the current project, but all were useful in informing how workforce practices for this project might be expressed. Some informed our framing of key concepts and the documents were useful in guiding consideration about how such competency frameworks can be structured and implemented. Ultimately, the review of these documents informed the description of the knowledge and workforce practices which were described in the Mental Health Consensus Statement for this project (see section 3.4 of this report). Workforce competency frameworks or reports reviewed as part of this process included: Ohio s Early Childhood Core Knowledge and Competencies (2008) - outlines knowledge and competencies for early childhood practitioners across three levels of practice, depending on formal qualifications, additional training and years of experience. Creating a Workforce in Early Childhood Mental Health: Defining the Competent Specialist (2008) compares six sets of competencies from the United States (applying to various professionals) and identifies core knowledge and skills. The content is mental health specific but the discussion is applied to diverse professions and settings. The Victorian Early Childhood Intervention Practitioner Competencies (2009) defines beliefs, values and competencies for tertiary qualified early childhood intervention practitioners such as teachers, social workers, speech therapists, psychologists etc. Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 10

15 3.3.2 Canvassing expert opinion As well as drawing on previous publications and consultation, it was also considered helpful for project consultation and for the engagement of key stakeholders to convene a subject matter expert group in order to refine definitions and language particular to this project. This involved bringing together experts on child mental health and representatives from early childhood bodies to consult on a definition of mental health and identification of the relevant workforce skills and knowledge, based on available scientific evidence. It was considered important to involve early childhood practitioners and peak bodies in this process, rather than relying solely on literature and mental health expertise, because of the need to use authentic and accessible language relevant to early childhood professionals in the Australian context. A subject matter expert group was convened in December 2011 in Sydney and was cofacilitated by HIMH and CS&HISC. The following individuals and organisations contributed to the discussion: Dorothy Rao Evan Cooper Emma Richards Emma Silvester Gavin Hazel Karen Stafford Celia Rae Nicole Edwards Damien McGrath Deidre Tranter Dr Elise Davis Elizabeth Fudge Helen Connolly Nan Greig Dr Nick Kowalenko Prof Margaret Sims Martha Birch Renaye Lucchese Sue Malone Tami Casey Trish Hanna Community Services & Health Industry Skills Council (CS&HISC) CS&HISC CS&HISC CS&HISC consultant (Co-Chair) Hunter Institute of Mental Health (HIMH) (Co-Chair) HIMH HIMH HIMH Department of Education, Employment and Workplace Relations Australian Psychological Society KidsMatter University of Melbourne National Children of Parents with a Mental Illness (COPMI) initiative National Association of Multicultural and Ethnic Children s Services Early Childhood Australia (NSW Branch) and ECTARC Royal Australian and New Zealand College of Psychiatry University of New England NSW Institute of Psychiatry Department of Health and Ageing Workskil (via telephone) Community Services and Health Industry Training Advisory Board Early Childhood Intervention Australia The following individuals or organisations were invited but were unable to participate: Prof Beverly Raphael Australian Child and Adolescent Trauma, Loss & Grief Network Catriona Elek Secretariat of National Aboriginal and Islander Child Care Dr Lance Emerson Australian Research Alliance for Children and Youth Prof Melissa Wake Centre for Community Child Health Michael Farrell Family Day Care Australia Trevor Hazell Director, HIMH Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 11

16 The meeting addressed four key areas: Concepts of children s mental health and wellbeing. HIMH provided several starting definitions of mental health, based on various sources such as the World Health Organisation, including a focus on definitions of infant mental health, usually applied to children from birth to three. Participants were divided into small groups for discussion, and then in the overall meeting they refined the definition to suit the context and needs of this project. Some participants suggested that the term resilience could also be usefully incorporated into the definition, but there did not appear to be consensus on this point. Roles of the ECEC workforce in children s mental health. To prime the participants to start thinking about the roles of the workforce, a discussion was held about factors known to influence children s mental health such as biology, childhood experience, and the environment. HIMH outlined some existing frameworks relating to early childhood mental health, and members considered how roles of educators might vary with children s developmental stage, the service type or. Consideration was also given to the mental health needs of the ECEC workers themselves and the influence this can have on their ability to educate and care for children. Participants discussed framing mental health related practices or competencies in a way that enables them to be viewed as an integral component of high quality early childhood education and care, rather than appearing to be an additional work element. Skills, competencies and professional practices. The members completed a visualisation activity where they reported what they would see, hear and feel in an ECEC centre that is supporting children s mental health optimally. Going on from this, participants listed several elements of workforce disposition, knowledge and skills that they considered that ECEC staff need to possess or display to support mental health and wellbeing in children. The group also reiterated that some of the skills, competencies and professional practices that support good mental health are already features of quality early childhood education and care, although they may not be explicitly described as relating to mental health outcomes. While the information obtained here would eventually be analysed alongside the literature on best-practice, the discussion was valuable in generating authentic contextspecific language that could be used in the mental health statement and during the consultation process. Implications for education and training. The participants discussed whether some broad competencies relating to mental health could be made common to all qualifications. It was also suggested that students could be assessed for certain basic competencies or dispositions before being accepted into ECEC training. For example, it was considered important that ECEC workers should have the capacity to work collaboratively with other individuals, professions and agencies in order to effectively meet the needs of children and families. Participants also noted that once a worker has completed their training, there is no way to ensure they continue self-reflective practice or formal professional development. This will largely be determined by the environment in which they work and the support they receive from their supervisor(s). The outcomes and discussions of the subject matter expert group meeting were synthesised with the principles and practices available in the literature to create a Mental Health Consensus Statement which formed the basis for subsequent consultation and discussion with project stakeholders. Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 12

17 3.4 The Mental Health Consensus Statement Definitions of Early Childhood Mental Health and Mental Illness Following on from the discussion of the Subject Matter Expert Group, and drawing on a range of research literature and policy documents, the definitions outlined in the following boxed sections were adopted for this project. These were incorporated into an internal document for the project partners known as the Mental Health Consensus Statement, to guide the organisations in their written and interpersonal communication with stakeholders. The definitions adopted were informed by international publications relating to infant and childhood mental health (such as: What is Infant Mental Health?, Zero to Three Infant Mental Health Task Force, 2002). However it was also important that the definitions be framed and explained in accessible language, using terms that would resonate with practitioners in Australian ECEC settings and with those who provide education and training for this workforce. Early Childhood Mental Health and Wellbeing Mental health refers to a person s psychological, social and emotional wellbeing. Mental health is related to capacity and wellbeing and should not be confused with mental illness. This distinction can be emphasised by using the expression mental health and wellbeing. Early childhood mental health and wellbeing is seen in the capacity of a young child within the context of their development, family, environment and culture to: participate in the physical and social environment; form healthy and secure relationships; experience, regulate, understand and express emotions; understand and regulate their behaviour; interact appropriately with others, including peers; and develop a secure sense of self. Early childhood mental health and wellbeing is related to healthy physical, cognitive, social and emotional development. Early childhood development and life experiences contribute strongly to a person s mental health and wellbeing during childhood and later in life. It was considered important that the definition should describe how mental health and wellbeing relates to children s optimal development across all domains, rather than being seen as something that is separate from development or relevant only to certain aspects of it. Furthermore, it was important that the statement should acknowledge not only the importance of mental health in early childhood, but also the potential longer-term impacts of early childhood mental health and wellbeing, without being overly deterministic in its language. Because the term mental health is not necessarily universally understood and may be confused by some with mental illness and related terms (and therefore associated with stigma) it was also considered necessary to define mental illness. In this area, the project broadly followed the language of the National Mental Health Policy 2008 which differentiates between mental health, mental illness or disorder and mental health problems. The statement also attempted to acknowledge the broad range of risk and protective factors which can be influential in children s mental health and wellbeing. Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 13

18 Mental Illness and Disorder Mental health and mental illness are not the same, but nor are they complete opposites. A mental illness or mental disorder is a diagnosable condition that significantly impacts on a person s social functioning or their experience of thoughts and feelings. There are various disorders that may occur in childhood which can impact on psychological wellbeing, social functioning or emotional wellbeing, such as: clinical depression and other depressive disorders anxiety and related disorders autism spectrum disorders other developmental disorders such as ADHD. Each condition has a unique profile of risk factors and protective factors. Risk factors tend to increase the possibility of having the condition, while protective factors tend to reduce the chances of the condition developing. Risk and protective factors may include genetic and biological influences, social context, psychological characteristics of the individual, and life experiences. Some literature also refers to mental health problems, a disturbance in social functioning, thoughts or feelings which does not meet the criteria for a diagnosis but is still distressing or disruptive to that person s life. Mental health problems may occur in association with psychosocial stressors in a person s life, such as grief and loss, vocational or family stress, etc. It was also important to agree on a term that could be used to indicate a range of potential early warning signs or risk conditions which early childhood educators might observe among children and their families. The role of the educator may include noticing and responding to developmental or wellbeing concerns before any formal diagnosis is applicable, as well as working with those who are already known to have additional needs. The pathway toward formal assessment and diagnosis (if needed) can involve lengthy periods of observing, monitoring and supporting a child and family in a variety of ways, until the child s needs become more clearly defined. A broad term was needed that would encompass this complexity and the variety of children s needs, but which would not be dependent on the identifiable presence of a known disorder. Some children do not attract a specific diagnosis and yet may still have additional needs in terms of their emotional and social development or their wellbeing. To acknowledge this complexity, the project adopted the broad term emotional, behavioural or mental health problems to encompass a range of issues of potential concern, such as risk factors and early warning signs of mental health or developmental issues in young children. This term, with some explanatory text, was incorporated into the Mental Health Consensus Statement, as shown below. Emotional, Behavioural or Mental Health Problems Early childhood is a period of significant and rapid change in a child s physical, cognitive, social and emotional capacities. These changes are subject to individual differences and unfold within the context of family and culture, so they are expressed differently for every child. Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 14

19 In the early years, distinctions between healthy development, mild or transient mental health problems, a mental illness or a developmental disorder are often initially unclear. Children and families may need specialist assessment to identify any issues and choose a course of action. Early identification of potential problems and referral to an appropriate specialist will help to promote the best possible developmental and mental health outcomes for the child and family. Therefore, it is useful to have a broad term that can be used to describe signs of potential concern in a child s social and emotional development or wellbeing, without requiring a specific diagnosis. For the purposes of this project, the term emotional, behavioural or mental health problems will be used to include a range of behaviours and other observations which may suggest an emerging difficulty in a child s social and emotional development or wellbeing. Emotional, behavioural or mental health problems might include: attachment and relationship difficulties, changes or differences in behaviour, apparent anxiety or sadness, difficulty with peer interactions, difficulty managing feelings, difficulty following instructions or regulating behaviour ECEC workforce practices Drawing on research, theory, policy, consultation and the principles articulated above, HIMH developed an evidence-based and practical list of some key areas of knowledge and skill for early childhood practitioners, which are believed to support positive social and emotional development in childhood and lay the foundations for good mental health later in life. These were grouped into five domains of early childhood practice, incorporated into the Mental Health Consensus Statement. As with other material developed at this stage of the project, this was used to inform subsequent discussions and consultations throughout the project. Because people s concepts of mental health differ and not all practitioners will have the same beliefs about the way it should be applied in early childhood settings, it was important to be able to outline some specific examples of how best-practice principles might be reflected in practice. The five key domains of practice that were identified were: The environment: Creating a supportive, inclusive environment that fosters a sense of belonging and connectedness. Child development: Supporting the social, emotional and psychological development of infants and children. Early intervention: Supporting children with emotional, behavioural, or mental health problems, and their families. Partnerships: Building effective partnerships with families, professionals, agencies and the community to promote mental health and wellbeing. Professional practice: Building the capacity of ECEC services, professionals, families and the community to promote children s mental health and wellbeing. In this project s original framing of the Mental Health Consensus Statement the five domains of practice were expanded to include a detailed list of the dispositions, knowledge and workforce practices that early childhood educators would need in order to complete these tasks optimally. This informed the consultation and discussion that was undertaken with stakeholders in stage two of this project. A slightly revised list of the domains of practice was formulated after further consultation in stage three. The revised list of work practices attempts to take differing s into account to a greater extent that seen in the first version, and is presented in section seven. Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 15

20 The domains of practice and associated knowledge and skills have some similarity to key findings from a previous scoping study conducted by ECA and the Secretariat of National Aboriginal and Islander Child Care (ECA and SNAICC, 2007). The aim of that study was to examine how the ECEC sector promotes children s social and emotional wellbeing and what knowledge, skills and resources would support the sector in this activity. The report from ECA and SNAICC (2007) highlighted a number of key areas of knowledge, including: children s development and when to be concerned; nurturing social and emotional health and creating an appropriate environment; attachment and security and implications for the educator s role; designing and implementing programs to minimise misbehaviour; current approaches to guiding positive behaviour; knowledge about disorders that might underlie social and emotional maladjustment; policies, protocols and procedures for dealing with problems; how to access support for children and families; and understanding cultural and community influences on parenting and children. A comparison of these items from the earlier report and the domains of practice identified within the current project (see section 7) shows considerable similarity, which suggests that the domains of practice developed here from literature and consultation represent a good fit with sector consultation conducted five years ago. The current project has been able to also integrate and take into account changes in context and research literature since that time and a further round of consultation with diverse stakeholders. It should be noted that the domains recommended here are not the only way of articulating relevant workforce knowledge and practice, as it would be possible to develop a number of different ways of framing these principles. However they are consistent with and use similar language to other resources and frameworks that may be familiar to the ECEC workforce and have been developed with significant practitioner consultation. For example, the domains of practice and accompanying skills and knowledge for this project are conceptually similar to material developed for other early childhood mental health programs, such as the CHILD framework in Response Ability and the four-part framework used in KidsMatter Early Childhood. The content also has links with some of the principles and practices described in the NQS and approved learning frameworks, such as belonging, creating a positive and supportive environment and the value of partnerships. The practices suggested in the Mental Health Consensus Statement also resonate with some of the elements described in other frameworks of knowledge and practice for the ECD workforce (such as the broader competency frameworks described in section 3.3.1) and with certain units of competency as currently defined in the CHC08 training package. For example, the knowledge and practices suggested under child development can be readily linked with the content of the Diploma level units CHCFC503A and CHCFC504A, on fostering social development and supporting emotional and psychological development in early childhood. This consistency with a variety of reports and frameworks, which are based in turn on research and/or consultation with early childhood practitioners, strongly suggests that the Mental Health Consensus Statement developed for this initiative is useful in integrating several core elements of practice and in reflecting the available evidence-base on promoting children s mental health and wellbeing. This helps to validate the Mental Health Consensus Statement as a useful foundation for further consultation and discussion with early childhood educators and further articulation of useful workforce practices. Children s Mental Health and Wellbeing: Exploring Competencies for the Early Childhood Education and Care Workforce 16