early intervention

Meet Colorado’s resident expert on early childhood mental health

Jordana Ash, Colorado's director of early childhood mental health

Jordana Ash holds a job that doesn’t exist in most states.

She’s Colorado’s director of early childhood mental health — a position created three years ago within the state’s Office of Early Childhood. A local foundation paid Ash’s salary for 18 months and then the state took over.

The addition of a high-level state job dedicated to the mental health of young children was a win for advocates, coming at a time of growing awareness about the long-term impact of childhood trauma. Ash said her role helps infuse both the Office of Early Childhood, where her unit is housed, and other state agencies with programs and policies focusing on child mental health.

Before coming to the Office of Early Childhood, which is part of the Department of Human Services, Ash ran a mental health consultation program in Boulder for 13 years.

We sat down with Ash this week to discuss her background, the state’s work on early childhood mental health and her thoughts on the recent defeat of state legislation that would have limited early childhood suspensions and expulsions.

The interview has been edited for clarity and length.

What sparked your interest in early childhood mental health?
My first job out of graduate school was in Alameda County, California and I was a child welfare worker. I didn’t have a lot of life experience at that time. I didn’t have children of my own. I didn’t know a lot about child development. But what I could really do is listen to families. We met families at the hardest times.These were families whose children were removed for suspicion of abuse or neglect.

Everybody has a story and if you spend time listening, you will hear about their hopes for their child, things that bring them joy in parenting. To me, it’s about the stories and what parents do every day to try to do better for their kids.

Can you put into context Colorado’s work on early childhood mental health compared to work in other states?
Colorado is really in a unique position compared to other states. My position was created three years ago with philanthropic dollars (from the Denver-based Rose Community Foundation, which is also is a financial supporter of Chalkbeat) looking to get a position in state government completely focused on early childhood mental health.

There are very few states that have a position of leadership in state government with (early childhood mental health) being their primary focus. Minnesota has a similar position, Connecticut has a coordinator position. A couple of states are coming along. Other states have recognized that it’s a wise investment to have a position where you can really institutionalize some of those important changes and policies for statewide reach.

Can you talk about the major efforts your unit is working on now?
Our two main initiatives are the mental health (consultant) program and Colorado Project LAUNCH. (See this story for more about Project LAUNCH.)

We are (also) studying the effects of parent adversity on child well-being. We were (also) selected to receive three years of technical assistance on infant and early childhood mental health consultation. We’re hoping that helps us finalize our system of consultation in Colorado so we are a premier program that other states look to.

Last year, the state doubled the number of early childhood mental health consultants available to help child care providers and preschool teachers manage challenging behavior. How is it going?
Our state-funded program of 34 full-time positions is one of the largest (in the nation). We’re working really hard on developing Colorado’s system of mental health consultation so it’s consistent — for state-funded positions, for positions funded by philanthropy for programs that have their own hired consultants — so everyone is working toward the same standard of practice.

Can you share an anecdote about how mental health consultation works?

I can think of a situation where a consultant provided support for a cook at a child care center. Her child was enrolled in the program. This was a 3-year-old with a lot of challenging behaviors. At first, (the mother) was really nervous to talk to the consultant. She confused the role of the mental health consultant with something like social services and wondered if she was going to be judged or somehow scrutinized about her parenting. She had never had contact with any kind of mental health service before.

In getting to know the consultant not only did she find some new ways to interact with her child so that he could be more successful in the classroom and at home, but she also had her first experience with a mental health professional. It reduced the sense of stigma (around) getting mental health help.

She found that she could get a better position at the child care center because her child was successful in his classroom. She wasn’t having to take him home because of his problems.

What advice do you have for child care providers or early childhood teachers who are at their wits’ end over a child’s challenging behavior and haven’t accessed a consultant? Take a deep breath. We want to understand that that child is telling us something. We might not understand what that behavior means but it’s our responsibility as adults to help figure that out.

We really encourage providers to access a mental health consultant or other support right away when they’re starting to be puzzled or concerned about a child’s behavior. It’s much easier to intervene if you have new ideas sooner in the process.

The role of child care providers and teachers is critically important. So we are not in a position to judge or to evaluate what you’ve done. We’re in a position to partner with you and help you provide the best care you can.

To locate an early childhood mental health consultant, providers can call 303-866-4393.

What advice do you have for parents who know their child is acting up at preschool or child care and worry they could get counseled out or kicked out?
Reach out and connect directly with your child care program about the problem before you start feeling like your child may be at risk of being suspended or expelled. That partnership between parents and providers is the most powerful part of a solution.

I would also say you can talk to your child’s primary care physician as a start. Maybe there’s a developmental concern your physician can help figure out and that’s gonna be a really important piece of the puzzle.

Connecting with a mental health consultant in your area is a really good solution to start looking at the causes of those challenging behaviors and to start putting in place some interventions while other tests or other assessments are being done.

For help locating a mental health consultant, parents can visit: http://www.coloradoofficeofearlychildhood.com/ecmentalhealth

What are your thoughts on the bill killed during Colorado’s 2017 legislative session that would have limited suspensions and expulsions in preschool and kindergarten through second grade?

The fact that the bill made it as far as it did meant lots of people were invested, were having great conversations about this problem in a way we never (had) before. Stakeholders were for the first time …. considering issues of disproportionality and implicit bias in a way that was a first. We had never had that kind of visibility to the early childhood time period and this very complex issue that affects children’s trajectories way into their school years.

Would you like to see a similar bill pass next year?
As an office, we’d be super interested in whatever’s put forward.

New direction

Three years in, an ambitious experiment to improve the odds for kids at one elementary school is scaling back

PHOTO: Ann Schimke
Tennyson Knolls students return to school after a ribbon-cutting ceremony on school grounds in September.

Blocks of Hope was once envisioned as a pint-sized version of the Harlem Children’s Zone.

The project would provide an array of educational and social services to young children and families living within the boundaries of one high-poverty Adams County school — in the process, changing not only the lives of individual children but also the community around them.

But after three years, the Westminster-based nonprofit that spearheaded Blocks of Hope is scaling back its ambitions.

While the project won’t disappear entirely, the nonprofit’s leaders say they’re no longer focusing services and staff so tightly on the school’s boundary zone and may eventually stop using the Blocks of Hope name.

“We’re starting to question whether it’s the right strategic direction for the organization,” said Karen Fox Elwell, the new president and CEO of Growing Home, which launched the project in 2014.

The shifting shape of Blocks of Hope — originally framed as a 20-year effort intended to change the trajectories of children 0 to 9 within the Tennyson Knolls Elementary School enrollment zone — is a disappointment for some advocates who’d hoped this “placed-based” approach would not only be successful, but also possibly serve as a model for other Colorado communities.

A raft of issues have prompted the changes, including greater-than-expected mobility among the school population, fundraising challenges, and the tension that came from devoting resources to the 2.25-square-mile project zone while also trying to serve the broader Adams County community.

“It was hard to find that balance to do both well,” said Fox Elwell, who joined Growing Home in January.

Organizers knew when they started that the community was changing, but gentrification pushed out families faster than they expected. About a quarter of Tennyson Knoll’s students left the school in 2015-16.

Leaders said that was one reason it was tricky to track child outcomes that would demonstrate the project’s impact — a hallmark of successful place-based work.

Fox Elwell said there’s more stability among residents in the Harlem Children’s Zone because of rent-controlled housing.

“So families are really staying in that community for years upon years,” she said. “With Blocks of Hope, it’s just not the case.”

Fox Elwell said the board and staff will determine the future of Blocks of Hope during the group’s upcoming strategic planning process starting in late spring.

Teva Sienicki, the former president and CEO of Growing Home and the project’s original champion, said significant evidence supports the place-based strategy that underpinned Blocks of Hope, but didn’t want to second-guess the decisions of Growing Home’s current leaders.

“I really do wish them the best,” said Sienicki, who left Growing Home last summer.

Even at the outset of the project,  Sienicki acknowledged that changing demographics and funding challenges could alter the long-term course of the project. Still, she was optimistic, projecting a gradual expansion that would bring two to three other elementary schools in the Westminster district under the Blocks of Hope umbrella, and increase the number of employees dedicated to the project from two to 70.

In addition to improving family functioning, the project’s goal was to boost school attendance, kindergarten readiness, and third-grade reading scores, and reduce the number of children referred for special education services. This year, 85 percent of Tennyson Knolls students are eligible for free or reduced-price school meals, a proxy for poverty.

One of the essential ideas behind place-based efforts like Blocks of Hope and the Harlem Children’s Zone is to flood a carefully defined geographic area with services in the hopes of touching a critical mass of residents, usually around 60 percent. By reaching such a large proportion of a population, proponents say such efforts create a kind of tipping point that pushes the whole community to adopt the norms and aspirations of those who receive services.

But Blocks of Hope never got close to that tipping point.

While certain components of the project, such as backpack and school supply giveaways, reached a large number of families, others, such as parent programs, never got above 15 percent, said Fox Elwell.

Aside from high mobility, the fact that many students ride the bus to Tennyson Knolls — instead of getting dropped off by their parents — made it harder to connect with parents than organizers anticipated.

The nonprofit’s limited budget was also a factor. Spending on the project was originally set at $250,000 annually, with eventual plans to reach $3 million if it expanded to other schools.

The nonprofit’s actual spending on Blocks of Hope has been around $100,000 a year, said Fox Elwell. In addition, a grant that Growing Home leaders hoped would pay for an evaluation of the project never came through.

“There were some incredible hopes to grow the budget and deeply invest in the community,” she said. “And maybe it was more challenging to fundraise than we anticipated.”

There are still several Blocks of Hope programs at Tennyson Knolls this year, including backpack giveaways, holiday gift and meal help, and two parenting classes. The school also houses a boutique with used children’s clothing and gear.

An after-school tutoring program was discontinued after last school year because it wasn’t effective, leaders said. Another program aimed at grandparents raising grandchildren was slated to launch this spring, but will not because school leaders felt they had too much going on.

A community organizer originally hired to work with Blocks of Hope families to advocate for affordable housing has expanded her territory to include other neighborhoods.

“There’s a lot of need just a little bit south and a little bit east of those (school) boundaries,” said Leslie Gonzalez, a Growing Home board member.

Residents in some of those areas began to assume they were no longer eligible for any of the nonprofit’s services as Blocks of Hope ramped up. That wasn’t true, but the project sent some “unintended negative messages,” she said.

Despite looming questions about the future of Blocks of Hope, leaders at Growing Home and Tennyson Knolls say the project has helped families, sparked welcome changes to the nonprofit’s case management strategy, and built community at the school.

Tennyson Knolls Principal Heather McGuire, who is the school’s third principal since Blocks of Hope began, said the project helped get parents involved at school, whether attending PTA meetings, taking Blocks of Hope classes, or attending “coffee with the principal” meetings.

She credits the project with giving rise to the school’s tagline, “We are TKE,” a reference to the school’s initials.

Gonzalez said, “We don’t view Blocks of Hope as a failure necessarily … Even though there were a lot of challenges, a lot of good came out of it, too, and we were able to meet even more families in that community we serve.”

safe haven

Colorado could get its first 24/7 child care facility for families in crisis

PHOTO: Jamie Grill | Getty Images
Mother rubbing forehead while holding baby son.

Last fall, Lisa Rickerd Mills, a medical social worker in Grand Junction, worked with a single mother who needed inpatient mental health treatment.

The problem was child care. The woman had no one to watch her two small children during her stay and bowed out of treatment.

It’s exactly the kind of scenario a group of advocates hope to prevent with a 24-hour, seven-day-a-week child care facility for families facing emergencies or periods of high stress.

The center, to be called the Grand Valley Crisis Nursery and set to open in late 2018, would provide free care for children 0 to 5 years old for periods ranging from a few days to 30 days. The idea is to give parents a safe place to leave their youngest children when they’re facing a crisis — a period of homelessness, an emergency medical procedure, domestic violence, or the threat of job loss. It’s meant to prevent child abuse and neglect and keep kids out of the foster care system.

While there are around 70 crisis nurseries nationwide, the one planned for Grand Junction would be the first of its kind in Colorado. It could pave the way for a new type of state child care license and perhaps crisis nurseries elsewhere in the state. The project is unfolding amidst a broader push in the western Colorado community to improve child and family outcomes by dramatically expanding child care options over the next three years.

Kaleigh Stover, a former pharmaceutical sales representative who moved to Grand Junction from Sacramento last summer, is leading the charge on the crisis nursery. Prior to her move, the 26-year-old volunteered at the Sacramento Crisis Nursery, which runs two of five crisis nurseries in California and, like many such facilities, relies heavily on volunteers to care for the children.

“I’m like that girl in the grocery store who will offer to hold your baby,” she said. “I have a soft spot for babies and moms and helping those people who are experiencing hard times.”

When she first arrived in Grand Junction, Stover called around to several nonprofit organizations and was surprised to learn there wasn’t a crisis nursery in town.

She said local advocates told her, “We don’t have anything like this … but we need it.”

Child abuse cases — and hotline calls about suspected child abuse — have steadily risen over the last few years in Mesa County. The western Colorado county also faces numerous other challenges: higher than average rates of child poverty, foster care placement, and teen pregnancy.

The community’s transience also means that parents of young children often arrive without a circle of family and friends to help out in a pinch, said Rickerd Mills, a member of the crisis nursery’s board.

That can mean parents leave their kids in the care of people they don’t know well or enlist older siblings to watch them.

In addition to providing licensed overnight care for young children, crisis nurseries have case managers who work to connect parents with community resources and get them back on their feet.

While there are a host of typical housing, job, and medical problems that prompt parents to use crisis nurseries, parents with a child care problem outside the usual list won’t be turned away at the Grand Valley center, Stover said.

“We let families define the crisis,” she said, adding that parents using the center would be required to check in with case managers regularly.

Over the past six months, Stover has steadily made progress on the nursery — holding a community town hall, recruiting board members, and finding a local nonprofit to serve as the nursery’s fiscal sponsor. She’s currently in the process of finding a location for the nine- to 12-bed center and will soon begin fundraising.

Stover expects the first-year costs to be around $455,000 if the group purchases a building, with operations costing $150,000 in subsequent years. About 80 percent of the nursery’s funding will come from individual and corporate donations and 20 percent from grants, she said.

In what might be the nursery project’s biggest victory so far, Stover got a preliminary nod in February from the state’s child care licensing advisory committee, which agreed to consider giving the crisis nursery a waiver from state licensing rules.

If the waiver is granted, it could set the stage for a new kind of child care license in Colorado — a cross between a typical child care center license, which doesn’t allow 24-hour care, and a residential child care facility license, which allows 24-hour care but doesn’t permit care for children under 3 years old.

“Having a new license type is kind of nightmare, but it changes the whole state if we can make it happen,” Stover said.

Ebony White Douglas, program manager at the 22-year-old Sacramento Crisis Nursery, praised Stover’s persistence in pursuing the project. She said she routinely consults with people in other states interested in launching crisis nurseries and has seen many such projects sidelined because of complex licensing logistics or daunting fund-raising requirements.

Rickerd Mills said she was heartened to hear about the positive reception from the state’s licensing advisory committee.

“I think it just goes to show the need in this community and the state,” she said.