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Mental Health Support Needed in the Child Care Sector During COVID-19

The pandemic’s initial wave was devastating not only for families, but also for the child care sector. Children missed out on key socialization and early learning opportunities, and parents were under additional stress due to grief, job losses, and the constant risk of infection. With many parents pulling their children out of child care, the sector faced the possibility of collapse.

I (Maya Jasinska) spent the spring of 2022 teaching kindergarten in an independent, K-8 school in New York City. Even among children from high socioeconomic backgrounds, who had additional resources and supports at their disposal, my co-teacher and I saw unprecedented levels of anxiety among our students. There were students in my class who had never attended school before and, if they were only children, had little –to no socialization and play experience with other children their age. Kindergarten, which has become increasingly academic in the U.S., needed to first and foremost be a place to practice social interactions and basic executive function skills.

Even with gentler expectations, one child who had psychosomatic stomachaches almost every day told us she got them when she “was scared she wouldn’t be able to hold all the learning in her brain.” On top of academic anxieties, children were struggling with the same worries over illness and the pandemic that adults were. One child would have a panic attack at lunchtime every day because she was scared to take her mask off to eat. On the day the school’s mask mandate loosened, another child told me he had not slept all night because he had nightmares about what it would be like to not wear a mask—these children had never not worn masks in school and had no frame of reference for what interacting socially without a mask was like. Classmates who got infected would be missing for days at a time and children worried about their friends and about if they might get sick next. As teachers, we needed to double our efforts to preserve a sense of community in the classroom and make it feel like a safe space for growing and learning.

At the same time, the pandemic took a severe emotional toll on child care workers. The child care workforce has always struggled with higher –than average rates of depression and stress due to low pay, frequent staff shortages, and strenuous work, and these rates only worsened during the pandemic. Teaching is hard work: emotionally, intellectually, physically. Early childhood educators don’t have the option of remote work. Child care centers needed to stay open to enable other essential worker parents to go to work. Child care workers were under the additional stresses of risking contracting COVID themselves or bringing it home to family members who may be at higher risk. A recent Yale research study, currently under peer review, reports that 66.5% of child care providers are currently experiencing moderate to high levels of stress and 45.7% of child care professionals are screening positive for depression.

Federal relief money was used to protect child care workers’ physical health with personal protective equipment, but few measures were undertaken to support the mental health of providers and child care workers. Despite federal relief funds being appropriated for mental health services, BPC found that Ohio was one of the few states to provide adequate guidance on the use of American Rescue Plan funds for mental health supports.

Early Head Start-Child Care Partnerships – Making a Difference

The Early Head Start-Child Care Partnership (EHS-CCP) program was a bright spot in providing essential mental health services to families and to their child care workforce partners throughout the pandemic. The purpose of the EHS-CCP program is to expand quality care for low-income infants and toddlers by connecting local child care providers with Early Head Start resources and holding them to the Early Head Start performance standards.

The EHS-CCP grants serve the poorest children in our country, including children who struggle with homelessness or hunger, those with disabilities, and children in the foster care system. Thanks to this grant, these children and families had access to essential resources and supports in and outside of the classroom that they would not have otherwise had.

BPC assessed the COVID response of eight EHS-CCP grantees to learn how the partnerships impacted emergency and sustainability efforts in their communities. Most grantees cited mental health supports as one of the most important services EHS-CCP provided throughout the pandemic. Many grantees provided virtual therapy sessions and increased existing supports throughout the initial wave to provide responsive and individual mental health care to providers and participating families and children.

Resources for families and children

Many grantees expanded existing mental health supports. The Montana AWARE EHS-CCP grantee has long provided mental health services to families. All children at AWARE Early Head Start centers and participating child care partners receive a social-emotional screening upon enrollment. During COVID, family advocates remained in constant contact with families throughout center closures and mental health services were virtually offered to families on a weekly basis. Families, those subsidized and not, joined group Zoom calls to connect as a community during the early crisis response of the pandemic, access resources, and get referrals for individual or family therapy.

Their two mental health consultants at the YWCA of Canton, OH screened the children across their partnerships in 2021 and found that approximately 22% had a social-emotional concern of some kind. These consultants helped provide resources to teachers, so that they could better support students in the classroom.

Resources for Providers and Staff

Grantees also expanded mental health services to support and help retain their workforce. The Ohio State University (OSU) is another EHS-CCP grantee contracting with the Nisonger Center (part of OSU Wexner Medical Center) to provide mental health and early intervention services to the community. During COVID, OSU began to refer partners’ teachers and staff to the Nisonger Center for mental health services as well.

The Early Learning Ventures (ELV) grantee in Colorado provided consistent access to mental health services in five out of six of their service counties thanks to state funding of mental health consultants. At the height of the pandemic, ELV used COVID relief funding to cover the cost of expanding telehealth services to include up to 12 virtual counselling sessions for teachers and staff.

Beyond the emotional stresses of working with children whose families are in challenging circumstances, child care workers are also stressed due to their low wages and poor benefits. Many interviewees told BPC that their Early Head Start teachers qualified for Early Head Start, meaning that their income was below the federal poverty level. This is deeply wrong: serving your community by working for a poverty intervention program should not impoverish you. The grantees told us that they were losing staff to large businesses like Target and Starbucks, because staff could be paid twice as much for work that was less emotionally taxing. As a result, almost every grantee we interviewed used their grant or COVID relief money for bonuses or wage raises to retain staff and honor their hard work supporting their communities.

Community Impact

The Georgia State EHS-CCP Director Megan Fickes described the stresses and challenges of the pandemic and the integral role EHS-CCP plays in communities: “Especially as we come out of a pandemic where the mental health needs of families and children have been much more significant than we thought they would be, the dynamic and scope of child care has changed….they [families] have programs…where they have a family services specialist who will connect them with a mental health resource…or send them home with diapers and formula if they don’t have any because that’s what we do at Early Head Start and that’s the difference our programs make.”

The impact of EHS-CCP grants shows that it is vital that we invest in mental health supports for families and child care providers. With the rising prevalence of mental health issues in the sector, EHS-CCP allowed programs to offer stability, community, and care throughout the pandemic. Strong mental health in children and providers is crucial for quality child care.

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