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The Pandemic Underscores Chronic Underinvestment in the Mental Health Care of Child Care Workers

The mental health of child care workers and the well-being of children in their care are critically linked. Supporting the mental health needs of child care workers is critical for the well-being of both providers and the age-appropriate, culturally competent development of the children in their care. Yet there has been chronic underinvestment in mental health supports in the early childhood field.  

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The pandemic has exacerbated workplace-related stress

Research has found a range of negative impacts on children, leading to higher rates of harsh discipline and expulsion, between poor mental health in child care providers and detrimental impacts on children’s learning and development. The American Rescue Plan (ARP) Act allocated $39 billion dollars in federal relief funding for the child care sector, and although supporting the mental health of children and child care providers is a specific line item in the law, only one state, Ohio, has provided adequate guidance on the use of ARP funds for mental health As states continue to disburse their federal child care dollars and endeavor to solve the child care crisis, provider mental health must be addressed.  

The child care workforce is no stranger to work-related stressors, including low pay, limited benefits, high turnover, and providing developmentally appropriate care for 10 or more young children learning essential skills day after day. The compounding effects of these stressors, without a comprehensive plan to support the mental health of providers, has led to concerning rates of mental health issues in the early childhood provider community.  

Prior to the onset of the pandemic, 16% to 36% of early childhood educators reported depressive symptoms. The pandemic compounded staff shortages, stress, and burnout among child care providers, and introduced increased and more stringent cleaning demands, additional COVID safety protocols, worries of contracting COVID, and caring for children with social and emotional challenges resulting from pandemic isolation. The impact of increased stress on child care workers has also increased exhaustion, feelings of anxiety, trouble sleeping, substance use, and temper issues, with emotional distress more pronounced for child care providers who dealt with disruptions in the continuity of child care. A new Yale research study, currently under peer review, reports that 66.5% of child care providers are experiencing moderate to high levels of stress and 45.7% of child care professionals screening positive for depression.   

Child care providers’ well-being and mental health has an impact on the academic success, behavioral outcomes, and mental health of children in their care. Child care workers who experience high levels of stress and burnout are less able to emotionally attend to children and are associated with high rates of student behavior problems and poor academic achievement. Depressive symptoms in caregivers have been tied to higher reported rates of behavioral problems in children. High levels of stress and depression among educators are also tied to higher levels of harsh discipline and expulsion

Approaches that work

While there are positive, evidence-based approaches to addressing the mental health crisis among child care workers, there continues to be an underinvestment in programs to help. Infant and Early Childhood Mental Health Consultation (IECMHC) programs have long been praised as a strategy to support child care providers and build their capacity to shape the development of children. Research suggests that child care programs with access to IECMHC report fewer depressive symptoms, less stress among child care providers, are associated with lower rates of expulsion, in addition to having larger classroom-scale benefits. Additionally, children who attend care programs with access to IECMHC services have lower rates of hyperactivity, restlessness, and behavior problems. Although there is a growing body of evidence about the benefits of IECMHC programs, not all states have IECMHC programs, and of those that do, services do not extend to all child care providers, leaving some programs without access to essential behavioral and mental health services. 

Ohio leads the way

The degree to which states have existing infrastructure to support the child care workers mental health varies. However, Ohio is a leader and established support for provider and child mental health pre-pandemic, including:

In response to the pandemic intensifying the mental health crisis among caregivers, Ohio allotted a portion of its ARP funding to support mental health. Specifically, Ohio established subgrant opportunities, including the Access Development Subgrant and the Mental Health Workforce and Family Support Subgrant. These subgrants support child care providers’ partnerships with Ohio Mental Health and Addiction Services to provide family-centered, therapeutic child care and provide funding to support mental health through coaching, training, and wellness experiences. Ohio is also conducting a Mental Health Bridge pilot program which will connect child care programs to mental health services.  

Other states should optimize ARP supplemental funding to bolster mental health support for the child care workforce and IECMHC through the American Rescue Plan’s stabilization grants, which explicitly identify supporting the mental health of children and staff as a legislative priority. Despite this designation, few states have provided guidance on how funding could be used to support mental health. Only 15 states provide further detail on how to spend funds on mental health and only 6 states mention IECMHC. Ohio is the only state providing comprehensive information about the use of ARP funds for mental health services, and they are the only state to appropriate their funds to support mental health.  


Given the rising prevalence of mental health issues among child care providers, it is concerning that more states are not using their supplemental funding to provide mental health support. As states continue to allocate and spend their federal child care relief funding, states should prioritize the mental health of providers to better ensure that children’s development is not negatively impacted 

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