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NCIT Spotlight: South Carolina

August 25, 2020

The State and Community Spotlight is an ongoing opportunity to share the work happening at the state or community level and foster connections between Pritzker grantees. Read this blog to learn about the work in South Carolina.

This State Spotlight features Kerrie Schnake, President, South Carolina Infant Mental Health Association, and Bryan Boroughs, Vice President and General Counsel, Institute for Child Success, co-leads on the South Carolina PN-3 Team.

The Capacity-Building Hub, an effort of the National Collaborative for Infants & Toddlers (NCIT), offers consultation and support to assist Pritzker Children’s Initiative-funded state and community leaders and their coalitions to make the provision of PN-3 opportunities and services more equitable. The goal, by 2023, is to help states and communities reduce by 25 percent the gap between the children and families served by high-quality programs and the children and families who want the services but don’t have access to them. The Hub aims, by 2025, to help states and communities decrease the gap by 50 percent. The Hub will progressively grow its efforts to increase the knowledge of all state and community leaders by sharing promising strategies and resources other states are successfully using to improve maternal health, birth outcomes, and infant-toddler well-being. 

The State and Community Spotlight is an ongoing opportunity to share the work happening at the state or community level and foster connections between grantees.

What big PN-3 goals is your state or community focused on?

Kerrie Schnake:

Our plan uses infant mental health or the social-emotional well-being of young children as the frame around which we have built our goals for increasing and building quality services for very young children and their families. The thinking behind that is that infant mental health or infants’ social-emotional well-being is really the crux of all other aspects of their health, development, and well-being. So we felt that was a good frame around which to build our goals.

More broadly, it’s policy and systems infrastructure building. It’s looking at skill building for the child and family workforce sectors. There’s a layer of programmatic intervention, scaling up, starting new, and scaling up existing programs that support that population – so things like Family Connects, mental health consultation in early care and education settings, Triple P, Help Me Grow, Safe Baby Courts.

What are your primary challenges in achieving these P-3 goals?

A lot of the challenges center on the relatively nascent state of the infrastructure for infant mental health. Kerrie and the South Carolina Infant Mental Health Association have done tremendous work building that infrastructure, but in many cases they were building it from scratch. They took the conversation from a place where you say “infant mental health” and people just look at you funny to saying it and they understand what you’re talking about, or are at least further along that path.

There are also the challenges inherent in a startup; you’re coaching folks through the language and connecting it to everything they do. One of the real strengths of this though is that infant mental health impacts everything relating to the zero-to-three space; it is core to the brand development. And that serve and return, or as I like to say in every conversation I possibly can, positive reciprocal verbal face-to-face interactions between safe and familiar adults and the child.

It’s the secret sauce: if you look at the research literature in education or in home visiting or abuse and neglect prevention or any number of domains relating to early childhood work, you can almost tie a direct line between the efficacy of that intervention and how much it facilitates positive reciprocal, verbal face-to-face interactions with the adults and how much they’re enabled to do that. And so, while it’s a challenge to build that, it’s also ripe and fertile ground because it’s so relevant to what so many people are trying to get after.

Kerrie Schnake:

We’re also contending with COVID in the world. It’s posing challenges in that we are up against a lot of other priorities. We’re trying to touch and engage all of these different child- and family-serving workforce sectors and say, “Babies are important. Babies are important.” And for a long span of time, they’ve been saying, “Yeah, yeah. We know, we know.” Attention is slowly shifting , but with COVID and a crisis situation, what’s right in front of their face is what gets attention right now. So, prioritizing this work in the face of everything else is a bit of a challenge.

Who makes up your coalition, including at the leadership level?

Bryan Boroughs:

It’s a broad group of stakeholders. One of the things that has been a real strength for us in this work is that there were several coalitions with overlapping membership. So there were some pretty good relationships already established between various sectors that you would normally think of as sort of natural silos. There was a common agenda that had a lot of the nonprofit sector.

For state agencies, there’s an advisory council that includes everybody who interacts with little kids, including the Departments of Social Services, Mental Health, Health and Environmental Control, and Health and Human Services (which is the Medicaid agency), First steps, IDEA Part C, and Home Visiting – in other words, everyone who works with infants.

There is a family engagement component with Save the Children Action Network. They already have a family engagement path there. They’re deepening it specifically to look at, for instance, building coalitions of alumni – either adult alumni who’ve benefited from some of the services as a kid or parents who have sent their kids to benefit from some of them. In addition, the state First Steps agency has a lot of family engagement work taking place.

For those outside of South Carolina, the state’s First Steps agency is a birth-to-five-focused agency that handles some of the state’s home visiting, privately provided preschool and daycare supports, and early care and education support. So it’s like other nonprofit and government agency hybrids that you see in some states. I think they modeled it after North Carolina, about 20 years ago.

Kerrie Schnake:

Right. SC First Steps has a state office and county affiliates. Each county has its own First Steps. When we were developing our plan, we leaned a lot on those local First Steps offices to engage their community, to get some feedback and input – and we’ll continue on that path.

How are you supporting families of infants and toddlers, and pregnant women who face significant barriers to supports and services?

Bryan Boroughs:

When you see the overall framework, a lot of the services that we’re looking at use something we’ve started calling targeted universalism or tiered universalism. So it’s something that has a universal touchpoint. So for instance, Help Me Grow, Family Connects, Triple P, and the infant mental health competencies are all designed to have at least some touchpoint with every family and then tier the response to that family, meeting them where they are. So that’s one way they reach the full community and then provide either more intensive or tailored services based on the needs of the individual families.

Kerrie Schnake:

As an example, infant health consultation has been shown to interrupt some of the inequities that show up in early care and education settings. Some of our programs are designed to address and interrupt some of those inequities.

What do you recommend to the new NCIT communities that are getting this work started?

Bryan Boroughs:

We’ve done a lot of work with small communities focused on this work. To quote  Former Mayor Bennett of Spartanburg, SC, “This type of work moves at the speed of trust.” And so it can sometimes be frustrating and painstaking to build those relationships in an authentic way because we all have things we want to check off the list. We want to get certain things done and that’s not necessarily what everybody else in the community wants to get done. And so it really matters to have that trust established. And if it’s not established, take the time to do that because otherwise you can have the best, prettiest, most research-based well-funded plan and it’ll all fall flat if the community doesn’t trust it.

Anything that you would want other states or communities to know?

Kerrie Schnake:

Just that it takes doggedness and a vision.

Bryan Boroughs:

There is one other nugget from the systems change literature: it takes three things all at once – a clear idea of what things could be, a clear idea of what things are, and still showing up to work every day. It’s easy to do any two of those things but doing all three day-in and day-out over the long haul is challenging. And it is especially hard in the context of COVID. It’s not that COVID is really derailing any of our plans. It’s just showing up every day in the context of all of the daily challenges.

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