Programs address behavioral challenges now to help avert mental health problems later

Nelson Mandela, one of the great moral voices of the 20th century, said this: “There can be no keener revelation of a society’s soul than the way in which it treats its children.” Indeed, in Philadelphia, and across the country, we have seen dedicated organizations and individuals work tirelessly to help our communities’ young people reach their full potential.

But the need for evidence-based, early-intervention programs for those most at risk of developing serious mental health problems is a significant ongoing concern. In the city of Philadelphia, 37 percent of young people under the age of 17 live in poverty—the highest rate among the 10 largest cities in the United States. Even more concerning is the fact that almost 61,000 of these 126,000 children and youth live in “deep poverty,” defined as an annual income of $12,000 or less for a household of four.

Poverty is associated with material deprivation—food insecurity; unsafe housing; and lack of reliable transportation, health services, and child care. Substantial evidence also indicates that poor children face a host of additional challenges. They risk falling behind in language, cognition, and social-emotional development, and have a higher risk of exhibiting mild to moderate behavioral problems, which their parents often may not fully recognize or feel equipped to manage. These deficits can lead to young children being ill-prepared to enter school and, once there, performing poorly—and, in some instances, exhibiting disruptive behavior, including difficulty interacting with peers and teachers.

And, as reported by the Children’s Hospital of Philadelphia’s Policy Lab, young people who demonstrate challenging behavior in preschool, elementary, or middle school can be at risk of developing full-blown mental health disorders, which can severely affect their life trajectories.

We now have a significant body of evidence showing that intervening early with these children can prevent more serious mental health problems down the road—which might require more intensive and costly intervention that can be difficult for families to access and afford. That is why The Pew Charitable Trusts supports nonprofit organizations in the Philadelphia region whose prevention and early-intervention programs are guided by research and real-world experience—and designed to reduce the likelihood of long-term behavioral and academic problems.

To highlight just three examples:

• Easter Seals of Southeastern Pennsylvania is implementing the Positive Behavior Intervention Support model, in which specialists train teachers to establish positive classroom rules and expectations for children. In addition, the training enables teachers to enhance the problem-solving and social skills of students and develop strong relationships with their families.
• The Children’s Hospital of Philadelphia offers, at two of its pediatric practices, PriCARE—a program designed to educate low-income parents and caregivers who are concerned about their child’s behavior or who are not sure about effective disciplinary methods. The training addresses issues early on, in a non-stigmatizing setting, and focuses on helping caregivers develop the ability to reinforce positive behavior, ignore minor issues, and impose age-appropriate discipline.
• Drexel University is implementing the Incredible Years program, focusing on children ages 6 to 9 in four Philadelphia elementary schools who are at risk of developing behavioral problems that can lead to low academic achievement. The program’s curriculum utilizes interactive activities to teach children about communicating feelings, solving problems, and managing negative emotions. It also trains teachers to improve classroom management and foster cognitive and social-emotional skills.

There is much work to be done to help our most at-risk children reach their potential, but in Philadelphia these organizations—and many others—are making a real difference.