Safe Start: An Early Childhood Mental Health Program in a Tertiary Healthcare Setting—a Critical Review

Abstract

Early childhood mental health programs are vital for the current and future mental health and brain development of infants, toddlers, and preschoolers. Founded in 2014, Safe Start is the only early childhood mental health program in Beirut, Lebanon. It aims at being the prototype of such services at the national level. A retrospective analysis of the outcomes of the first year of operations has resulted in important findings about the age of the participants, their diagnoses, previous therapies that the participants have undergone, types of referrals recommended, and the number of participants who were lost to follow-up. This first analysis pointed at the need for more in-depth research to encompass the gaps and benefits of such services. It shows the pivotal importance of designing awareness strategies about the importance of early childhood mental health services and care; to move from a diagnostic seeking behavior to commitment to psychotherapy and follow-up interventions.

The state of psychiatric research in the Asia Pacific region

“…The latter group has been of particular interest, with many studies assessing the mental health needs of Syrians and other refugees who fled their nations to Lebanon (E. Karam et al, 2016; Kerbage et al, 2020; Yassin, Taha, Ghantous, Atoui, & Forgione, 2018). Lastly, many mental health interventional activities are being studied in these groups (Dirani, Raad, & Akoury‐Dirani, 2018; Harper Shehadeh et al, 2020; Kaplan, El Khoury, Lize, Wehbe, & Mokhbat, 2019; Noubani et al, 2020).…”

DC: 0–5 system in clinical assessment with specialty pediatric populations

“…Given that the signs and symptoms of mental health disorders are less understood in infancy, there may be a lack of referral of infants to services. This was a concern also noted by the Safe Start Clinic in Lebanon (Dirani et al, 2018). A strength of the DC: 0-5 is its specificity to young children, its diagnostic criteria describe symptoms in multiple years of early childhood.…”

“…In 1 year, the clinic saw 125 children for assessment, between the ages of 2-6 years. The most common diagnosis in this sam-ple was autism spectrum disorder (ASD) followed by global developmental delay (GDD), and it was suggested by the authors that the high prevalence of the presentation of these disorders was due to parents being more educated on their presentations than other ECMH disorders (Dirani et al, 2018).…”

“…Safe Start is the first infant mental health clinic established in Lebanon (Dirani et al., 2018). The assessments in this clinic are conducted by a child psychologist and include a full medical review, observation of child, and developmental testing and parent questionnaires.…”