Infant Mental Health

Marcy Safyer, PhD, LCSW-R, IMH-E

Marcy Safyer, PhD, LCSW-R, IMH-E

What is Infant Mental Health and Why is it Important?

The term Infant Mental Health (IMH) is a slight misnomer and also includes Early Childhood Mental Health.  IMH can be understood as the developing capacity of a 0-5 year old child to experience, regulate and express emotions, form close and secure interpersonal relationships and explore the environment and learn within the psychological balance of the parent-infant relational system, as well as larger family, community and culture without serious disruption caused by harmful life events (National Zero to Three, 2004).

Recent neuropsychological research has shown that infants are born with their brains wired to be engaged in important nurturing and protective relationships.  They come into the world with remarkable capacities to establish and regulate these relationships.  Infants are surprisingly competent and endowed with predispositions toward attachment promoting behaviors.  They are not the “blank slates” they were once thought to be.  Infants possess an amazing repertoire of social and emotional capacities that are designed to give their parent information about their well-being and to actively behave in ways that modify and regulate the behavior of their parents.  The infant’s capacities to execute these signaling behaviors have roots across developmental domains.  In turn, infants seek emotional responsiveness from their parents and become distressed when it is not forthcoming.

Although the infant’s contribution to the relationship with his parent is great, it cannot be separated from the context of the parent.  The infant-parent relationship will suffer when infants fail to display behaviors or characteristics which elicit responsive caregiving as can be the case with babies who are premature, drug-exposed, or have developmental challenges.  Sometimes it is parents who cannot modify their expectations because their early life was characterized by unmet needs, abandonment and maltreatment, or because current stressors like maternal depression, mental illness or domestic violence are present.

Infant Mental Health-Developmental Practice (IMH-DP) is an interdisciplinary field that represents a dramatic shift in clinical practice.  IMH-DP focuses on the development of 0-5 year olds within the context of the early parent-child relationship as the foundation for healthy social-emotional, cognitive, language and even physical development.  IMH-DP offers ways of conceptualizing early disruptions in the attachment process, and of organizing interventions.  Its focus is on the mental health and relational dimensions of development that unfold in the context of other related domains of development, all of which are intimately and inextricably interlaced in infancy.  Thus the thrust of IMH-DP must be both developmentally and trauma informed.

At the Adelphi University Institute for Parenting and within the IMH-DP Master’s Degree program, multidisciplinary IMH specialists work within the context of the parent-child relationship to strengthen parental capacity while promoting both an understanding of the needs of young children and their parents’ unique ability to meet those needs.  In addition, IMH specialists work in a range of settings with care providers, preschool teachers and pediatricians, to name a few, as consultants to help address young children’s needs from a relationship-based perspective.  The dimensions of service aim to meet the needs of families on multiple levels and in many settings and include a service continuum that includes both prevention and intervention.  This comprehensive and intensive approach integrates a range of methods and services that include: developmental and trauma screening for children; depression, anxiety and trauma screening for parents; emotional support; developmental/parent guidance; early parent-child relationship assessments; dyadic (parent-child) psychotherapy; advocacy; and concrete assistance.  The Institute applies theoretically sound evidence-based approaches to clinical practice to support and enhance relationships between parents and their 0-5 year olds.  We aim to address early identification and assessment of children at-risk for developmental and mental health problems, strengthen attachment quality between young children and their parents and improve developmental trajectories through specialized dyadic services for at-risk populations of 0-5 year olds and their parents.

Pediatricians play a key role in the identification of high-risk children and families, provision of developmental guidance, referral of families to intervention resources and serving as a consistent touchpoint in the continuity of care.  The non-stigmatizing, health-oriented perspective of pediatrics makes pediatricians a safe and supportive port-of-entry for difficult-to-engage families facing the challenge of identification and referral.  Pediatricians can serve as critical links between the medical community, the mental health and developmental service systems and early care and education programs to promote integration of service delivery.

The Institute for Parenting at Adelphi University and its graduate program in IMH-DP can serve pediatricians as a resource for early identification, direct treatment services, mental health consultation to early care and education, coordinating child-serving resources in the community and a source of awareness information and expertise about infant mental health and developmental practice.

You can refer families with 0-5 year old children for services through the Institute of Parenting, if you are concerned that a child is has behavioral or developmental challenges, a family history of trauma or current traumatic events (i.e., child maltreatment, intimate partner violence, ongoing medical concerns/frequent hospitalizations, changes in family structure, loss of a close family member, or parental mental health and substance abuse issues), a parent suffering from Postpartum Mood and Anxiety Disorders (PMADs), or an impaired parent-child attachment relationship. Services are available to both English speaking and Spanish speaking families.  Referrals can be made by contacting Stacy Kurtz, PsyD at (516) 877-3911 or

Dr. Marcy Safyer, PhD, LCSW-R, IMH-E® IV-C is Director of Institute for Parenting at Adelphi University and Co-Director of Adelphi University Infant Mental and Developmental Practice (IMH-DP) Training Program.  She is the President of the New York State Association for Infant Mental Health.  She is a member of the NYS AAP Chapter 2 Foster/Kinship Care Committee.