Infant and Early Mental Health Care Pathways

Establishing Community Systems of Care

Key Points

  1. Many Canadian communities do not have systems, services, and policies in place to support infant and early mental health. 
  2. Because a child's brain changes very quickly during the first three years of life, it is important for families with young kids to find and use the right support at the right time. Systems of care pathways guide families through the process of accessing support. 
  3. The Infant and Early Mental Health (IEMH) Care Pathways project aims to improve systems of care for preschoolers and their families. 
  4. The goal of the project is to enhance community and system capacity for infant and early mental health and developmental support and ensure that staff in those communities have access to training and best practices to support infant and early mental health. 
  5. The project will examine the impact of IEMH Care Pathways on communities, organizations, families, and young children.
An Example of a Care Pathway developed with the City of Hamilton An Example of a Care Pathway developed with the Simcoe County

(Click on a map above to access the entire series of pathways for that community.)


In partnership with community-based agencies, the goal of the IEMH Care Pathways project is to help communities better serve the youngest children in their region by:

  1. Developing comprehensive systems of care pathways 
  2. Building knowledge, skill, and capacity among those agencies supporting young children prenatal to age 6 
  3. Exploring how system of care pathways can impact the support young children and families receive, ultimately


Right now, many jurisdictions across Canada lack the systems and services needed, informed by science and best practices, to help babies, toddlers, and preschoolers with their mental health. As a result, many children sit on waitlists far too long and do not receive the support they need.

For many children, mental health challenges begin to develop in early childhood. When these mental health challenges are not noticed early, at-risk children will not receive the help they need to reduce the impact of these challenges on their development.

In fact, if support is not provided within the first 6 years of life, the optimal window of opportunity for intervention has been missed. This means that more efforts and resources will ultimately be required to improve the child’s long-term outcomes.

Developing a system of care Pathway is one way to address early mental health challenges. (See ‘Beyond Building Blocks: Investing in the lifelong mental health of Ontario’s 3-6-year-olds' report.)

These Pathways guide children and families to, through, and out of care. Specifically, these pathways help match families with the right services, at the right time, and in the right way.

With financial support from the Mental Health in the Early Years Implementation Science grant by the Canadian Institutes for Health Research (CIHR), and in collaboration with the Knowledge Institute on Child and Youth Mental Health and Addictions, Kids Brain Health Network, University of Calgary and Queens University IEMHP created the Infant and Early Mental Health Care Pathways project.

Through this work, IEMHP partners with diverse community organizations to:

  1. Help create their unique system of care Pathway map.
  2. Determine how the Pathway impacts capacity to support infant and early mental health.


Care Pathways Background

In late 2019 and early 2020, IEMHP and partners met with leaders across various sectors from 3 communities to pilot system of care Pathways. We engaged in discussions that helped us identify the following:

  • What a Pathway to support the mental health of children from prenatal to six might look like.
  • The steps required to use and test these care Pathways in the community.
  • Two of the 3 communities created Pathways at the end of the pilot. The third community finalized their Pathway through consultations. Examples of finalized Pathway maps are provided below. Click on a map to access the entire series of pathways for that community.
  • One Indigenous community partner taught us that one Pathway map for an entire community is not always inclusive enough. Instead, extra Pathways may be helpful to the families they serve, as they can be more specific.

At the end of a workshop, the maps created from post its on posters, as messy as they may look, are gathered for all sectors and areas and gathered into global maps by the facilitators.Discussion

Community and organization leaders were invited to create community-specific Implementation Teams.

These Implementation Teams:

  • Include decision-makers representative of their sectors,
  • Lead the ongoing tasks required to update the Pathway to better meet the needs of families,
  • Ensure conversations about infant and early mental health remain a priority in the community.


In partnership with community-based, cross-sectoral groups of professionals, we propose to:

  • Ensure high-quality, evidence-based information for service providers across sectors
  • Find opportunities to enhance existing programs, services, knowledge, and policies affecting preschoolers
  • Get rid of barriers between sectors and promote inter-organizational collaboration
  • Develop system of care Pathways that will benefit communities, organizations, families, and children
  • Support use of Pathways maps in practice
  • Enhance practitioners' competence, confidence, and capacity
  • Work with Ontario communities in various contexts (rural/urban, multicultural/Indigenous, etc.)
  • Assess the impact of the IEMH Care Pathways on children, families, practitioners, organizations, and communities.

Project Objectives

Our goal is to evaluate the IEMH Care Pathways approach as an intervention in Canadian communities to ensure that children at risk of poor mental health outcomes are equitably identified and supported as early and effectively as possible.

Project Team

This project is led by a collaboration between IEMHP, The Hospital for Sick Children and:
Dr. James Reynolds’ team at Queen’s University in Kingston, ON
Dr. Sheri Madigan’s team at University of Calgary
Dr. Jennifer Zwicker’s team at University of Calgary
The Knowledge Institute on Child and Youth Mental Health and Addictions at the Children’s Hospital of Eastern Ontario

Would you like to learn more and get involved in this project? Contact us today.

Infant and Early Mental Health Promotion, the hospital for sick children

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The Hospital for Sick Children

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