Identifying the mental health needs of preschool children

The city of Chicago offers publicly funded preschool education to 20,000 3- and 4-year-olds through its State Pre-Kindergarten program. The students attend some 300 schools, and their health needs are monitored by 11 nurses and 8 aides. In the last several years, the nursing coordinator recognized the need to improve the mental health assessment skills of the school nurses. To that end, a relationship was developed with a child psychiatric nurse who had expertise in assessing young children's behaviors, particularly in the context of the classroom milieu. The collaboration of the school nurse and mental health nurse-consultant was structured as one-on-one sessions, each focusing on a particular child. A case is presented to illustrate the assessment method and accompanying suggestions for early intervention strategies. The case also points out how school nurses can structure assessments of at-risk children that lead to classroom-based interventions.