For survivors of sexual violence, healing rarely follows a predictable timeline — or a single path.
At Avalon Healing Center in Detroit, that understanding shapes everything from how clients receive counseling to the physical environment where care takes place.
As Avalon celebrates its 20th anniversary, the organization is expanding the choices available to survivors while responding to growing demand for its free, confidential services.
“We meet survivors where they’re at,” says Katie Smith, Avalon’s director of marketing and communications. “We’re never going to turn anybody away, and we’re going to find a way to make sure that they’re provided services.”
Since opening in 2006, Avalon has served more than 30,000 survivors of sexual violence.
Today, the organization serves approximately 1,500 people each year across seven Wayne County clinic sites. Smith says demand is not decreasing: In the past year alone, calls to Avalon’s hotline increased 38%.
Reaching survivors begins with helping the wider community understand the prevalence and realities of sexual violence. Through an awareness initiative called Unmuted, Avalon is speaking more openly about what its staff encounters and why specialized mental health and healing services remain so vital.
Avalon uses its social media channels, blog and podcast to share statistics, stories about its work and information that may be difficult, but important, for the public to understand. More than 30% of the survivors Avalon serves are children, Smith says. Over its history, Avalon’s patients have ranged from two weeks old to 101 years old.
Smith recognizes that Avalon must approach these realities carefully. Many people who follow the organization are themselves survivors, so potentially triggering posts include content warnings. Avalon’s communications must create a supportive space for survivors while also helping donors and community members understand the urgency of the work.
The goal is not to shock people. It is to make an often-hidden need visible — and help survivors and their loved ones know where support is available.
“As we bring more awareness in the community about our services, we’re getting more calls and more intakes,” Smith says. “It’s showing that it is working, because we’re trying to reach everybody that we can.”
During Avalon’s anniversary year, the organization is also sharing photographs and milestones from its history, tracing its growth from a small grassroots nonprofit into Michigan’s largest and most comprehensive provider of free sexual-assault services.
Mental health support is not a separate part of Avalon’s work; it runs through every service the organization provides. Smith says everyone experiences difficult periods with their mental health, but sexual violence can intensify existing struggles and introduce new ones.
“You attach something horrific that’s happened to you to that, and it exacerbates everything,” she says. “We’re focused on supporting our clients through their trauma, but also supporting their mental health every day.”
For some survivors, an Avalon counselor or advocate may be their only consistent source of emotional support. Not everyone has family members or friends they feel safe talking to, and some fear they will be blamed or disbelieved. Avalon’s individualized approach helps fill that gap without imposing a predetermined treatment plan or timeline.
“Sometimes that’s the only support system that person has,” Smith says.
Avalon’s comprehensive model connects survivors with medical-forensic care, counseling, advocacy, transportation, court accompaniment and follow-up medical services. Increasingly, the organization is also providing different ways for people to access that support.
Counseling may take place in person, by phone or through a virtual appointment, depending on what is most comfortable and practical for the survivor. Clients can also participate in individual and group counseling or explore holistic healing practices such as trauma-informed yoga, sound bowl therapy, art, movement and meditation.
Those choices matter because traditional talk therapy is not the right — or only — healing tool for every person.
“Everybody’s story is different. Every client is different,” Smith says. “What does that specific client need to feel supported?”
Trauma-informed care recognizes the survivor as a whole person, including their identity, culture, circumstances and individual needs. It can mean connecting someone with resources tailored to LGBTQ+ survivors or honoring a client’s request to communicate only in a particular way or at a particular time.
It also means allowing survivors to decide whether and how long they want to participate in services. Someone might meet with a counselor twice and decide not to continue. Another survivor might need support for years or return after time away.
Avalon provides information and resources without prescribing what healing should look like.
“We want to make sure that they are doing what they need to do for themselves,” Smith says.
Avalon has also invested in making its Detroit healing center feel welcoming, calm and accessible. The organization worked with a trauma-informed designer to create spaces that feel safe without introducing features that might be intimidating or triggering.
“We spent a lot of time creating spaces in our building that reflect that trauma-informed lens,” Smith says. “We want to make sure clients feel like the building is accessible to them, that the building is for them.”
A new mural by Detroit artist Jake Dwyer will extend that idea to the building’s exterior. Inspired by the Arthurian legend of Avalon as an island where people went to recover after battle, the nature-filled mural depicts cranes flying toward an island of healing.
The artwork is more than decoration. It is intended to make the previously plain brick building recognizable and welcoming before a survivor walks through the door.
Avalon is also working with community partners to explore additional support for survivors during the perinatal period and to develop a digital resource hub that could help survivors find services in one place.
Avalon’s growth comes with a significant gap between the cost of providing specialized care and available public funding.
Smith says each medical-forensic examination costs Avalon approximately $2,500 to provide, while the organization receives about $1,200 in state reimbursement. In 2024, Avalon had to raise approximately $870,000 to help close funding gaps and continue providing services at no cost.
The organization is always seeking additional resources, but Smith emphasizes that the type of funding matters, too. Many grants restrict dollars to a designated program or project. Those grants are essential, but they do not necessarily cover needs that arise elsewhere in the organization.
Unrestricted funding gives Avalon the flexibility to pay for facility improvements, additional construction, features inside the healing center and projects such as the exterior mural. These investments may not fit neatly within a program-specific grant, but they help Avalon create and maintain an environment intentionally designed to support survivors’ mental health.
Flexible dollars also allow the organization to respond when needs change or demand increases.
Philanthropic support carries another benefit, Smith says: It signals to survivors and the wider community that established institutions recognize the importance and credibility of Avalon’s work.
“So much of this work is collaboration in the community,” she says. “Avalon cannot do the work alone.”
That includes caring for the people who provide the services. Avalon staff members regularly absorb the secondary trauma that can accompany years of supporting survivors. Yoga, sound bowl sessions, creative time, staff retreats and paid time off are among the ways the organization encourages employees to care for their own mental health.
“How can we support the staff so that they can be the best for their clients?” Smith says.
Community members can support that work at Avalon’s upcoming Waves of Change: 20th Anniversary of Healing and Hope fundraiser. The event will take place aboard the Ovation yacht on the Detroit River on Sept. 24 from 5:30-9 p.m.
The evening will celebrate Avalon’s two decades of service while raising unrestricted funds for the organization’s continued work. Avalon is seeking additional sponsors as well as guests who want to purchase tickets, celebrate the milestone and show survivors that their voices matter.
Although Avalon provides highly specialized services, Smith says every person has a potential role in a survivor’s mental health and healing, particularly when someone first discloses an assault.
There is no correct timeline for coming forward, she says. Fear of judgment, blame, disbelief or repercussions for the person who caused the harm may keep a survivor silent for months, years or decades. Waiting to disclose does not make the experience less real, nor does choosing not to disclose publicly make someone less courageous.
The first response a survivor receives can influence whether that person feels safe seeking further help.
Smith encourages everyone to remember three statements:
“I believe you. It’s not your fault. You’re not alone.”
Knowing how to respond — and knowing where specialized help is available — can make an enormous difference. Smith wishes awareness of Avalon were “just as important as knowing where your local hospital is.”
After 20 years, Avalon’s message remains both simple and urgent: Healing is personal, survivors deserve choices and no one should have to navigate trauma alone.
Learn more about Avalon Healing Center.
When someone is wrongfully imprisoned and eventually exonerated, many people assume the hardest part is over. Freedom is finally restored, family and friends celebrate and the prison gates close behind them for the last time.
But members of the Organization of Exonerees know that’s often when a different journey begins.
Founded by exonerees themselves, the Detroit-based nonprofit supports people who have been wrongfully convicted as they rebuild their lives after release. While the organization helps members navigate practical challenges like obtaining identification, housing and other essential resources, its leaders say one of the greatest needs is often invisible: mental health.
“People assume that you’re normal when you come home,” says Executive Director Kenneth Nixon, who was wrongfully imprisoned before being exonerated. “There’s this assumption that you walk out of prison and everything’s fine. You just go back to life as usual. When in reality, the entire world has changed.”
Michigan is home to approximately 193 exonerees, according to Nixon. Since its founding, the Organization of Exonerees has supported close to 100 people, and its long-term goal is to reach every living exoneree in the state.
The organization didn’t begin with a strategic plan or a vision to start a nonprofit.
“It was just a group of people with similar experiences and similar backgrounds that were trying to navigate systems and agencies that were locking us out,” Nixon says.
When he was released from prison, five exonerees were waiting outside the prison gates. They helped him obtain identification, navigate government systems and answer questions that only someone who had lived through the experience could answer.
“There were no resources for people that were wrongfully convicted,” Nixon says. “The system is designed to put you in. It is not designed to let you go when they figure out that you did not commit the crime.”
That need led exonerees to begin helping one another, eventually forming what Nixon believes is the only peer-led organization of its kind in the country.
“There was no blueprint to the Organization of Exonerees,” he says. “We’re the only organization in the country that operates like this. We’re peer led. We make our own decisions. We help our community because we feel like it’s necessary.”
Today, lived experience remains the organization’s greatest strength. Rather than relying solely on traditional models of reentry support, the people leading the work have navigated the same challenges themselves, allowing them to build programs around what exonerees actually need.
Many people assume freedom brings instant relief. Ciera Renee’, Director of Mental Health and Wellness at the Organization of Exonerees, admits she once believed the same thing.
Working alongside exonerees quickly changed that perspective. “The layer of being wrongfully convicted, that amount of trauma that was imposed on all of them is definitely different,” she says.
Nixon says prison fundamentally changes how people survive and interact with the world.
“PTSD is an understatement for a lot of people,” he says. “Prison is exactly what you think it is. It is a highly violent environment. It is a very hostile environment.”
Even everyday interactions can become difficult after years of adapting to prison life. “It’s against the rules to touch people in prison,” Nixon explains. “Now when you come home, your family wants to hug you. There’s a level of trauma associated with that that is not easy to navigate.”
Some members struggle with crowded spaces. Others have difficulty sleeping. Certain smells or places can trigger painful memories. “We have people within our organization that can’t even say their own names without crying,” Nixon says. “We have people that won’t leave their houses. We have people that have been triggered by scents. The scent of soap triggers some people.”
The organization has also created regular mental health check-ins to make sure members stay connected. “We do touch points with everybody,” Nixon says. “It’s simply a mental health check. I don’t need to know what’s going on in your life. I just need you to respond and tell me you’re alive.”
Because every person’s experience is different, the organization believes mental health support must be equally flexible. “Healing looks different for each person,” Nixon says.
Renee’ helps connect members with therapeutic resources, facilitates monthly gatherings and creates retreats intentionally focused on emotional wellness. But she also encourages people to think differently about healing.
“Sometimes we have to be honest about some things you can’t heal from because it is what it is,” she says. “So what we try to teach very well is managing.”
She continues, “Healing could also mean that’s a lifelong journey. But if we can be the best manager of our emotions and experiences, that’s our best possible outcome.”
That philosophy shapes everything the organization does. Sometimes support means helping someone process trauma during a retreat in northern Michigan, away from distractions and surrounded by peers who understand. Sometimes it means accompanying an exoneree to a courtroom years after their release because returning to court is emotionally overwhelming.
Sometimes it’s simply answering a phone call after hours when someone has been triggered.
“We can be creative, we can be unique, we can be whatever that person needs in that particular moment,” Nixon says.
Renee’ says even her professional training couldn’t fully prepare her for this work. “The first exoneree that I met with on an individual basis was Kevin Harrington. I had my toolkit ready. I know exactly what needs to happen here.”
But after listening to his story, she realized she needed a different approach.
“I said, ‘I know nothing about what’s going on. I know nothing about what he went through.'”
Instead of assuming what people need, the organization lets exonerees lead the conversation.
“When you make space for people to tell you their needs and then you help with the functional things that go around that, that’s when I believe you have the most success,” Renee says.
For Nixon, that lived experience is what makes the organization unique. “It made an enormous difference in my transition,” he says of being greeted by fellow exonerees when he was released. “I felt like somebody understood what I was feeling.”
He credits that peer support with helping ground him as he began rebuilding his life.
“You can assume you know what we’ve gone through,” he says. “But nobody actually truly knows unless you’ve been there.”
The organization’s work continues to expand. Support from partners, including the Ethel and James Flinn Foundation, has helped the organization grow its mental health programming, including retreats and wellness initiatives. But Nixon and Renee say the need continues to outpace available resources.
Their vision includes embedded therapists dedicated specifically to exonerees, more staff to respond quickly when people need help and the ability to reach every exoneree in Michigan.
“We don’t get to choose,” Nixon says. “We have to take them in whatever condition they show up, whether that’s severely damaged or highly functional.”
For Nixon, that’s what the organization has always been about: making sure no one has to rebuild their life alone. “It made an enormous difference in my transition,” he says of being greeted by fellow exonerees when he was released. “I felt like somebody understood what I was feeling.”
Today, he hopes every exoneree in Michigan has that same opportunity: someone who understands, someone who checks in and someone who reminds them they don’t have to navigate recovery alone.
Learn more about Organization of Exonerees.
Many people who die by suicide have already interacted with the healthcare system before their death.
According to Brian Ahmedani, Ph.D., director of the Center for Healthcare Improvement and director of research for Behavioral Health Services at Henry Ford Health, approximately 83% of people who die by suicide have a healthcare visit in the weeks and months leading up to their death.
“That means we have an opportunity within a healthcare system to identify people at risk and to intervene,” Ahmedani says.
That idea has guided more than two decades of work at Henry Ford Health and helped shape an approach to suicide prevention that is now being implemented by healthcare organizations across the United States and in more than 30 countries worldwide.
Known as Zero Suicide, the model is built on the premise that suicide prevention should be an integrated part of healthcare, supported by systems designed to identify risk, provide evidence-based interventions and connect people with ongoing support.
The Ethel and James Flinn Foundation has supported Henry Ford Health’s behavioral health work for many years, including earlier efforts to integrate behavioral health services into primary care settings.
Andrea Cole, president and CEO of the Ethel and James Flinn Foundation, says Henry Ford Health’s evolution from behavioral health integration to Zero Suicide demonstrates how prevention-focused investments can grow over time. Those earlier efforts helped establish systems for screening, assessment and behavioral health support that continue to support the organization’s suicide prevention work today.
The roots of Henry Ford Health’s suicide prevention work date back to 2001, when the organization launched an initiative known as Perfect Depression Care.
The name and work transitioned rapidly to the Zero Suicide model as the team created an audacious vision for a world with a perfect system of care and a perfect outcome. The Zero Suicide model is a comprehensive approach that includes suicide risk screening, assessment, brief intervention, treatment and follow-up support.
The model has continued to expand as research has improved understanding of suicide risk and effective interventions. Today, Henry Ford Health serves as a leader in implementing and advancing the approach nationally and internationally.
Research conducted by Ahmedani and his colleagues has shown reductions in suicide attempts and deaths across healthcare systems implementing Zero Suicide principles. At Henry Ford Health, Ahmedani says the organization saw a reduction approaching 80% when the model was initially launched.
One of the defining features of the Zero Suicide model is its focus on suicide risk itself.
Historically, suicide risk has often been addressed indirectly through treatment of underlying mental health conditions such as depression or anxiety. Henry Ford Health’s approach recognizes that while those conditions remain important, suicide risk requires its own assessment and intervention strategy.
“We treat suicide risk as a separate disease — not as part of another mental health condition, but as its own disease,” Ahmedani says.
That philosophy shapes how the health system approaches care. Patients are screened specifically for suicide risk, not simply for other behavioral health concerns. When risk is identified, providers can connect patients with evidence-based interventions designed to address suicide risk directly.
The result is a more targeted approach that seeks to identify risk earlier and connect individuals with appropriate support before a crisis occurs.
The Flinn Foundation has supported Henry Ford Health’s behavioral health work for many years, including efforts to integrate behavioral health services into primary care settings.
Those programs embedded behavioral health providers within primary care clinics, creating opportunities to identify concerns, assess risk and connect patients with care as part of routine healthcare visits.
“The Flinn Foundation funded the original adult and child and adolescent behavioral health integration pilot programs,” Ahmedani says. “Those programs are the foundation of what we’re building on.”
As Henry Ford Health’s suicide prevention efforts have expanded, those early behavioral health integration programs have continued to provide an important foundation for identifying risk and connecting patients with support.
While healthcare remains a critical component of suicide prevention, Henry Ford Health increasingly views community partnerships as an essential part of the solution.
Ahmedani says people experiencing suicidal thoughts may first come to the attention of teachers, faith leaders, community organizations or others outside the healthcare system.
“We really have to partner with organizations and community groups, including schools, churches, jails and other service organizations,” he says.
Those partnerships help create additional pathways for identifying risk and connecting people with prevention and care.
Henry Ford Health is also expanding efforts focused on specific populations, including veterans.
With support from the Flinn Foundation, the organization is conducting proactive outreach to veterans who may not receive care through the Veterans Administration but remain at elevated risk for suicide.
Henry Ford Health continues to expand and refine its suicide prevention efforts.
Recent support from Four Pines Fund, a Vermont-based philanthropic organization focused on suicide prevention, is helping launch several new initiatives. These include efforts to improve the quality and delivery of safety plans, develop technology-based safety planning tools and expand access to suicide-specific psychotherapy treatment through virtual care.
The goal is to make evidence-based suicide prevention interventions more accessible while continuing to improve how they are delivered.
For Ahmedani, that work represents the next chapter of an effort that has been evolving for more than two decades.
“We’re actively expanding locally, nationally and globally,” he says. “We’re continuing to test, innovate and adapt new approaches.”
Although significant progress has been made, Ahmedani believes suicide remains one of the most urgent public health challenges facing communities today.
Millions of Americans experience suicidal thoughts each year, and the effects of suicide extend far beyond those who die, impacting families, friends, workplaces and communities.
For Henry Ford Health, the response is to continue building systems that identify risk earlier, strengthen connections to care and expand access to effective interventions.
“We’re committed to working every day to try to prevent every single suicide in any way that we can,” Ahmedani says.
Learn more about Zero Suicide at Henry Ford Health and discover the work of the Ethel and James Flinn Foundation.
The Ethel and James Flinn Foundation is pleased to announce that we are accepting proposals from non-profit organizations that deliver mental health care and services in southeast Michigan (Wayne, Oakland, Macomb and Washtenaw).
All applications must be submitted through our Online Grant Application Process which is accessible directly from our website.
The deadline for all applications is July 16, 2026 — before 4:00 p.m.
Please click on the following Request for Proposals (RFPs) links for details:
EVIDENCE-BASED PRACTICES – ADULTS
EVIDENCE-BASED PRACTICES – CHILDREN AND YOUNG PEOPLE
CAPACITY BUILDING OPPORTUNITIES
MENTAL HEALTH AWARENESS, EDUCATION AND OUTREACH MINI-GRANTS PROGRAM
Get full information at the How to Apply page.
For more than 30 years, Dr. Calvin Mann has worked with boys and families through his organization, Encourage Me I’m Young (EMIY), developing a mentoring model centered on relationships, structure, and early intervention.
That work is now captured in a newly published book that outlines what Mann calls the “EMIY Way” — a practical framework designed to help parents, educators and mentors better support young people before challenges escalate.
At the core of the approach is a simple idea: prevention starts with relationships. By focusing on connection, clear boundaries, and encouragement, the model aims to create more supportive environments at home, in schools and in community settings.
Mann’s work emphasizes engaging not only young people, but also the adults around them. His mentoring programs incorporate strong family involvement and provide tools that can be applied across classrooms, households and youth-serving organizations.
As communities continue to look for ways to strengthen mental health and well-being, particularly among young people, the EMIY model offers one example of how early, relationship-based approaches can help build resilience and support healthier outcomes over time.
The book is available on Amazon and provides an introduction to the framework, along with practical strategies for those interested in applying it in their own settings.
The Boys & Girls Clubs’ Behavioral Health program, launched in 2022, was designed to integrate behavioral health support into everyday club programming. By embedding services such as therapy, social-emotional learning and staff consultation, the program aimed to make mental health support accessible and normalized for young people.
The former Boys & Girls Clubs of Southeastern Michigan is now Boys & Girls Clubs of Greater Detroit, a name Dr. La-Toya S. Gaines, Executive Director of Behavioral Health, says reflects the organization’s current and future growth.
That growth includes a new location inside Michigan Central, which officially opened in February 2026. The 15,000-square-foot club is located inside The Station and is described by Michigan Central as a first-of-its-kind model that places youth inside a working innovation district.
For Gaines and her behavioral health team, the new site offers a different setting for the same larger goal: making mental health support accessible, relevant and connected to young people’s lives.
Gaines, a licensed clinical psychologist, oversees a behavioral health department that includes a director of social work, a program coordinator, psychology and social work interns, and other trainees. She describes the team as “small but mighty.”
Across the clubs, their work includes direct care for youth and families, consultation with staff, and support during mental health needs or crises that may arise during programming.
Gaines says part of the behavioral health team’s role is collaborating with staff across the clubs to help them recognize and respond to mental health needs and crises that may arise during programming. That includes supporting youth development staff in approaching youth through a trauma-informed lens and connecting young people to additional support when needed.
Any adult interacting with youth, including club directors, youth development specialists, transportation staff and culinary team members, can make a referral to behavioral health. Parents and caregivers can also request services.
Most services are provided on site. When a young person has more complex needs or requires longer-term care, the team helps connect the family to outside support. Gaines said the most common concerns include anxiety, depression, trauma, attention-related challenges and behavioral concerns.
Last year, the behavioral health department served more than 900 youth and families in some capacity, including individual counseling, family therapy, assessments, group programming, emotional regulation support, conflict resolution, resiliency work and workshops.
The Michigan Central location is not structured like a traditional club. It is designed primarily for older youth and young adults, with programming aimed at exposure to career pathways and hands-on experience in a range of fields.
Gaines said the club is especially geared toward youth ages 14 and older. Young people can explore areas such as media production, fashion and other fields through “industry clubs” that provide exposure to career pathways and connections to professionals in mentorship roles.
The physical environment reflects that focus, with spaces dedicated to podcasting, production, fashion and other creative pursuits. For youth with interests in those areas, the club provides access to equipment, practice opportunities and guidance they may not otherwise encounter.
“I think it is very affirming for somebody to say, not only verbally, ‘I believe in you,’ but ‘here are the tools you need, here’s the space that you need, and here’s a person who can assist you with that,’” Gaines says.
“That goes from being something you imagine or visualize to something that’s real and tangible,” she adds.
Because the Michigan Central site functions differently, the behavioral health approach there is different as well.
Rather than focusing primarily on one-on-one therapy, Gaines and her team provide workshops that meet youth where they are.
Topics include managing stress, coping with disappointment, navigating new responsibilities and understanding emotions that arise as young people begin to think more seriously about adulthood and future careers.
For example, a young person may participate in a pitch or performance opportunity and not be selected. Experiences like that create opportunities to talk about resilience, confidence and self-worth in real time.
The approach also helps reduce stigma. Gaines says the workshops introduce mental health topics in a way that feels relevant rather than clinical.
“I think it’s a nice way to introduce mental health in a way that’s not stigmatizing,” she says.
Youth voice is also shaping the programming. After workshops, participants are asked what they found useful and what topics they want to explore next. Gaines says she has been struck by how often youth ask for more information about mental health.
After one session on depression and anxiety, youth asked how to support friends who may be struggling. That feedback led to additional programming focused on peer support. Other requested topics have included navigating adulthood, having difficult conversations with adults and learning how to advocate for themselves.
Gaines says that support is especially important because the organization continues serving youth into early adulthood, helping maintain access to behavioral health resources, mentorship and other supports during a period when many young people are navigating major transitions related to school, work and independence.
Across all Boys and Girls Clubs in metro Detroit, the most common concerns include anxiety, depression, trauma and behavioral challenges. But many families also face needs beyond behavioral health, including housing instability and financial stress.
The behavioral health team often works to connect families to community resources that address those broader challenges.
The organization has also expanded outreach into schools, with staff currently working in at least one neighborhood school and plans to grow that effort.
One area of focus is increasing engagement with parents and caregivers.
“When we are not just treating the child, but working with the family, those outcomes improve tremendously,” Gaines says.
The organization has introduced more parent coaching, aimed at helping caregivers support emotional regulation, respond to behavioral challenges and strengthen family dynamics.
Even as the organization expands, capacity remains a challenge, with more behavioral health staff at the top of the wish list for Gaines.
The department relies in part on interns, and additional staffing and resources would help meet the level of need among youth and families.
The Michigan Central club reflects a broader shift in how youth-serving organizations can integrate mental health into environments that also offer skill-building and career exposure.
For the Boys & Girls Clubs of Greater Detroit, it is one part of an ongoing effort to provide support earlier, in settings where young people are already spending time, learning and building toward their futures.
Header photo by Darren Clark/via Redfoot Vegas. Inline photo by Michigan Central.
Learn more about the Boys and Girls Clubs of Greater Detroit.
At Wayne State University, a cross-disciplinary partnership is advancing a different approach to early childhood mental health — one that begins within pediatric care and challenges how systems are structured to support infants, young children and their caregivers.
The Early Childhood Support Clinic (ECSC) brings together the Wayne State University School of Social Work, the Merrill Palmer Skillman Institute for Child & Family Development and Wayne Pediatrics to deliver integrated, relationship-based care.
The clinic was launched in 2023 with support from the Ethel and James Flinn Foundation, along with Priority Health Total Health Foundation, Blue Cross Blue Shield Foundation, the Community Foundation for Southeast Michigan and Southeast Michigan Perinatal Quality Improvement Coalition. The clinic reflects a growing recognition that early developmental and mental health needs cannot be addressed effectively within traditional service silos.
The effort is led by Dr. Carolyn Dayton, professor of social work at Wayne State University and associate director of the Infant Mental Health Program at the Merrill Palmer Skillman Institute, and Dr. Alissa Huth-Bocks, director of the Institute. Both emphasize that the clinic was designed to meet immediate family needs, prevent future developmental and mental health problems from arising, and test a model that existing systems are not structured to support — particularly when it comes to delivering and sustaining relationship-based care for infants and caregivers.
Since its launch, ECSC has served nearly 1,000 infants, young children and their families, most under age 3, by embedding mental health clinicians directly within Wayne Pediatrics.
Rather than relying on families to seek out behavioral health services independently, the model ensures that support is available as part of routine pediatric care. According to Dr. Huth-Bocks, this integration allows clinicians to engage families in real time, often during the same visit in which concerns first emerge.
“We’re located right in the pediatric clinic, so we can literally cross the hallway and connect with families,” she says.
Services include developmental guidance, emotional support, and assistance with concrete needs, as well as coordination across medical, behavioral health and community-based systems. More than half of encounters involve coordination of care, reflecting the complexity of navigating services that are often fragmented and difficult for families to access.
Families may engage with the clinic once or over time, depending on need. Dr. Huth-Bocks indicates that this flexibility is essential, as some concerns can be addressed quickly while others require ongoing support and monitoring.
At the center of ECSC’s approach is dyadic care — an intervention model that focuses on both the child and the caregiver, as well as the relationship between them.
For infants and toddlers, Dr. Dayton explains, developmental and mental health concerns are inseparable from the caregiving relationship itself. Challenges such as feeding difficulties, sleep disruption or excessive crying can place significant strain on caregivers, particularly in the context of stress, limited resources or perinatal mental health conditions.
“These are the kinds of early problems that, when they begin to affect the relationship, can become much more serious if we don’t intervene,” Dr. Dayton says.
Despite strong evidence supporting dyadic intervention, both Dr. Dayton and Dr. Huth-Bocks emphasize that traditional medical and behavioral health systems are not structured to deliver or sustain this type of care. Current reimbursement models, for example, are typically designed around an individual patient with a diagnosable condition, rather than a caregiver-child pair receiving preventive, relationship-based services.
“We’re working with the parent and the baby together, but the system doesn’t account for that,” Dr. Dayton says.
According to Dr. Huth-Bocks, this disconnect is particularly pronounced for children birth-age 5. While integrated behavioral health models are becoming more common for older children and adults, similar approaches for infants and toddlers remain rare.
“What we’re doing for this age group is almost non-existent,” she says.
The ECSC model is fundamentally preventive, focusing on strengthening early relationships to mitigate the risk of more serious behavioral health challenges later in life.
Dr. Dayton indicates that early intervention can reduce the likelihood and impact of adverse childhood experiences (ACEs), while also supporting healthier developmental trajectories.
“This is prevention through and through,” she says.
The long-term implications are well established in research. Early relational health is associated with improved educational outcomes, better physical and mental health, and greater economic stability across the lifespan. According to Dr. Huth-Bocks, the return on investment is substantial.
“For every dollar you put into this kind of work, you get it back many times over,” she says.
ECSC also responds to a practical challenge within pediatric settings. Pediatric providers are often the first point of contact for families with young children, yet they may have limited capacity to address complex mental health concerns without additional support.
Dr. Huth-Bocks notes that this is not a limitation of individual providers, but rather a reflection of how systems are structured. “It’s not a failure of pediatricians—it’s a system issue,” she says.
By embedding mental health clinicians within the pediatric environment, ECSC creates a pathway for early assessment and intervention that would otherwise be difficult to access.
According to both Dr. Dayton and Dr. Huth-Bocks, pediatric providers have responded positively to the model, reporting that it enhances their ability to care for families and expands what can be addressed within a single visit. At the same time, demand continues to exceed capacity.
“The biggest complaint we hear is that there aren’t enough of us,” Dr. Huth-Bocks says.
Beyond direct service delivery, ECSC is contributing to broader efforts to align policy and financing with early childhood mental health practice. The team is engaged in national collaborations focused on expanding Medicaid reimbursement for dyadic care and addressing structural barriers that limit access to preventive services.
Dr. Dayton points to emerging policy changes in other states, including legislation that allows reimbursement for services without requiring a formal diagnosis in very young children, as an important step forward.
At the same time, the field of pediatrics is evolving, with increasing emphasis on early relational health as a core component of child well-being.
Despite demonstrated impact and growing demand, ECSC currently relies on grant funding, highlighting the broader challenge of sustaining and scaling innovative models within existing systems.
For Dr. Dayton, the long-term goal is clear: a system in which integrated, relationship-based care is standard practice in pediatric settings.
“There’s no reason every pediatric clinic shouldn’t have someone trained to do this work,” she says.
As policymakers and funders consider how to strengthen behavioral health systems, ECSC offers a clear example of both what is possible and what remains to be addressed.
Learn more about the Ethel and James Flinn Foundation.
Over the past five years, the Ethel and James Flinn Foundation has invested deeply in strengthening mental health services across Michigan — from early intervention and workforce development to cross-sector collaboration and policy influence. As the Foundation reached the conclusion of its 2021–2025 strategic plan, it partnered with Tyler Logan, Founder of Black In Public Health, LLC, to step back and answer a critical question: How is this work contributing to real systems change?
Logan served as Flinn’s learning and evaluation partner, synthesizing reports from 30 Flinn-funded organizations across the state. His work culminated in a December 2025 presentation to the Flinn Foundation Board of Trustees, where he introduced a refined Theory of Change — a framework that clearly shows how individual grants connect to broader, long-term impact.
“A theory of change helps make the through line visible,” Logan explains. “Flinn already had a strong mission, vision, values and strategic priorities in place. My role was to connect those dots and show how change is happening at multiple levels, not just within programs, but across systems.”
Rather than focusing solely on outputs or individual initiatives, the evaluation looked at outcomes across four interconnected levels: individual, organizational, political and ecosystem. What emerged was a clear picture of how Flinn-funded work is embedded within the systems people rely on every day, including health care, schools, justice settings and community-based services.
Across the portfolio, organizations are not only delivering services, but also building sustainable models of care. This includes integrating behavioral health into primary and perinatal care, strengthening workforce capacity through training and professional development, improving data-sharing and evaluation practices, and creating stronger partnerships across sectors.
“What stood out most was how deeply practical and systems-oriented the work is,” Logan says. “Grantees are embedding mental health into the places where people already are — clinics, schools, community spaces — and reaching populations that are often left out of traditional systems.”
A consistent theme throughout the evaluation was the importance of early intervention and prevention. Whether through school-based mental health programs, suicide prevention coalitions, perinatal mental health supports or youth justice diversion efforts, Flinn’s investments help connect people to care before challenges escalate into crisis.
From a public health perspective, Logan emphasizes that mental health needs develop over time. “When people can only access care once they reach an emergency, the costs are higher for individuals, families and systems,” he says. “Early connection to care supports healing, dignity and stability, and leads to more equitable outcomes.”
The evaluation also highlighted philanthropy’s unique role in advancing mental health equity.
While philanthropic funding cannot replace federal or state resources, it can move more nimbly, investing in trust-based partnerships, data infrastructure, workforce development and collaboration.
“Philanthropy isn’t just about funding services,” Logan notes. “It’s about investing in the conditions that make systems change possible — trust, partnerships, learning and sustainability.”
Over the past five years, the Flinn Foundation has increasingly focused on these conditions, contributing to stronger regional coalitions, shared data systems, and policy-aligned approaches that extend beyond individual grants.
As Flinn builds on the insights from this evaluation, the refined Theory of Change offers a clear foundation for the future. It reinforces the Flinn Foundation’s commitment to early intervention, prevention, culturally responsive care and systems-level impact while providing a shared framework for learning with grantees, partners and other funders.
“This work shows that change doesn’t happen in one place or at one level,” Logan says. “When investments align across individuals, organizations, policy and the broader ecosystem, that’s when you start to see real community transformation.”
Learn more about the Ethel and James Flinn Foundation. Visit flinnfoundation.org.