The Diversity-Informed Infant Mental Health Tenets in California

Maria Seymour St. John and Ayannakai Nalo

The 163,696 square mile region that presently comprises the State of California has historically been the homeland of many native peoples and tribes including the Modoc, Shasta and Wintu; the Pomo, Ohlone, Miwak and Yokuts; and the Serrano, Cahuilla, and Quechen, among hundreds of others. It was part of Mexico before it was one of the United States. And the lifeblood of many immigrant communities, often themselves grossly disenfranchised, contributed to the infrastructure and cultural and economic wealth of the State. California’s borders have been contested, it’s natural resources multiply claimed, and it’s political and cultural status variously defined.

California’s infants are reared in families speaking more than 200 languages. Their parents represent all present-day census race categories and hundreds of ethnic groups and national origins. California’s percentage of multiracial people is one of the highest in the country. In order to ethically and effectively support this vibrant and diverse multicultural state, California’s infant/family workforce must be equipped with tools that help us to collectively:

  • Honor and celebrate human diversity;
  • See the historical and socio-political contexts that shape families’ experiences;
  • Appreciate the complexity of cultural identities;
  • Collaborate and practice cross-culturally;
  • Value and cultivate expertise in a wide range of traditions, discourses, and practices;
  • Continually expand our linguistic competence across disciplines;
  • Close gaps between practice-based learning with families, policy-production impacting families, research about families, and systems of care serving families.

We must also be prepared to collaboratively:

  • Eliminate barriers to infant/family health and well-being for all cultural groups;
  • Register and respond to the intergenerational sequelae of historical and present-day trauma;
  • Ensure universal access to services;
  • Create institutional climates that are welcoming across cultures.

The California Center for Infant/Family and Early Childhood Mental Health’s Compendium of Training Guidelines, Personnel Competencies, and Professional Endorsement Criteria for Infant-Family and Early Childhood Mental Health does not include a separate knowledge domain pertaining to “cultural competence.” Instead, every knowledge domain includes items related to culture, suggesting that consideration of cultural issues is an inextricable element of all knowledge domains within the field. But how are professional capacities related to culture best developed?

Many powerful frameworks, approaches, and curricula have been developed to help people become more attuned to and skilled at addressing issues of culture. Diverse terms include “cultural competence,” “cultural humility,” “social justice,” “anti-racism” “equity and inclusion,” “race, power and privilege,” “cultural attunement” and others. Some of these approaches originated in grassroots political organizing efforts, some hail from organizational psychology, others were created to address systemic race-based disparities in health, school achievement, or socioeconomic status.

The Irving Harris Foundation’s Diversity-Informed Infant Mental Health Tenets (Tenets) is a framework developed specifically for the infant/family workforce created collaboratively by a group of infant mental health workers through a project of the foundation. The original Tenets article notes that in order “to create a just and equitable society for the infants and toddlers with whom its members work, the infant mental health field must intentionally address some of the racial, ethnic, socioeconomic, and other inequities embedded in society” (St. John, Thomas, & Noroña, 2012). The Tenets are a set of “guiding principles outlining standards in the field and pointing the way to a just society via engaged professional practice (St. John, Thomas, & Harris, 2012, p. 13).” The Tenets are reproduced here with permission from the Irving Harris Foundation and may be accessed at the website:

The authors believe that the Tenets are a “good fit” for the California infant/family workforce and a critical resource for those on the pathway to endorsement.


©2012, Irving Harris Foundation. Reprinted with permission.

1. Self-Awareness Leads to Better Services for Families:
Professionals in the field of infant mental health must reflect on their own culture, personal values, and beliefs, and on the impact racism, classism, sexism, able-ism, homophobia, xenophobia, and other systems of oppression have had on their lives in order to provide diversity- informed, culturally attuned services on behalf of infants, toddlers, and their families.

2. Champion Children’s Rights Globally:
Infants are citizens of the world. It is the responsibility of the global community to support parents, families, and local communities in welcoming, protecting, and nurturing them.

3. Work to Acknowledge Privilege and Combat Discrimination:
Discriminatory policies and practices that harm adults harm the infants in their care. Privilege constitutes injustice. Diversity-informed infant mental health professionals work to acknowledge privilege and to combat racism, classism, sexism, able-ism, homophobia, xenophobia, and other systems of oppression within themselves, their practices, and their fields.

4. Recognize and Respect Nondominant Bodies of Knowledge:
Diversity-informed infant mental health practice recognizes nondominant ways of knowing, bodies of knowledge, sources of strength, and routes to healing within diverse families and communities.

5. Honor Diverse Family Structures:
Families define whom they are comprised of and how they are structured; no particular family constellation or organization is inherently optimal compared to any other. Diversity-informed infant mental health practice recognizes and strives to counter the historical bias toward idealizing (and conversely blaming) biological mothers as primary caregivers while overlooking the critical child-rearing contributions of other parents and caregivers including fathers, second mothers, foster parents, kin and felt family, early care and educational providers, and others.

6. Understand That Language Can Be Used to Hurt or Heal:
Diversity-informed infant mental health practice recognizes the power of language to divide or connect, denigrate or celebrate, hurt or heal. Practitioners strive to use language (including “body language,” imagery, and other modes of nonverbal communication) in ways that most inclusively support infants and toddlers and their families, caregivers, and communities.

7. Support Families in Their Preferred Language:
Families are best supported in facilitating infants’ development and mental health when services are available in their native languages.

8. Allocate Resources to Systems Change:
Diversity and inclusion must be proactively considered in undertaking any piece of infant mental health work. Such consideration requires the allocation of resources such as time and money for this purpose and is best ensured when opportunities for reflection with colleagues and mentors as well as ongoing training and consultation are embedded in agencies, institutions, and systems of care.

9. Make Space and Open Pathways for Diverse Professionals:
Infant mental health workforces will be most dynamic and effective when culturally diverse individuals have access to a wide range of roles, disciplines, and modes of practice and influence.

10. Advance Policy That Supports All Families:
Diversity-informed infant mental health practitioners, regardless of professional affiliation, seek to understand the impact of social policies and programs on diverse infants and toddlers and to advance a just policy agenda for and with families



Irving Harris Foundation. (2012). Diversity-informed infant mental health tenets. Retrieved from

St. John, Thomas & Noroña. (2012). Infant mental health professional development: Together in the struggle for social justice. Zero to Three, November.

Author Biographies:

Maria Seymour St. John, PhD, MFT, is associate clinical professor in the Department of Psychiatry, University of California, San Francisco, and director of training at the Infant-Parent Program, Zuckerberg San Francisco General Hospital. Endorsed as a Reflective Practice Mentor by the California Center for Infant-Family and Early Childhood Mental Health, Dr. St. John writes, teaches, practices, and consults in the areas of infant-parent psychotherapy, reflective supervision, and the application of postcolonial, feminist, queer, and psychoanalytic theories in infant mental health. She has developed the Parent-Child Relationship Competencies (St. John, 2010), a framework for relationship-focused clinical assessment and treatment planning. Dr. St. John has been active in the collaborative process that gave rise to the Irving Harris Foundation’s Diversity-Informed Infant Mental Health Tenets and works with groups and individuals to facilitate integration and implementation of the Tenets across diverse spheres of practice.

Ayannakai Nalo, LCSW, is the manager of Early Intervention Services at University of California San Francisco Benioff Children’s Hospital Oakland and a faculty member of the Irving B. Harris Early Childhood Mental Health Training Program. The California Center for Infant-Family and Early Childhood Mental Health has endorsed Ms. Nalo as a Reflective Practice Mentor. Ms Nalo feels committed to integrating diversity-informed principles from the Irving Harris Foundation’s Diversity-Informed Infant Mental Health Tenets and other sources into reflective supervision and infant mental health services. As a member of the Harris Foundation Professional Development Network, Ms. Nalo also trains organizations and mentors individuals in the implementation of the Tenets across infant and early-childhood mental health providers and public health fields.