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Executive Summary 14 North Carolina Institute of Medicine have the potential to generate savings and benefits to society that more than repay their costs.1,9 Such investments include programs, policies, and services to strengthen the relationships young children have with their caregivers, improve the environments of young children, teach young children social and emotional skills, ensure the workforce is adequately trained, and provide treatment for young children and their families. This knowledge should inform and undergird all decision-making with regard to spending and programs intended to affect children and their families. North Carolina has an abundance of governmental, non-governmental, non-profit, and educational resources which address various aspects of early childhood social-emotional development and mental health needs. This report identifies short- and long-term strategies for addressing these problems through systemic changes, and greater interaction and cooperation among the systems, agencies, and individuals who interact with children who are younger than 5 years of age and their families. The North Carolina General Assembly (NCGA) recognized the need to examine the social-emotional and mental health needs of North Carolina’s youngest children. In 2010, the NCGA asked the North Carolina Institute of Medicine (NCIOM) to convene a task force to study the adequacy of the current systems serving the mental health, social, and emotional needs of young children and their families.a The charge included a systematic evaluation of the needs, gaps, strengths, and resources of the public and private systems providing prevention, promotion, and treatment for young children’s mental health and social- emotional well-being. Funding support for the Task Force was provided by the North Carolina Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services through the North Carolina Substance Abuse Prevention and Treatment Block Grant from the Substance Abuse and Mental Health Services Administration. The Task Force was co-chaired by Marian Earls, MD, FAAP, Medical Director, Guilford Child Health, Inc.; Beth Melcher, PhD, Assistant Secretary for Mental Health, Developmental Disabilities, and Substance Abuse Services Development, North Carolina Department of Health and Human Services; and John Thorp, MD, Division Director and Distinguished Professor, Department of Obstetrics and Gynecology, University of North Carolina Health Care. They were joined by 40 other Task Force and Steering Committee members including legislators, state and local agency representatives, service providers, and community representatives. The Task Force met 15 times between March 2011 and June 2012. The Task Force made 12 recommendations, 3 of which were identified as priority recommendations. a Section 16.1of Session Law 2010-152 Wise investments in children and families can lead to future savings, better health, and increased productivity.