“Interview” features Q&As with both professionals and users of the mental health system on topics of special interest to parents and families. They are designed to provide a closer look at new research, trends, and people.
We often hear that there is a youth mental health crisis and about the roles U.S. schools are playing to ease students’ struggles so they can learn and thrive. (Or not: Our “Editor’s Corner” covered this issue here and here.) According to one nationwide 2022 study, the quantity and quality of such programs vary widely by state. Some experts, including the Center for Trauma-Informed Policy and Practice (CTIPP), argue that efforts need to be more consistent, better coordinated, and above all “trauma-informed.” That means acknowledging and addressing the impact of common Adverse Childhood Experiences on human development.
CTIPP’s mission is to help individuals, families, and communities adapt to adversity and stress in healthy and productive ways through coalition-building, advocacy, and policymaking. Its goal: “building a movement that integrates community-led, trauma-informed, resilience-focused, and healing-centered prevention and intervention approaches across all sectors and generations.” So, just as schools were reopening last August, CTIPP released its “Trauma-Informed Schools Report.” Authored by CTIPP’s https://www.ctipp.org/jesse-kohlerDirector of Government Affairs Jen Curt and young ACEs activist Peyton Barcel, the report summarizes the hows and whys of building trauma-informed educational policies and practices.
Here, CTIPP’s Executive Director, Jesse Kohler, M.Ed., answers our questions about the report’s findings, recommendations, and what they mean for families. Kohler, who has been with CTIPP since a year after its founding and has a background in nonprofit management, helms the organization’s administration and HR, fundraising, strategic planning, and public engagements and works alongside staff and volunteers.
Q: What led you to do this study; why, and why now?
A: Trauma, chronic stress, and overwhelming adversity negatively impact the health of individuals, families, communities, and systems across generations. In society, trauma doesn’t discriminate or exist in a vacuum—it manifests in our schools, homes, hospitals, workplaces, and beyond.
CTIPP compiled this report because children experiencing trauma need caring adult relationships and trauma-informed environments to help them regulate their nervous systems so they can function successfully at school.
The youth mental health statistics before 2020 were already alarming, and the crisis continues to be exacerbated by the global COVID-19 pandemic. Last year, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association declared the youth mental health crisis a National Emergency. In 2020, the number of young children (ages 5-11) who sought mental health care at emergency departments increased by 24% compared with 2019. For older children (ages 12-17), the increase was 31%. And last year, 37% of high school students reported poor mental health.
We keep pouring money into the problem and are still looking for our desired results. Trauma-informed policies and practices represent the shift this nation needs to build healing, resilience, and well-being in the face of ongoing stress and adversity. We must address disparities’ root causes and drivers to achieve the desired transformation.
Q: What type of research did you perform, and what was the age range and demographic breakdown?
A: Since 2015, CTIPP has served as a convener of leaders, organizations, and everyday people working to promote trauma-informed practice in schools and across society. The report is a tool to introduce people, policymakers, and those who interface with the education system to the topic of trauma-informed schools, and we gathered information from frontline leaders—school leaders that had facilitated a trauma-informed transformation in their schools/districts, as well as advocates and experts in this space. Our report focuses on children in K-12 schools, and many of the principles can be applied to early care, education, and higher education settings.
Q: Let’s talk about some of the main findings. You note that 60% of American kids have been impacted by Adverse Childhood Experiences (ACEs). That’s eye-opening. What are some of the main types of traumas seen in today’s youth?
A: Trauma is common and pervasive, and it impacts every person, family, community, and system differently at different times in different ways, so there’s no standard category type or response.
Common traumatic events for students today include experiencing community violence, losing a caregiver or loved one, living with an adult who is struggling with their mental health or substance use, surviving a natural disaster, or living in poverty or financial instability, to name a few.
Without a counterbalance from positive experiences and supportive relationships, the negative impacts of trauma can stretch across a lifetime and, indeed, into future generations.
Q: Another finding: Trauma disrupts children’s nervous system and makes it hard for them to learn (leading to failure in school and struggles in adult life). How so?
A: The human brain—particularly the young, developing mind—cannot easily perform complex and long-term thinking while experiencing stress and adversity. This happens because stress necessitates neural activity toward fight-flight-freeze-fawn-flop. This mechanism helps us survive in the short term and is not conducive to executive functioning.
A dysregulated nervous system can manifest in infinite ways based entirely on the individual, timing, and context. For example, if a child arrives at school hungry and upset from watching their parents fight the night before, they may have difficulty focusing on their assignment or sitting still at their desk. Often, this behavior is labeled as defiance when it is a child’s form of communicating needs for which they may not have language.
Unfortunately, students experiencing trauma and adversity are more likely to be labeled and punished. They are also more likely to encounter disciplinary measures, struggle to complete assignments, perform poorly on tests, and struggle with language skills. They can be wrongfully referred to special education programs. What they really require is more compassion and understanding to support their situation.
Q: According to CTIPP, trauma-informed schools led by caring adults who model and teach certain skills lead to better youth mental health and academic success. What does a trauma-informed school look like, versus a more traditional model?
A: Trauma-informed schools exist in all types of communities across the United States. They have been proven to reduce suspension, expulsion, and drop-out rates, improve graduation rates and test scores, increase teacher retention, and create positive school cultures.
They are less about a specific program or curriculum, and more about an ongoing process of education, understanding, and reform tailored to their community. Methods focus on honing compassion, resilience, and emotional regulation versus antiquated practices—like behavioral charts or retributive punishment—that can exacerbate trauma responses and worsen symptoms.
The process and support also extend beyond students to teachers, faculty, staff, administrators, parents, and the community. Stability serves as a guiding objective, so teacher retention and professional fulfillment are common priorities that produce successful results.
Common elements that are necessary for transformation include:
- Members of school leadership prioritize psychological safety for students and staff throughout the school environment. This commitment must be modeled from the top.
- School staff have a baseline level of training and take part in ongoing process conversations to understand how stress impacts the brain, the prevalence and impact of ACEs and trauma, regulation skills (to support themselves, students, and colleagues), the difference between therapy and therapeutic intervention, and reflection about what is working and what needs to improve.
- Relationship development and maintenance are valued within the school, with students’ caregivers and other community stakeholders working to create a whole community of support.
- School personnel view behavior as an adaptive way of communicating unmet needs rather than as an act of defiance.
- Appropriate measures are taken to repair harm when harm is done, but punishment without opportunity for restoration is avoided at all costs.
Q: What do you mean by the “psychological safety” that needs to be ensured throughout the school environment? How can it be modeled?
A: Psychological safety is when you believe that you won’t be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes. When students fear ridicule, they are less likely to ask questions or attempt to answer problems in the classroom. Additionally, students and staff who do not feel as though their perspectives are valued in the school environment are less likely to engage altogether.
Respecting diverse thoughts and engaging all people respectfully helps to ensure a greater likelihood of psychological safety for everyone throughout the school environment.
Q: Are the in-school mental health initiatives we’ve seen in the news lately (mindfulness lessons, stress-break rooms, ability to take a “mental health day”) the type of thing one would ideally see in trauma-informed schools?
A: Integrating mental health initiatives like yoga, breathwork, and meditation are powerful tools that can help build healthy self-awareness and emotional regulation. Teaching mindfulness can also help meet basic safety needs while building confidence from learning new skills.
There must also be a shift in the entire school environment and not just a couple of activities promoting regulation with the same stress outside of some programming. They are necessary but insufficient in creating trauma-informed school environments.
Q: What are the basics of the training school professionals and other adults across a community would ideally receive in a trauma-informed school system?
A: Essentials include ongoing training and conversations on how stress impacts the brain, the prevalence and impact of ACEs and trauma, regulation skills, and the difference between therapy and therapeutic intervention. In particular, understanding and addressing self- and co-regulation (for example, secondary and vicarious trauma, burnout, etc.) are foundational to supporting the process.
We have to start viewing behavior as an adaptive way of communicating unmet needs rather than an act of defiance. Appropriate measures should be taken to repair harm when harm is done, and punishment without opportunity for restoration should be avoided at all costs. The school’s process must also embed reflection about what is working and what needs to improve with a commitment to ongoing learning and reform.
Q: The report includes case studies from several American schools, including one in Hawaii that really turned itself around. What are a couple of examples of the school’s problems, specific changes they made, and positive outcomes?
A: The Nānākuli-Waiʻanae Complex Area in Hawaii began its trauma-informed transformation in 2014 to disrupt the school-to-prison pipeline, improve career prospects, and decrease suspensions.
They provided trauma-aware and trauma-skilled training to administrators, faculty, staff, and parents, emphasizing how intergenerational trauma and poverty could be reversed. Trauma-informed practices included restoration, de-escalation, self-care, youth mental health first aid, and exploring challenges around restraint and security. They also successfully shifted school policies and practices from discipline- to relationship-oriented and exclusionary to inclusionary.
Their results were nothing short of remarkable. Over just five years, the schools reduced reported behavioral incidences from 2,260 to one and the number of out-of-school suspensions from 2,277 to zero. Bullying reports fell from 60% to 36%. The graduation rate increased by 10%, early college enrollment skyrocketed, and the number of teacher vacancies was cut in half.
Q: What do you mean by discipline vs. relationship-oriented policies and “exclusionary to inclusionary” practices?
A: Many American systems operate on an Eject-Reject model for folks who fall outside the “norm” or do not operate ideally within the system. The education system is no different. When we recognize behavior as a method of communication, we are less likely to punish kids who act out and are more likely to build relationships to learn where the behavior originates from.
By regulating, relating, and reasoning (sequenced in that order), we can promote better behavior in the future without relying on punishing unwanted behaviors, which is the model and reason behind relationship-oriented and inclusionary practices.
Q: Another case study comes from Texas. What were some of that school’s challenges and what specific changes did they make?
A: For years, the John T. White Elementary School in Texas experienced constant fights, failed state exams, and a high-class removal and walk-out rate. Seventy-six percent of students reported trauma, and many could not focus on academics due to food insecurity and stress from home life.
In 2017, they mandated a trauma-informed district-wide initiative that prioritized relationship-building and emotional regulation. They transformed their students’ daily schedules to create a more welcoming atmosphere that helped set positive intentions for the day.
Students were greeted each morning by at least five adults. They started a morning circle to build connection and practice self-regulation. They also enjoyed free water and snacks. New spaces, like calm corners and wellness rooms, were created with daily physical activity breaks. They practiced re-dos and apologies, reinforced self-regulation, and suspensions became the last resort.
The results speak for themselves: during the 2017-2018 school year, suspensions decreased from an average of 445 a year to just 19, the school passed its state exams for the first time, teacher retention dramatically increased, and the school culture became calmer.
Q: What steps could a parent or group of parents take to ensure more trauma-informed practices at their children’s school(s)?
A: The first step always begins with awareness and understanding. Educate yourself on the potential of trauma-informed schools and then work with like-minded people to create the right strategies for your community.
Trauma-informed communities support trauma-informed school environments, so outreach must extend beyond supporting parents and caregivers to work across relevant community systems. Schools typically require leadership buy-in, so advocates should also reach out to principals and school board officials.
Beyond our report, folks can access more education-related ideas (here and here) with resources (here). For those new to advocacy, we have developed a free, nine-part advocacy series that provides the education, resources, and reflective exercises to become a changemaker in your community.
Q: Could the federal government play a role in promoting trauma-informed schools?
A: There is no doubt that the federal government has a role to play. The federal government provides billions of dollars annually in essential school funding nationwide, and they have grant programs to address school dropout, substance use, and mental health.
U.S. Department of Education Secretary Cardona has verbalized his support for trauma-informed schools, and CTIPP met with Department staff this fall to discuss our vision. The White House, Department of Education, and Congress can all collaborate with schools to guide and support trauma-informed strategies to help children and school staff.
We also wrote this report so these policymakers can understand exactly what we mean by “trauma-informed strategies.” It’s a comprehensive, whole-school approach involving policies and practices and school-wide changes. We gave specific examples of just two of the schools that have done this. These concrete examples and clear explanations resonate with those in the federal government with whom we have shared it.
Q: Anything important I haven’t asked about that you’d like to share?
A: One area of success with Congress: CTIPP organized more than 170 advocates across 36 states to successfully urge Congress to invest $1 billion in this year’s federal budget to increase trauma-informed resources and improve access to mental health professionals in America’s schools. This funding is included in the House and Senate versions of the FY23 appropriations bills, and we are hopeful it will pass in the final package. We also mobilized our national network to support Elementary and Secondary School Emergency Relief Fund (ESSER) funding in COVID-19 stimulus bills.
We believe transformation is possible, and it will take a groundswell of support to generate and maintain the momentum. CTIPP plays an important role in coordinating and advancing the trauma-informed movement, and we rely on community activism across the country to achieve our collective goals. We invite like-minded individuals and organizations to join the trauma-informed movement through our CTIPP Community Advocacy Network (CTIPP CAN) to advocate for policy change and promote trauma-informed practices. Local, state and regional trauma-informed coalitions are encouraged to join our national alliance, PressOn. We also have a resource library focused on research, policymaking, advocacy, and multimedia resources to support your trauma-informed work and journey. We also welcome feedback, ideas, tax-deductible donations, and shared wisdom.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.