Community leaders work to address childhood trauma, psychological distress

Lee Acers had simple instructions for the class of second-graders sitting cross-legged on a rainbow-colored rug at her feet.

Acers, a school counselor at Wilson Elementary School, struck a chime with a small mallet and told the students to raise their arms when they no longer heard the instrument. Seconds later, nearly two dozen hands shot in the air as the ringing sound faded.

The listening exercise was part of a program called Second Step that Oklahoma City Public Schools is implementing as part of a comprehensive mental health plan.

As the impact of adverse childhood experiences and of trauma gains more attention, agencies and stakeholders in communities across the state are looking at ways to mitigate negative effects and promote resilience and protective factors. In this case, something as simple as a listening exercise teaches skills that can help improve learning and focus.

"It's a whole child approach," Acers said. "You can't just focus on teaching them to read and write and do math. We also need to prepare them and support them emotionally, socially, so they can really be successful."

Adverse childhood experiences is a term used to describe all types of abuse, neglect and other potentially traumatic experiences that occur before age 18. Such experiences include a family member who is incarcerated, a family member who suffers from mental illness or parents who are divorced.

Adverse childhood experiences have been linked to risky health behaviors, chronic health conditions, low life potential and early death, according to the Centers for Disease Control and Prevention. The more adverse childhood experiences a person has had, the higher his or her risk for those negative outcomes, according to the CDC.

It's an issue that community leaders are working together to address.

"Trauma affects us all in some way or other," said Linda Manaugh, director of communications and program support for the Potts Family Foundation. "If I can't point to an experience that I personally have had, I can point to somebody close to me. … It's all around us, and it's incumbent on all of us to be informed."

On Sept. 30, the Potts Family Foundation and other community partners are holding a screening of the documentary "Resilience: The Biology of Stress and the Science of Hope." The Oklahoman is a presenting sponsor of the event, which is scheduled from 10:45 a.m. to 1 p.m. at the Tower Theatre. First Lady Sarah Stitt will moderate a panel discussion afterward.

During the past couple of years, the Potts Family Foundation has shown the film to about 8,800 people across the state. Other organizations have purchased the film to show to groups in their communities.

"We just really hope that people seeing this film is a call to action," Manaugh said.

Teri Bell, executive director of student support services for Oklahoma City Public Schools, said the Potts Family Foundation has helped to start a movement across the state. Bell has shown the film to principals, student support staff and others within the school district.

Oklahoma City Public Schools and community partners are working to address mental health needs of students through an initiative called Embrace OKC. It's a project of the OKC Schools Compact, which is comprised of community partners working together to support improvements identified by the school district. The partners are: The Greater Oklahoma City Chamber of Commerce, the Oklahoma City Public Schools Foundation, the United Way of Central Oklahoma and the city of Oklahoma City.

As part of the initiative, the school district worked with the Oklahoma Department of Mental Health and Substance Abuse Services to survey more than 7,000 students in sixth, eighth, 10th and 12th grades.

The survey, called the Oklahoma Prevention Needs Assessment, showed 48% of students were in moderate-to-severe psychological distress. When Bell gives presentations about the initiative, she tells people to picture a class with 20 students, 10 of whom are in some type of distress where they can't focus.

"Our data's pretty overwhelming when you look at it," Bell said. "I think we realized we had kids who were facing a lot of trauma and a lot of distress but (not) until we actually did the assessment did we realize the magnitude of it."

According to the survey, one in five students felt so hopeless most or all of the time during the past 30 days. One in five felt worthless most or all of the time during the past 30 days. One in five felt so depressed nothing could cheer them up.

Of the 7,074 students who were surveyed, close to 1,000 students, about one in seven, said that either they had attempted suicide at least once during the past 12 months or they had a plan or they had thought seriously about committing suicide.

"That's powerful data," Bell said. "And it says that this state has a lot to do to take care of our kids. Our state, our city, our district. We have kids who are hurting."

Using data from the survey, officials identified three target areas to focus efforts on: psychological distress, high-risk behaviors and substance use and abuse. They created a comprehensive mental health plan with about 65 actions ranging from prevention to treatment, designed to address some of the challenges students and families are facing.

It will cost about $6.5 million to fully implement the plan during the first year, Bell said. The school district has already contributed about $1 million for additional staff, and the Department of Mental Health and Substance Abuse Services has put in about $500,000, Bell said. Those involved with the compact are working to raise the remaining $5 million.

The largest portion of that cost is associated with treatment, Bell said. Eventually, the district hopes to have a direct behavioral health aide in every school who will work directly with an agency to help connect students with treatment.

Officials anticipate the cost of implementing the plan will decline over time as they begin treating students and seeing improvements, Bell said. The district has committed to absorbing the cost by year four of the plan, she said.

All of the programs, strategies and interventions they plan to implement are research-based, Bell said.

The district has already started adopting pieces of the plan and taking steps to address mental health needs, such as adding a director of mental health, reorganizing social workers and hiring more counselors. All elementary schools now have at least a full-time counselor, and the ratio is now about 500 students for every one counselor. Last year, the ratio was about 750:1.

On Tuesday morning, Acers, the counselor at Wilson Elementary, led the second grade class she was working with through a series of listening exercises during a lesson about focusing attention and listening. The Second Step program is designed to teach skills for learning, emotion management, empathy and problem solving. Acers said having a full-time counselor in every elementary school allows them to invest more time in building relationships, not only with students, but also with faculty, administrators and parents. It takes everyone involved in the school to make a difference, she said.

The American School Counselor Association recommends a 250-to-1 student to school counselor ratio.

"We have done so much better," Acers said. "We used to travel to three schools, have 1,200, 1,300 students, but now we have 500 students in our caseload. And that helps us to be able to focus on doing a program like (Second Step) weekly and be able to see the students in a small group, but it's still a challenge."

Bell said the district could not implement the plan without support from community partners who have made addressing mental health a priority. For many years, mental health was not really recognized in school districts, Bell said, but now districts across the country are realizing that mental health is as important as academics.

"If we do this right, we can change not just our kids, but this community," Bell said. "Mental health is an issue in this community and to say it’s a priority in the district, that means 10 years down the road, 20 years down the road, we have a healthier community. It’s almost overwhelming to think the long-term impact this could make."

See the documentary:

What: Screening of the documentary “Resilience: The Biology of Stress and the Science of Hope” and panel discussion moderated by First Lady Sarah Stitt

When: 10:45 a.m. to 1 p.m. Sept. 30 Where: Tower Theatre in Oklahoma City

The event is free but registration is required. For more information, visit https://tinyurl.com/y4jykete