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Children and youth who experience trauma display increases in stress hormones comparable to those displayed in combat veterans. Click here to learn more about the behavioral health impact of traumatic events on children and youth.

Awareness Day Collaborating Organizations
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Awareness Day 2011 Final Report
The reach of SAMHSA’s Awareness Day messages continues to expand, and 2011 was our biggest year yet! Email AwarenessDay2012@vancomm.com to request a copy of the Awareness Day 2011 Final Report and see the results of your contributions!

New research has shown that children’s risk for learning and behavior problems and obesity rises in correlation to their level of trauma exposure, says the psychiatrist at the Stanford University School of Medicine and Lucile Packard Children’s Hospital who oversaw the study. The findings could encourage physicians to consider diagnosing post-traumatic stress disorder rather than attention deficit/hyperactivity disorder, which has similar symptoms to PTSD but very different treatment.

The study examined children living in a violent, low-income neighborhood and documented an unexpectedly strong link between abuse, trauma and neglect and the children’s mental and physical health: It reported, for instance, that children experiencing four types of trauma were 30 times more likely to have behavior and learning problems than those not exposed to trauma.

“In communities where there is violence, where children are exposed to events such as shootings in their neighborhoods, kids experience a constant environmental threat,” said senior author Victor Carrion, MD, associate professor of psychiatry and behavioral sciences at Stanford. “Contrary to some people’s belief, these children don’t get used to trauma. These events remain stressful and impact children’s physiology.”

The new study is being published online today in Child Abuse & Neglect; The International Journal. Carrion collaborated on the research with scientists at the University of New Orleans and the Bayview Child Health Center, part of San Francisco’s California Pacific Medical Center.

The findings provide compelling evidence that pediatricians should routinely screen children for trauma exposures, said Carrion, who is also a child psychiatrist at Packard Children’s.

“As simple as it may seem, physicians do not ask about trauma,” he said. “And kids get the wrong diagnoses.”

The study builds on earlier work that linked worsening health in adults with their dose of exposure to nine types of adverse childhood events, including being subject to various kinds of abuse or neglect; having a household member who abused alcohol or drugs, was incarcerated or was mentally ill; having a mother who was treated violently; and not living in a two-parent household. Middle-class men exposed to more of these events had more chronic diseases in adulthood, the prior research found. The results of the current study highlight the need for early identification of such adversity-associated health problems, and early intervention. Obesity, for example, may act as a mediator to other health problems such as diabetes, cardiac risk and inflammatory illness.

To perform the study, the researchers evaluated medical records from 701 children treated at a primary-care clinic in Bayview-Hunter’s Point, a San Francisco neighborhood with high rates of poverty and violence. About half the children were African-American; the rest came from other ethnic backgrounds. Each child’s exposure to adverse events was scored on a scale from 0 to 9, with one point given for each type of adversity. The researchers also evaluated the medical records for evidence of obesity and learning or behavior problems.

Two-thirds of the children in the study had experienced at least one category of adversity, and 12 percent experienced four or more categories. An adversity score of 4 or higher left kids 30 times as likely to show learning and behavior problems and twice as likely to be obese as those with a score of 0. Children with an adversity score of 1 were 10 times as likely to have learning and behavior problems as those not exposed to trauma.

Prior research has shown that about 30 percent of children in violent communities have symptoms of post-traumatic stress disorder, which can include the learning and behavior problems detected in the current study, Carrion noted. However, a physician unaware of the fact that a child experienced trauma, and noting the child’s physiological hyperarousability and cognitive difficulties, may diagnose ADHD instead of PTSD. That’s a problem because the two disorders have opposite treatments, he said. Kids with PTSD need psychotherapy, not the stimulant medications given for ADHD.

“Children can recover from PTSD with the appropriate treatment, which is one of approach and not avoidance,” Carrion said. “By not asking about trauma, we’re utilizing avoidance. We’re perpetuating PTSD.”

As part of their efforts to address the long-term health problems that stem from childhood trauma, Carrion, his collaborators and several San Francisco community partners are working to launch the Center for Youth Wellness, a one-stop health and wellness center for urban children and families in San Francisco. The Center for Youth Wellness will combine pediatrics with mental health services, educational support, family support, research and best practices in child-abuse response under one roof. With both public and private support, the center will coordinate the services of multiple agencies to give children a safe and accessible place to increase their resilience to adverse life experiences and improve their well-being.

The center, which aims to begin operation by mid-2012, is a partnership between California Pacific Medical Center’s Bayview Child Health Center, San Francisco Child Abuse Prevention Center, San Francisco District Attorney’s Office, Stanford’s Early Life Stress Research Program at Lucile Packard Children’s Hospital and Tipping Point Community. Nadine Burke, MD, director of the Bayview center, is also a co-author of the study.

“We need to create trauma-informed systems,” Carrion concluded, adding that the Center for Youth Wellness hopes to function as a model for such systems across the nation. People working for the welfare of children need to be on the lookout for trauma and know how to intervene, and how to work with the family and with schools, he said. “If trauma goes untreated, it’s very costly for the individuals involved and for society in general.”

The research was funded by the Lennar Urban Corp. and awards to Carrion from the National Institute of Mental Health and the Evans Foundation. For more information, visit www.lpch.org

 Click here for WCHS6-TV report

Stories of Resiliency: Youth & Family Share Powerful Messages of What Works Best

     AUGUSTA — Children’s Mental Health Awareness Week got off to a great trauma-informed start in Maine!

     On May 3, at the Hall of Flags, Augusta, more than 30 service providers heard seven youth and family members share inspiring stories of resiliency and the stabilization of emotional wellness in the face of challenges ranging from abuse and teen pregnancy, juvenile incarceration and autism, to a learning disability and depression.  Adults spoke of the difference a family organization can make and family-strengthening intergenerational resiliency.

     Resiliency from within nurtured by family and other natural supports, as well as youth-guided, family-driven and culturally competent treatment goes a long way towards countering research that children, even as young as 18 months old, who are  exposed to traumatic events, can develop serious problems as they mature, including substance abuse, depression, anxiety and stress management issues. Click here for childhood trauma resources.

     May has been  Mental Health Awareness month since Congress established it in the late 1960s. Seven years ago, the National Federation of Families for Children’s Mental Health declared the first week of May Children’s Mental Health Awareness Week.  Last year, nearly 11,000 children participated in awareness events nationwide and the number of national organizations collaborating on this public awareness effort has risen from four in 2005 to 88 in 2011.

     Weeklong awareness events are now part of Substance Abuse and Mental Health Services Administration (SAMHSA) overall strategy to raise awareness that positive mental health is essential to a child’s healthy development from birth. Click here for SAMHSA’s 2011 Short Report on data demonstrating the effectiveness of Systems of Care and National Child Traumatic Stress Network grantees in treating children with trauma. To learn more, visit www.samhsa.gov/children.

       LEWISTON –  To celebrate Children’s Mental Health Awareness Week, THRIVE System of Care Initiative today released its first-round evaluation results for trauma-informed services in Maine.

        In partnership with Maine’s Children’s Behavioral Health Services and Hornby-Zeller Associates, THRIVE developed, administered and validated a Trauma-Informed Agency Assessment (TIAA) of how well mental health agencies are meeting principles of: physical and emotional safety; youth and family empowerment, choice and control, trauma competence, trustworthiness and cultural competence.

         “The results show the positive effects of trauma-informed services on children and why they are needed by their  caretakers, as well as by youth who may be on their own,” says THRIVE director, Arabella Perez.

         Future objectives include Continuous Quality Improvement plans for agencies that have completed TIAAs, and continued development and/or support of youth and family organizations’ peer partner programs. THRIVE plans to expand its trauma-informed training and technical assistance to 150 child-serving mental health agencies and the juvenile justice system in Maine. 

            In 2009, researchers found that nationally more than 60 percent of youth age 17 and younger have been exposed to crime, violence, and abuse either directly or indirectly including witnessing a violent act, assault with a weapon, sexual victimization, child maltreatment, and dating violence. Nearly 10 percent were injured during the exposure to violence, 10 percent were exposed to maltreatment by caretaker, and 6 percent were a victim of sexual assault.¹

             The above are common examples of a traumatic experience, but by no means the full list. The death of a loved one, a natural disaster, living with terminal illness or alcoholism are other examples of situations that can cause children and youth to manifest symptoms of anxiety, depression, anger, post traumatic stress, dissociation and sexual concerns. These and other behaviors related to traumatic stress can manifest in school, community agencies, foster homes, homeless shelters, youth correctional facilities — anywhere and everywhere youth and families are found.

          Five years ago, because of its high rate of reported domestic violence coupled with low income levels, the tri-county area received a federal System of Care grant to provide trauma-informed training and technical assistance aimed at improving services for affected families and their communities.

            THRIVE’s first round of evaluation data shows that many youth reported trauma experiences, such as physical abuse and violence in the home, each affecting nearly 40 percent of them. Those who had experienced trauma, either acute or prolonged, displayed significantly more symptoms of depression, anxiety, anger and post-traumatic stress at the beginning of services. After six months of treatment, symptoms of anger, depression and anxiety were reduced.

            Of note was that the majority of children who had trauma experiences had a family member with a mental illness. Moreover, over 40 percent of caregivers reported that they themselves experienced some form of trauma as a child, including sexual abuse, emotional abuse and being separated from their own families. This brings the aspect of intergenerational trauma to the fore. Almost twice as many caregivers who had numerous trauma experiences as children, also had chronic physical health problems, which can certainly impact the public cost of healthcare. 

¹ http://www.samhsa.gov/children/social_media_lateapr2011.asp

THRIVE (www.thriveinitiative.org) helps child-serving providers and community organizations transform the way services are delivered to children, families of children, and to youth who are affected by serious emotional and behavioral challenges. THRIVE trauma-informed trainings and technical assistance are  family-driven, youth-guided and culturally and linguistically competent. THRIVE is funded by Maine’s Children’s Behavioral Health Services and the Substance Abuse and Mental Health Services Administration.

            Click here for Sun Journal story and photo caption

     AUGUSTA — Maine’s premiere youth aadvocacy group, Youth Motivating Others through Voices of Experience (“Youth MOVE Maine”) launched its 2010 public awareness campaign at the Children’s Mental Health Awareness Day celebration, May 6, State House, Hall of Flags, Augusta.

Youth MOVE joined a line-up of youth and family speakers that also included James VanOver, a Morse High School senior, who credited his biological mother’s hard choice, adoptive family’s love, group home’s perseverance and teachers’ supports with getting him to graduation day and a focused future.  Twelve-year-old Kala Grant, a Girl Scout with her troop mate at her side, spoke of her efforts to educate and build awareness in Scouts and middle school about being the sibling of “My Very Special Brother” who is autistic.

Youth MOVE speakers were: operations lead Ryun Anderson, who explained the history of this youth movement in Maine; Jenn McLaughlin who introduced the public service message “You Decide!“; and, Jenn, Allie Spear, Rodney Keisman and Brendon Venable  who performed “Shift your mind, drive your dreams,” a poem by Stephanie Knaus-Tucker, Brendon and Jenn.

NASCAR Pro Series rookie driver Travis Dunbar described how his life from chaotic home life to teenage track star to a two-time All-American with hopes of an Olympic run overcame the results of an auto accident that ended his running career to become a race car owner/driver and mentor of the Youth MOVE Maine Racing Team.

“Travis is the perfect spokesman for our 2010 awareness campaign,” says Brianne Masselli, Youth MOVE Maine’s co-founder. “His life is literally all about shifting gears. He is a role model for what youth stand for— resiliency, self-determination and hope— key factors in mental health and wellness.”

“I’m so pleased to represent these young people,” says Dunbar. “Their commitment to unite their voices and inspire others mirrors my own desire to mentor and motivate young people who persevere through adversity and keep driving their dream.”

Through youth-adult partnerships Youth MOVE trains providers, collaborates with family members, advocates in the community and works with policy makers and program administrators to enhance governance and evaluation.

“We are always getting new members that come from backgrounds where they don’t have access to resources,” says member Matt Brooks, “and Youth MOVE is a perfect place for them to find the help that they need.”

“Through Youth MOVE I am helping to improve the mental health system where youth are concerned,” says Kyle Prior, “I am able to help make the mental health system more accessible to youth.”

“What means the most to me is knowing that I’m helping people,” says Brooks.

“And sometimes, it’s just about getting together and having fun!” Masselli says.

There is lots of fun in store these parallel rookie seasons starting with the Youth MOVE Racing Team’s 2010 Season Opener scheduled for May 29, 6:30 pm at Beech Ridge Motor Speedway in Scarborough.

Youth MOVE Maine (www.youthmovemaine.org), the state chapter of Youth Move National, works to ensure that youth in Maine’s youth-serving systems are prepared for life. Youth MOVE Maine is dedicated to the redevelopment of systems and services, and advocates for youth to use their power and expertise to make change within their communities and within their own lives.

From left: Arabella Perez, Lisa Preney, Chris Copeland, Rep. Brian Bolduc, Dustin Strout, Ani Sebastian, Matt Brooks, Cheyenna Spelman, Hillary Groves, Allie Spear, Rep. Peggy Rotundo, Kyle Prior, Ryun Anderson, Ryan Conrad, Brianne Masselli, Enrico Herring

LEWISTON- Young people who say they now have hope for the future because of life-saving mental health and social services shared their stories with local legislators January 25 at a “Legislative Dialogue Café” hosted by Tri-County Mental Health Services at the Carriage House. 

Five members of Youth M.O.V.E. Maine told Rep. Peggy Rotundo (D-Lewiston) and Rep. Brian Bolduc (D-Auburn) individual stories of how combinations of mental health services, area homeless shelters, subsidized housing, drug court, case management, community-based services, a system of care youth committee, and natural peer supports have helped them and/or their immediate family members manage depression, self-abuse, and the effects of trauma, neglect, and violence. 

• “If services get cut, then I won’t be able to continue working towards my goal to get off disability and go to college to be a nurse or CSI. I want to provide my son the best life. I won’t be able to do these things and stop the abuse in my family if cuts are made.”

• “It costs taxpayers more to keep a person in jail than it does to provide them community-based services. Before I went to drug court, I didn’t know help was out there, and I did not know how to ask for it. In drug court, I learned about services that have helped me stay safe and drug-free so that I can finish high school.”

• “Without all the resources that the foster care and mental health systems have provided me, I wouldn’t be sober now and in college. Because of services, I am studying to become a social worker to help kids like I was– in group homes, foster homes, and homeless.”

The Legislators congratulated the youth on their compelling stories, their strength and their resilience. They explained the struggle Maine is in to close its budget gap, and why the largest cuts are aimed at education and health and human services. 

“I encourage you all to continue telling your stories,” said Rep. Rotundo, who acknowledged the young people’s emphasis that cuts in services will have a negative ripple effect on them, their famlies and their peer supports.

Rep. Bolduc agreed with the youth that short-term gains have long-term consequences, and that services are cost-effective in supporting recovery and independence.

For more information on youth-guided opportunties, go to:  http://thriveinitiative.org/youth-guided/ For more information on youth voice, youth advocacy and Youth M.O.V.E. - Maine, go to:  http://www.youthmovemaine.org/ or call Brianne Masselli at 207-782-5783 x1602.

May 7: “Digital Stories: Where there is help, there is hope” and Community Dialog

Premiere of an 11-minute video filmed at original locations of two separate autobiographical stories of youth resiliency in the face of foster care/homelessness and suicide/substance abuse. In addition to the moving stories, the video displays relevant statistics as well as crisis hotlines and shelter numbers. It stars, as well as is written, directed and produced by Thrive Youth. Following the showing, a youth panel hosted a community dialog.

Outcomes: In addition to media publicity, 25-30 community members attended, including a middle school principal, school staff, youth and adults. Discussion is ongoing about offering Digital Stories to area middle and high schools and/or using at conferences.

May 8-31: “Digital Stories: Where there is help, there is hope”

Digital Stories aired full-length prior to “Wolverine” at Flagship Cinema, Auburn, Maine, each Fri-Sat-Sun during the month of May.

Outcomes: Two full-size movie posters with movie stills, shelter and crisis phone numbers were posted in and outside the cinema for the month of May. Older youth and general movie audiences saw youth-narrated and produced stories of hope and recovery from homelessness and suicide. Posters will be reused at other venues.

May 8: Hall of Flags “Know Us, Know Our Stories”

Hosted by Maine’s Children Behavioral Health Services with organizational planning by G.E.A.R. Parent Network and THRIVE, which managed agenda, exhibitor coordination and provided five speakers, including two youth and a parent. Thrive youth told stories of hope and recovery from homelessness and suicide/substance abuse. Thrive family member and a Thrive family partner explained the elements and benefits of the family partner program. Thrive staff summarized Family and Youth programs.

Outcomes: Event coverage by local ABC afilliate WMTW-TV 8; more than 60 attended, including exhibitors, youth, visitors and legislators. The 32 exhibiting organizations were nearly double the number from the prior year.

May 11, 18 and 26: THRIVE Family Committee Open Houses

Outcomes: These *first-time* events hosted by Thrive Parent Partners in three separate counties received both print and repeat radio publicity. Participation was: 15 providers and families in Lewiston, ME; 20 in Farmington, ME; and 13 in Norway, ME. Area families learned more about community resources, including family organizations, and providers. THRIVE networked with all participants increasing awareness of its supports.

Tri-County Mental Health Services, the area’s largest and most comprehensive provider of mental health services for children, will observe the event by reaching out to children and families through public libraries. Focusing on its groundbreaking work to develop a “Trauma-Informed System of Care” for children with severe emotional disturbances, the agency will offer informational toolkits for public libraries to share with their communities. The toolkits will contain a resource list of books for children from grade school to high school that address the issues of mental health, free bookmarks for children, youth, and families, and other resource information.

Tri-County Mental Health Services is Maine’s most comprehensive agency dealing with the psychological and social well-being of children, adults, and elders. TCMHS serves over 6,000 individuals each year with innovative programs and services addressing mental health, substance abuse, mental retardation/developmental disabilities, autism, and more. Its philosophy of building toward recovery and sensitivity to traumatic experiences of consumers gives hope to individuals, families, and communities in Androscoggin, Northern Cumberland, Franklin and Oxford counties. For information about Children’s Mental Health Awareness Day, call 783-9141 x 300.

For Immediate Release
Media Contact: Tina Clark, APR
Director of Development & Community Relations
207-784-4110 x 158
tclark@tcmhs.org