Learner Mental Health Needs in Iowa

August 7, 2014

Agenda

Mental Health Data Great Smokey Mountain Study

Adverse Childhood Experiences (ACEs) Brain Development

Iowa ACEs Study Iowa Youth Survey What can we do?

About one-third – mental disorder across their lifetimes

More than ½ of youth – Co-occurrence with substance abuse

About 8% of teens – ages 13-18 – have anxiety disorder (symptoms? Age 6)

About 11 % - depressive disorder by age 18 Less than ¼ of adolescents receive treatment

Great Smoky Mountains Study(Published 2011)

1,420 participants11 counties in the southeastern USAssessed 9 times through ages 9 to 21Prevalence for any mental health

disorder by adulthood?

82 %

“Only a small percentage of young people meet criteria for a DSM disorder at any given time, but most do by young adulthood. As with other medical illness, psychiatric illness is a nearly universal experience.”

(Copeland, Shanahan, Costello, & Angold, 2011)

Adverse Childhood Experiences (ACE) Study

Vincent Felitti (Kaiser) & Robert Anda (CDC) Telephone surveys between 1995 and 1997 White, educated, middle class 17,000 members of Kaiser Health Plan in San

Diego

ACEs – Adverse (Traumatic) Childhood Experiences

10 types of trauma Three categories of Trauma

Abuse: physical, sexual, psychological

Neglect: emotional, physical

Household dysfunction: substance abuse, divorce, mental illness, battered mother, criminal behavior

Links childhood trauma to a range of

health and social outcomes:

Alcoholism Liver disease Heart disease

COPD Adolescent pregnancy

Depressed Smoking Intimate partner violence

Attempted Suicide

Compared with 0 ACEs

1 ACEs 80% increase

4 or more1,120% increase

What is the impact on learning?

Likelihood of a learning delay

0 ACEs 10%4 ACEs 40

%6 - 7 ACEs 100%

Children with higher ACE scores are more likely to …

Be designated to special educationFail a gradeScore lower on a standardized testHave language difficultiesBe suspended or expelledHave poorer health

Brain Development

Serve and ReturnToxic Stress

http://developingchild.harvard.edu/key_concepts/toxic_stress_response/

When the brain “downshifts”…

FightFlightFreeze

Even when there is no real threat…

Why?

Iowa ACEs

Childhood Abuse Physical abuse Psychological abuse Sexual abuse

Household Dysfunction Substance abuse Member imprisoned Mental illness Adult violence Parental separation or

divorce

At 28% childhood

emotional abuse was the most common ACE

55%

of Iowa adults experienced at least one ACE

Zero ACEs

10% rated health poorly

1-3 “bad health days”

4 or more ACES

23% rated health poorly

5 – 7 “bad health” days in month

ACE-related odds of having a physical health condition

Health Condition 0 ACEs 1 ACEs 2 ACEs 3 ACEs 4+ ACEs

Arthritis 100% 130% 145% 155% 236%

COPD 100% 120% 161% 220% 399%

Heart Disease 100% 123% 149% 250% 285%

Stroke 100% 114% 117% 180% 281%

Vision 100% 167% 181% 199% 354%

ACEs and Depression

School age?

According to the Iowa Youth Survey (2012) 13 percent of Iowa’s youth in grades 6, 8, and 11 ( or 13,772) reported they have seriously thought about killing themselves within the past twelve months

7 percent (or 7,415) of these young people reported they actually developed a plan to do so

Not all suicides or attempts are due to ACEs

So, what do these results mean to me in

my work?

What can we do tomorrow?

Has a sense of belonging, of being welcomed and valued

Is treated with dignity and respect

- 2001 Bluestein, Jane: Creating Emotionally Safe Schools

Social emotional learning is an essential condition for academic success

“Survival trumps learning.” (Blodgett, 2012)

Actions learned to survive ACEs are not acceptable in schools.

“Calibrate our relationship and goals to the arousal level of the child.”

“New learning cannot occur effectively in high states of painful arousal…

Arousal level can be re-regulated to permit access to higher levels of thought and new learning.”

Christopher Blodgett, 2012

Example

One way

Adult gives direction Child acts out Adult punishes Child escalates Adult escalates

Other Way

Adult gives direction Child acts out Adult changes goal:

de-escalation Child de-escalates Adult changes

activity/direction

How could our policies and practices differ?

Think: What’s wrong with you?

Do: When act out, punish.

Do: When frustrated, become angry.

Think: What happened to you?

Do: When act out, provide calming response or activity.

When frustrated, calm encouragement.

Think about adults with ACEs in Iowa? Teachers? Others?

1 in 3 Iowans experienced 2 or more ACEs

1 in 5 Iowans reported 3 or more ACEs

14% of Iowans experienced 4 or more ACEs

Self-Care

Before a caregiver can help a child manage emotional experiences, the caregiver must manage their own emotional experiences. (Blodgett, 2012)

http://developingchild.harvard.edu/search/?cx=001599101917928556767%3Acfzjkqwnev8&cof=FORID%3A9&ie=UTF-8&q=videos&sa=Search&siteurl=developingchild.harvard.edu%2Fresources%2F&ref=developingchild.harvard.edu%2F&ss=752j131456j6

And, by the way…

“ Relationship is the evidence-based practice.”

Christopher Blodgett, 2012

Thank you.Web site: Iowa ACES 360