A service of the California Health Care Foundation

Legislation Signals Growing Support For Significance Of Trauma Indicators

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As a college student, Rob Bonta had a summer job working as a counselor for troubled kids.

Now, two decades later he is bringing legislation to address some of the needs he saw then.

“I worked with some of these kids as a counselor out of college, and I’d walk them home and hear some of these stories,” Assembly member Bonta (D-Oakland) said. “Shootings they heard. Or shootings they witnessed the night before.”

It was the summer of his junior year at Yale, when he worked in the Leadership Education and Athletics Partnership program in Connecticut. That took him to a side of idyllic New Haven most people don’t see — the economically depressed inner city. He said kids there endured trauma sometimes on a daily basis.

Those traumatic events add up in children’s lives, Bonta said, and have been shown to result in higher risk of chronic health conditions and risky health behaviors later in life.

The medical community uses a scale of ACE indicators — for adverse childhood experiences — to measure that higher risk category. People with four or more childhood traumas, such as physical abuse or having a family member with a drinking problem, have a much higher prevalence later in life for a host of health issues — chronic obstructive pulmonary disease, asthma, kidney disease, stroke, depression, dementia and other maladies.

“We see childhood trauma and ACEs as a public health crisis that is critical for the state to address,” said Ben Rubin, senior associate of neurodevelopment and health at Children Now, a children’s health advocacy group based in Oakland.

“More and more ACE indicators have been gaining traction,” Rubin said, not just in the medical community but in criminal justice and legislative circles as well. “We think [addressing] this has been a big deficit in the state. This bill is a good step toward providing services.”

Childhood Trauma Bill

Bonta’s legislation would establish a four-year pilot program to help some schools and communities provide mental health services with the state chipping in funds, training and technical assistance. It also would commit state money for the Early Mental Health Initiative, which was cut by the governor in 2012.

Bonta’s legislation would establish a four-year pilot program to help some schools and communities provide mental health services with the state chipping in funds, training and technical assistance. It also would commit state money for the Early Mental Health Initiative, which was cut by the governor in 2012.

The benefits for the state are many, he said:

  • School classrooms would be more effective if teachers are better able to screen and help children who exhibit symptoms of adverse childhood experiences;
  • Dealing with children’s trauma now could mean big savings in health care spending in the future, as ACE indicators are one of the telling signs of those who are the heaviest users of the health care system; and
  • The ability of children to become adults who contribute to society goes down among those with a number of ACE indicators, so there are a strong economic and workforce reasons to address those problems earlier.

“It’s true, it’s our moral imperative to do something about it, to protect our children,” Bonta said. “But there’s also a financial imperative, because early prevention saves dollars down the road.”

The pilot program would target younger students, up to third grade. It would provide teachers with a better screening tool to identify withdrawal problems, anxiety or bullying, among other behaviors, Rubin said.

“Schools across the state are doing it to some degree, but not with any kind of state support,” Rubin said. “We need to invest in providing those services, so we wanted to fund a modest but important state role.”

Through the pilot program, the state’s Department of Public Health could help provide regional training and outreach to schools that providing those types of services, and also expand the number of school sites providing services.

“Every year more and more folks become more aware of what this is,” Bonta said. “More and more people are seeing the adverse impact of this and the multiplier effect of it. There are just so many social and health consequences of childhood trauma. It’s something we have to address.”

What Bonta saw 20 years ago on the streets echoes the pervasive and persistent quandary now, he said. “This is not a new problem,” Bonta said, “but we want to come at it with new focus and new momentum.”

The bill is expected to be heard in committee in April.

Categories: Insight, Mental Health

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