Transcript Learner Mental Health Needs in Iowa

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
participants
 11 counties in the southeastern US
 Assessed 9 times through ages 9 to 21
 Prevalence 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

4 or more
increase
80% increase
1,120%
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 education
 Fail
a grade
 Score
lower on a standardized test
 Have
language difficulties
 Be
suspended or expelled
 Have
poorer health
Brain Development
Serve
and Return
Toxic Stress
http://developingchild.harvard.edu/key
_concepts/toxic_stress_response/
When the brain “downshifts”…
Fight
Flight
Freeze
Even when there is no
real threat…
Why?
Iowa ACEs
Childhood Abuse
 Physical abuse
Household Dysfunction
 Substance abuse

Psychological abuse

Member imprisoned

Sexual abuse

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
Actions
trumps learning.”
(Blodgett, 2012)
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?

Think: What happened
to you?

Do: When act out,
punish.


Do: When frustrated,
become angry.
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/sea
rch/?cx=001599101917928556767%3Acfzj
kqwnev8&cof=FORID%3A9&ie=UTF8&q=videos&sa=Search&siteurl=developi
ngchild.harvard.edu%2Fresources%2F&re
f=developingchild.harvard.edu%2F&ss=7
52j131456j6
And, by the way…
“
Relationship is the
evidence-based
practice.”
Christopher Blodgett, 2012
Thank you.
Web site: Iowa ACES 360