Treat­ing Bal­ti­more trauma

Too many city res­i­dents face trauma from vi­o­lence, home­less­ness, eco­nomic hard­ship and drug use

Baltimore Sun - - COMMENTARY - By Leana Wen Dr. Leana Wen is the com­mis­sioner of health in Bal­ti­more City. Twit­ter: @DrLeanaWen and @BMore_Healthy.

When I first came to Bal­ti­more, I had a se­ries of “lis­ten­ing tours.” One of the most poignant ex­pe­ri­ences was with a group of youths — some no more than 8 years old. I asked them to share the sin­gle big­gest is­sue on their minds. Their an­swers shocked and sad­dened me; the big­gest prob­lem these chil­dren saw was men­tal health.

They didn’t say those words, but what they spoke about was trauma — trauma of watch­ing peo­ple they loved be­ing shot and killed; trauma of not know­ing whether they would have a bed to sleep in or din­ner that night; trauma of be­ing the only per­son in the house­hold who gets up in the morn­ing be­cause ev­ery­one else is ad­dicted to drugs.

There are those events we can di­rectly point to as a source of trauma — such as gun vi­o­lence and death in the fam­ily. How­ever, there are so many other in­puts of trauma that im­pact our com­mu­ni­ties ev­ery day, in­clud­ing do­mes­tic vi­o­lence, eco­nomic hard­ship and the ex­pe­ri­ence of liv­ing with some­one strug­gling with drug or al­co­hol ad­dic­tion.

Trag­i­cally, our chil­dren are of­ten the most at-risk to suf­fer the ef­fects of this trauma. We know from sci­en­tific stud­ies that child­hood trauma is a risk fac­tor for many ad­verse out­comes later in life. We also know that there is per­va­sive trauma in our com­mu­ni­ties, ev­ery sin­gle day. This is what our res­i­dents tell us, what our teach­ers tell us, what our fam­i­lies tell us, and what our chil­dren tell us them­selves.

The Bal­ti­more City Health Depart­ment, to­gether with our part­ners across the city, knew that we needed to act. To ad­dress trauma, we started with four prin­ci­ples.

First, our chil­dren are not prob­lems to deal with; they are our great­est as­sets. As our youths tell us, they are not “at risk,” but rather “at hope.”

Sec­ond, our city should not be branded as one of vi­o­lence and un­rest; we must set the ex­pec­ta­tion to be­come the na­tional model of re­cov­ery and re­silience.

Third, we must ac­knowl­edge that the per­va­sive trauma did not oc­cur overnight. We must ac­cept that decades of poverty, ne­glect, racism and wide­spread dis­par­i­ties have got­ten us to where we are. This re­spon­si­bil­ity re­quires both shoul­der­ing the weight of our his­tory and ac­cept­ing the duty to re­shape our fu­ture, and it is the un­der­pin­ning of our new blueprint for health, Healthy Bal­ti­more 2020.

Fourth, we must fight stigma with sci­ence. There is per­va­sive stigma and Chil­dren play in a bounce house last year af­ter the an­nual Cherry Hill Prayer Walk, ask­ing for bless­ings upon the Bal­ti­more neigh­bor­hood his­tor­i­cally be­set by vi­o­lent crime. mis­con­cep­tion around men­tal health and trauma. Sci­ence shows us that the ear­lier we get in­volved, the more we can im­prove out­comes for our young peo­ple. Sci­ence shows that we can break sys­temic cy­cles of trauma. Sci­ence shows us that men­tal health is just as im­por­tant to well-be­ing as phys­i­cal health.

Last month, we were ex­cited to an­nounce a big step for­ward in our ef­forts to bridge the gap of un­met men­tal health and trauma needs here in Bal­ti­more City. The Bal­ti­more City Health Depart­ment, Bal­ti­more City Public Schools and our part­ners were proud to an­nounce mul­ti­ple awards that will al­low us to flip the nar­ra­tive around vi­o­lence, trauma and men­tal health.

Through a $5 mil­lion grant by the Sub­stance Abuse and Men­tal Health Ser­vices Ad­min­is­tra­tion (SAMHSA), we will be able to di­rectly fund our com­mu­nity part­ners to re­duce the im­pact of trauma and build re­silience in Sand­town-Winch­ester, Penn North and Up­ton/Druid Heights.

Through a $2.3 mil­lion grant from the U.S. Depart­ment of Ed­u­ca­tion, we will be able to treat men­tal health with the same at­ten­tion and fo­cus as we do phys­i­cal health, by ex­pand­ing men­tal health ser­vices with a full-time clin­i­cian at each of our 13 fo­cus schools. We will be able to pro­vide train­ing to all staff in ev­ery school so that teach­ers, sup­port staff, and any­one who comes in con­tact with our stu­dents are trained to rec­og­nize, treat and pre­vent ef­fects of trauma.

And through a $500,000 grant from the Depart­ment of Jus­tice, we will be able to in­ter­rupt the cy­cle of vi­o­lence and trauma in our hos­pi­tals so that those who are the vic­tims of vi­o­lence will re­ceive out­reach ser­vices at the time that they present with an in­jury.

These grants are just the be­gin­ning of many years of work that must be done. It will take all of our fed­eral, state and lo­cal lead­ers to fo­cus on preven­tion, in­crease treat­ment, re­duce stigma and im­prove health, well-be­ing and re­siliency of our young peo­ple.

Con­gress­man Eli­jah Cum­mings speaks about how our chil­dren are mes­sen­gers to a fu­ture that we will not see. It is our duty to en­sure that where our chil­dren live does not de­ter­mine whether they live. It is our duty to cre­ate a com­mu­nity such that per­va­sive trauma is no longer the ac­cepted norm. It is our duty to work in part­ner­ship to­ward a Bal­ti­more where all young peo­ple are val­ued, pro­tected and em­pow­ered.

KEN­NETH K. LAM/BAL­TI­MORE SUN

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