Teaming up on trauma
Mental health experts, police, firefighters combine efforts
A shooting. A car crash. A suicide. Those are big, traumatic events. Carnelius Russell worries about a different kind of trauma. The kind felt by a kid who counts how many drinks his dad has, realizing once he reaches a certain number, there’s a chance of a beating.
“It’s that sustained trauma that kids are experiencing on a daily basis,” Russell said.
Russell, a psychiatric counselor, joined Milwaukee’s Trauma Response Team in January after a decade of county experience helping children in mental health crises.
The city-funded team is on the frontline of a growing effort in Milwaukee to confront and address trauma, especially in children.
The team gets referrals from Milwaukee police officers — more than 700 since the program started in 2015 — and follows up with families to see if they want counseling or other services.
It’s up to the families if they want to participate. About 28% of families
contacted last year declined.
The Milwaukee Fire Department signed on as a partner earlier this year. Firefighters and paramedics are expected to start referring families this month, city officials said.
Russell and other trauma counselors believe the new partnership will bring more acceptance from families, especially those who don’t trust the police.
“It’s a different relationship,” Russell said.
Why is trauma important?
Decades ago, a study looked at the relationship between childhood trauma — such as abuse, neglect, and drug and alcohol abuse in the home — and health and behavior problems in adulthood.
Known as the Adverse Childhood Experiences study, the research found the more of those experiences a child had, the more prevalent and more serious problems emerged in adulthood.
In the years since, researchers have discovered more evidence, finding chronic stress and trauma can actually change a child’s brain structure and distort their DNA.
Layered on top of that are structural or historical traumas, such as systemic racism. Experts say trauma can be passed down generation to generation.
When that cycle of trauma is interrupted, it can stop a cycle of violence, too.
“I think the increased recognition of trauma is truly revolutionary,” said Steven Dykstra, a clinical psychologist at Milwaukee County’s Behavioral Health Division who directs the team.
Like Russell, Dykstra highlighted the importance of seeing the “small traumas.”
“If a kid gets beaten up twice on the way to school, that’s bad,” he said. “What’s really bad is the other days they’re worried they’re going to get beat up. That’s what really crushes them.”
The anxiety and worry of the unknown can consume a person. Dykstra compared it to driving in a snowstorm at night on an unfamiliar road.
“You can’t carry on another conversation, can’t work with the radio, all of your energy is going into this,” he said. “That’s what’s happening to people. Their bandwidth, their energy, their resources are being pushed over to these survival issues.”
What does the team do?
It starts with a phone call. Counselors with the Trauma Response Team pick up referral forms from Police Districts 7 and 5, on the north and northwest sides of the city. Officers have written basic information about what happened, when, where and who was involved.
The counselors, who work in pairs and different locations in the county, call the families and try to set up a time for a home visit.
Last year, the team got 236 referrals and successfully made contact with half. Of those, 39 families got additional services, 47 received information about the program and 33 declined any involvement.
Usually, it takes several calls before a family invites them over, said Theresa Barnett, a counselor who works with Russell.
“Families are guarded,” she said. “It’s been a stressful event.”
Some families end up in therapy or group sessions. Others are connected to youth activities, like basketball or music programs.
Barnett remembers one girl who was attacked at school and suffered a brain injury as a result.
The girl withdrew from friends and family. She had thoughts of harming herself. Barnett kept meeting with her and called her between appointments.
Over time, Barnett said, the girl started talking with her family members more and more. She joined a community group for teen girls.
“I could see her blossoming,” Barnett said.
Dykstra compares the process to treating a broken bone.
“A cast doesn’t heal your arm; you heal your own arm,” he said. “We just want to support that arm so it heals better, faster and with less pain and less fuss.”
The challenge of police referrals
The first question families usually ask is: “How did you get my information?”
“You say it’s from the police, and some families just aren’t interested,” Barnett said.
She and Russell, who are working with about 30 families at any given time, stress that their services are confidential and mental health information will not be shared with police.
If a child has been a victim of or witness to a robbery or shooting, it’s easier to connect with the family.
But domestic violence, when police often are arresting a parent, brings other complications — and the larger history of police-community relationship in Milwaukee cannot be ignored.
“Police have a job to do and we clearly understand that,” Russell said, adding: “It’s hard to change the dynamic of a relationship.”
Training in New Haven
The Milwaukee Police Department sent several officers with Dykstra and two other county clinicians to New Haven, Conn., for training in 2015. The police department there has used a trauma-team approach since 1992.
As the program was rolled out in Milwaukee, county mental health counselors went to district stations to explain what trauma is and why it’s important to address it.
But it can be tough for officers to remember that as they’re going from 911 call to 911 call, often seeing the worst of people and becoming desensitized to it, the counselors said.
“Initially I think everyone had high hopes of changing culture,” Russell said. “I think people didn’t realize how embedded that culture is.”
The team has had success approaching officers one on one.
“I would rather have 15 to 20 officers really being conscious and trauma-informed … rather than 300 just giving us any referral case just because their captain said to do it,” Russell said.
From trauma to healing
The city’s Office of Violence Prevention, which coordinates the team, wants to shift the conversation from trauma to healing.
“When trauma has occurred and there’s no outrage about it, no concern about it ... then people feel like no one cares or that this is OK,” said Reggie Moore, the office’s executive director.
Part of healing is having access to resources so people can process what happened, which is exactly what the team’s counselors do, Moore said.
The team, a city-county partnership in which the city contributes about $180,000, is a way to make that healing more accessible, he said.
And that access should only increase as more agencies, like the Milwaukee Fire Department, get involved.
“We want to make sure there are as many doors as possible for people to get the healing support they need,” Moore said.