Let’s make this an easy assignment: We believe that America can take a huge step forward with the prevention of ACEs and trauma by helping school boards develop ACEs policy. This policy would articulate how a school identifies students with trauma due to ACEs and provides the help they and their parents need. The policy would also educate all school staff about ACEs and create a trauma-informed learning environment.
Some readers might be thinking, “School boards are not ready to take on ACEs policies—at least not in the near future with all their other challenges.”
To that I say that I was recently approached by two school board members in Las Cruces, NM who earnestly asked me at the end of my forum, “What are we supposed to do? Can you send us some sample ACEs school policy?”
I believe the time is right for engaging with our school superintendents and school boards to talk about policies and programs that make each school a place where ACEs are acknowledged and healing can take place.
To address the epidemic rates of trauma in the schools, districts will have to make school-based behavioral health care a priority. We have an opportunity to prevent and treat ACEs by installing behavioral health services in schools, and streamlining the process by which students and their family members get access to services.
The following is an excerpt from our book Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment. This segment focuses on making schools places where behavioral health care exists, and students can achieve success as opposed to being marginalized because of their ACEs.
Schools already have counselors, but they tend to focus on testing, academic planning, college applications, and the like. Some schools have a resident social worker who may be covering numerous schools. And just like so many social workers, their caseloads are often much too high to allow for effective psychological work. Coverage is spotty, and it’s not what we’re talking about anyway.
We would instead like to see regular psychologists, psychiatrists, and other counselors actually set up practices for kids and their families right in the schools. Once the final bell rings, there is usually plenty of space to be had, but every school we’ve ever been to could probably fit a few providers in during the day as well. There are many models for this. Sometime a school-base behavioral center is staffed by school district employees. Sometimes the center is a self-standing non-profit raising its own funds but given free space in the school. In this scenario, the school would not need to hire the practitioners, but rather just give them space and let them bill insurance just like they always do. (For the uninsured, it would be important to establish a subsidized, sliding scale fee structure.)
This sort of school-based operation would go a long way toward removing the practical and psychological barriers to behavioral healthcare. Finding a provider can be a pain, but much less so if you already know where one or two of them practice. Transportation to a provider’s office can be hard as well, both because it could be far away and because it could require extra emotional energy learning a new place and how to get there. But that’s not the case if they work at the school.
This system would also reduce the logistical burden of parents, who often don’t have the resources to make the health care happen in the first place. Their role would be reduced from critical to optional. Today, if a teacher or school nurse recommends to a parent that a child get some help, it is usually up to the parent to make the phone calls and arrange for transportation. If the provider worked at a school, it could be as simple as sending the parent a courtesy heads up that the health care was happening. (This referral process would be an established protocol that all staff and parents are well aware off.)
There are lots of models for school-based health care out there, and if we had a magic wand, we would actually do something more comprehensive than this. But we still like the model because it has a very low barrier to entry. Schools can just let practitioners use space they weren’t using anyway, and maybe do a little logistical work on the side. No funding streams to manage unless someone really wants to go above and beyond the call of duty. But for the “ideal world” version of this, if you want to learn more, we recommend a quick search on “full-service community schools” and “school-based health centers.”
Finding Models for Success Near You
You may be happy to find that one out of thirty schools in your district already has a state-of-the-art behavioral health care center serving students and their families. (That was my experience in Santa Fe, NM.) Further research can reveal that that your state has a handful of family-centered schools with full-time community support directors who are coordinating school-based behavioral health, medical and dental care, parent supports, tutoring and afterschool programming. The good news is that schools are changing and in a few years school boards will adopt school ACEs policies, fund behavioral health care, create community schools, train staff on trauma-informed education, implement protocols for helping students with ACEs, provide parent education on ACEs, and create family-friendly school environments where students and their parents thrive. That’s the future I’m working toward.
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