We interrupt this public health crisis to share another one

When the pandemic hit, all we could focus on was the immediate threat. It’s time to ask, “How are our kids doing?”

COVID-19 grabbed the headlines in the US a few months ago and because the viral pandemic first hit older adults, we focused on that population. This makes sense. We saw news images of elders in nursing homes and hospitals gasping for air. We immediately worried about everyone over 60 and rightfully so. We did this because this segment of the population was at risk for severe illness or death due to COVID-19. 

The first time children were mentioned in frantic emails passing back and forth about COVID-19 was focused on the closing of schools. OK. That made good sense if we were to be prudent. Of course, for the vast majority of parents who work outside the home, this meant a major disruption. Then work went remote (for those who had jobs that still existed and that could accommodate the option of working from home). A few days later across our desktops were filled with emails that were bringing up the issue of feeding students who depended on school breakfasts and lunches. Kids were part of the emergency preparedness equation and that was good to see.

Eventually, the inevitable happened and some children were exposed to COVID-19. A few days later I got a call from a health clinic medical director who was concerned that in his county, there were a lot of unanswered questions about services for families and students. He sent me a list of twelve:

1. Do school leaders know how they can best reach students and their families, via phone and/or online?
2. Have all educators and school staff helped parents and students identify a health care provider who they can access easily?
3. In case of crisis, do parents and students know where to go for medical help?
4. Who can contact the county’s network of school educators and staff during a public health crisis?
5. Have school directors been trained how and when to keep in contact with staff during a public health crisis?
6. Do school food banks have enough supplies for an extended period during a public health crisis?
7. Do school-based health centers have staff trained to operate during a public health crisis?
8. What supplies might they need to serve school staff, students and families?
9. Who is in charge of food and how do schools keep food services going for students?
10. Are school-based health care providers trained to offer services and support during a public health crisis? What supplies might they need?
11. How can all schools be prepared to serve as a shelter if need be?
12. Is there a number that students can call for support if they face challenges at home but do not wish to involve child welfare?

These were excellent questions that every school district working on readiness with county and city leaders needed to get answers to. The word of the day was “alignment” with no duplication of services or activities in a time of crisis.

Who is there to call?

It was the last question on the list that caught my eye, about students having a number to call if they felt unsafe at home, but didn’t want to call child protective services. This is where we depart from focusing on one public health crisis, a new pandemic, and turn to a very long-standing one called childhood trauma.

In so-called normal times, if youth face abuse or neglect at home, we don’t give them many choices. If they tell anyone working for the school, child protective services must be called immediately and kids know this. But as businesses close, parents lose jobs, a sense of panic fills the web, stressed parents get desperate, and children and youth get scared to be at home. Do we file “child abuse and neglect” under “Very important, but we’ll get to that after we deal with this current giant crisis”?

Many of our kids were not safe before the pandemic and economic disruption hit and it's most likely worse for them now. Are they dying quickly? No, and that’s not the point. 

Of course we need to marshal resources into helping those in immediate peril. It goes without saying. And as days and weeks pass, we need to broaden our lens to ensure that our kids, as in 100% of them, are in clear view. 

The irony here is that years ago in the book Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment, we advocated for ten vital surviving and thriving services as the way to prevent abuse and neglect. We made a plea to all who would listen, that if we provide to our most vulnerable families the resources to be healthy and safe (medical and behavioral health care at the top of the list, with food, shelter and transport right behind), we get to end epidemic rates of adverse childhood experiences (ACEs), which describe the abuse and neglect many of our children endure and are currently enduring as you read this.

We now find ourselves in the middle of a global public health crisis colliding with an economic free fall and the best prevention and treatment calls for timely access to well-resourced health care providers. As things get really stressful and desperate for our most vulnerable families, ten vital services for surviving and thriving will also become part of the prescription for keeping all of us healthy and safe.

Forward or Backward?

If COVID-19 recovery means we finally provide to all families the resources they need to be healthy, we will see childhood trauma decrease. If we go back to the way it was, we have epidemic rates of childhood adversity, abuse and neglect that will be ignored. A future where childhood adversity is considered by the public “sad” but a part of life, is one I will work tirelessly to prevent. I hope you will join me.

For those of you who have the bandwidth to absorb a quick course in childhood trauma and how to ensure safe childhoods, Anna, Age Eight will let you know what social workers have known for decades: our kids from all social classes, from mansions to housing projects, need our attention and their parents desperately need help before a totally overburdened police force and child welfare system are called in.

Too early to ask about the kids?

Some might say it’s too early in the pandemic to ask what impact COVID-19, social distancing, isolation in a home with parents struggling with untreated mental health challenges, and economic disruption are having on our children. Is it?

At what point in our nation’s timeline do we make our children’s health and safety a top priority in times both calm and chaotic?