Dennis McCollins recounts some of the experiences that caused him to harden against the world as a teenager. “There were times I went to more funerals than birthdays,” says McCollins, who is the clinical director of the School Based Health Center at Greenwood Academy in Richmond, Calif. And it took its toll: “I spent time homeless. I got expelled [from school]. I was so angry and upset and mad,” he says.

Then a man that he met when he was sent to Job Corps as a teen turned his life around. “He said, ‘Getting mad is like drinking poison and expecting another person to die.’ The lesson was: Me being mad won’t fix the situation,” he recalls.

That exchange looms large in McCollins’ mind in his work as a case manager for the Young Men’s Empowerment Collaborative (YMEC), a project of the California School-Based Health Alliance (CSHA) in Oakland, Calif. YMEC began in 2016 in five schools in the West Contra County Unified School District. They include three high schools — Richmond High School, Kennedy High School, and Sylvester Greenwood Academy —and two middle schools —  Lovonya Dejean Middle School in Richmond, Calif., and Helms Middle School in San Pablo. YMEC is trying to fill a gap that leaves many young men of color out of the equation when it comes to helping them heal from violence and other trauma, according to a summary of the program. (To find out more details about the program, please contact Molly Pilloton at mpilloton@schoolhealthcenters.org)

The program, which will continue to 2020, was funded by a grant from the U.S Department of Justice, which was a good fit for the CSHA, according to Molly Pilloton, CSHA’s project director: “It hit upon our overarching goal of placing health and mental health services on school campuses so [students] don’t have to travel to access those services.” 

In the 2017-2018 year alone, 524 students were referred to YMEC for trauma screening, according to the most recent available report. Any student who attends the schools where YMEC is offered is eligible to participate in the program, according to CSHA Communications Manager Alex Medina. The students were screened for trauma using a modified Primary Care PTSD screener and the Center for Youth Wellness’s ACE questionnaire designed for teenagers, according to a report by CSHA and researchers from the University of California at San Francisco. Of those screened for trauma, 81 percent participated in one-on-one counseling and/or joined a YMEC group. Some 230 boys and young men joined YMEC groups. In the groups, they create safe spaces that allow open discussion about the violence and emotional wounds they’ve experienced, according to McCollins.

The students are taught about the landmark CDC/Kaiser Permanente Adverse Childhood Experiences Study (ACE Study), which showed a dose-dependent and striking link between childhood trauma and the adult onset of mental illness, chronic disease, violence and being a victim of violence. (To learn more, see  ACEs Science 101, Got Your ACE Score?) Students are offered the option of filling out an ACE questionnaire to learn their score, according to McCollins, who says the average ACE score of the students he’s encountered is between 5 and 7.  And their initial reaction, he says, is sometimes shock.

“[They’ll say] ‘You mean my mom and my father out of the house can have a long-term effect on me. I’m broken!’” explains McCollins, who tells them “that hurt and pain, that’s good to bring to the front rather than put it off to the side. And you won’t believe how many young men will actually tear up or cry or they want to leave, because they finally have someone who’ll say, ‘It’s ok to show your emotions.’”

McCollins and other case managers steer the young men in the direction of considering one-on-one counseling and/or joining a YMEC group if they indicate they want help: “What we try to say is we’re letting you know there’s the possibility of having problems in the future so we want to focus on getting as much help as possible now so it could help you with things in the future.”  

That initial encounter that YMEC case managers hold with students seems to be a productive way of unearthing need, according to Samira Soleimanpour, a senior researcher at the Institute for Policy Studies at UCSF, and one of the evaluators of the YMEC program. “Some students are absolutely fine with completing the questionnaire and discussing it. Some don’t want to do it, and hand it back to the case manager, but it opens up the conversation and they will disclose when they have a conversation,” she says.

To get to a complete understanding of a student’s need in terms of mental health support, case managers also use a modified version of the Primary Care PTSD screen. And they ferret out whether there’s anything in the students’ lives that buffers trauma. “What’s important is a connection with a positive adult or peer who can relate to them or is willing to listen to them,” says YMEC Case Manager Albert Law, who works for Bay Area Community Resources, and has YMEC groups at Dejean and Helms Middle Schools.

In group meetings, one of the topics they break down and get inside of is what it means to be a man. A popular way to get to the heart of that question among Law’s groups is through an art project where the students make masks.

“On the outside [of the mask] they write what they show to people, and on the inside they write what they keep to themselves,” says Law. On the outside they’ll make the masks look aggressive or appear to be the face of someone who is funny and jokes around, he notes, while a common inside feeling is sadness. And then the kids talk about those feelings and the disconnect. “Honestly, some of them have said, ‘This is the only place I can talk about these emotions,’” says Law. (YMEC case managers asked students whether they’d speak to me for this story. None of the students wanted to participate.)

The exercise and its results get to the root of what CSHA learned in developing its approach for YMEC through focus groups and listening sessions with young men in Richmond with the assistance of the RYSE Center, the youth empowerment organization in Richmond, Calif. “They felt this pressure to be strong men but were really carrying around a lot of emotional baggage for what they’ve seen or experienced,” says Pilloton. “So, providing a safe space for them that was also run by men who looked like them would be something they were hoping for, so it normalized the need to process.”(See this report by the RYSE Center on perceptions about trauma, violence, coping and healing among Richmond youth.)

McCollins agrees and says, to build trust, he shares his background with the students. “I tell them: ‘I’m from the same place as you. I’m not just some guy trying to lecture you. I’ve been where you’ve been. I’ve been at continuation schools. I don’t have a father in my life. I want you to understand I’m not out there selling drugs or in a gang.’”

He leads the students through a discussion about the larger impact of systemic racism that undermines people of color and their efforts to become economically and socially healthy. To get the students talking, for example, he shows them a video by African American hip-hop artist Joyner Lucas called “I’m not racist” that shows a white man and a black man facing off on the issue of race to the sound of Lucas’ lyrics.

“It’s powerful because they’re getting the breakdown of the opinion of someone they don't agree with and that’s interesting,” says McCollins. “And then it shows them an African American guy, which shows them how they actually feel themselves.”

And as McCollins and other YMEC case managers help guide these boys and young men through understanding how forces beyond their control play a role in what they have experienced, they also help them identify ways to develop healthy reactions to stress. In one session, for example, McCollins has the boys identify ways of coping when they’re triggered into fight, flight or freeze mode. “Some will say ‘I walk away, I listen to music, I have to yell and get it out but I’m not going to get physical,” says McCollins. The students also know that they can always find refuge at the student health center, where he says they can chill out until they’re ready to talk.

On average, group participants stay in the program for 11 sessions and have about six one-on-one sessions with a mental health specialist. The sessions include developing an understanding about systemic oppression, exploring traumatic grief, developing ways to manage trauma triggers, and identifying mentors and building relationships with them. Surveys of the students before and after their participation showed the program has made some inroads. Ninety percent of the participants felt cared about by an adult at school, representing a 13 percent jump from before they participated. Eighty percent felt close to people at school, an increase of 7 percent. After going through the program, 100 percent of the students noted that “They could achieve what they want to if they put their minds to it,” an 8 percent increase from where students said they were prior to the program, according to the report. (Please see attached documents for details).

How do students find YMEC? They may reach out to McCollins, Law or YMEC case managers at other schools. They may hear about it from a friend or may be referred by a teacher because they’ve talked back to a teacher or started a fight with another kid, or other behavior that’s not acceptable in the classroom, says Law.

“I look for early warning systems – if they’ve been absent or truant or have very poor grades, just in case there’s something behind the grades that involves trauma,” says Law.

And for many of the students, the need is upfront and clear: “I have several students who have witnessed their family members being killed in front of them and a lot of them have unstable households where they’re not quite sure if the next bill can be paid, or there’s domestic violence,” says Law.

McCollins, who will be working full time in his position next year as the clinical director of Greenwood Academy’s Student Health Center reflects back on a comment a student made. “He said, ‘I’m so mad right now. Usually I’ll go fight. But I’ll take a second and relax,’” says McCollins. “That's the cool stuff we’ve seen.”