• Trauma Informed Schools 

    The Need for School Mental Health Services in LAUSD


    Shocking statistics tell the local and national story of the need for mental health services for students, families and school communities. Both within LAUSD and across the nation, an overwhelming number of students come to school every day with a myriad of adversities and mental health1 problems that compromise their ability to learn and achieve academically. Research suggests that schools function as the de facto mental health system for children and adolescents2. Nationally, only 50% of youth in need receive any mental health services3. In California, three out of four children with mental health needs do not receive treatment despite having health care coverage4. Of those receiving care, up to 80% receive it in a school setting5.  More than 25% of American youth experience a serious traumatic event by their 16th birthday, and many children suffer multiple and repeated traumas including: abuse, maltreatment and neglect; traumatic loss; serious accidental injury; experiencing or witnessing violence in neighborhoods, schools and homes; treatment for life-threatening illness (medical trauma); accidents and fres; disasters and terrorism. Twenty-one percent of youth aged 13-18 have a mental illness that causes significant impairment in their daily life6, 50% of all mental illnesses begin by age 14, and 75% by age 24. 7 In a 2013-2014 screening of 572 LAUSD students, 88% reported experiencing three or more traumatic events in their lifetime, 55% of whom showed symptoms of PTSD, depression, or anxiety.


    The above statistics are startling for many reasons. Within the context of the nation’s second largest school district, perhaps the most compelling of those is that mental wellbeing is an essential component of success in the classroom, and, if students are experiencing adversity and mental health issues without access to appropriate support and services, they won’t be able to learn, achieve, and graduate from high school ready for college and/or a career. In addition, the staff and administrators who are dedicated to support LAUSD students in their success need the support of qualified professionals to address needs ranging from students who become disengaged from learning because of trouble at home, to students with special needs who are experiencing emotional and behavioral disturbances, to violent and traumatic incidents in the community or on the campus.


    Current Landscape of SMH Theory and Best Practices in LAUSD


    For the last decade, SMH has engaged in mental health research through partnerships with universities and other institutions. Through this commitment and participation, SMH has become a national leader in two key research-based approaches to school mental health services: trauma-informed and evidenced-based practices. SMH places a high priority on research-based interventions and practices which have the skillset and training to promote social-emotional wellbeing that is needed for academic achievement.


    A Trauma-Informed Approach What is trauma-informed practice?


    SMH utilizes a trauma-informed, multi-tiered approach to student support. By viewing a child’s past experiences through a trauma lens, it is recognized that behaviors (e.g., disruptive behavior, difficulty engaging, or trouble learning) may be a student’s attempt to communicate an emotional need or to cope with symptoms of trauma. By shifting away from a deficit approach, exemplified by the question, “What is wrong with you?” and asking instead, “What happened to you?” an opening to begin the process of support and recovery is created. This approach not only aids the healing process for individuals who have experienced trauma, but it also increases the likelihood of early detection and early intervention. Evidence shows that the healing process plays a key role in a student’s ability to learn and achieve in school and in life.


    Why a trauma-informed approach?


    Over the last 20 years, studies have demonstrated an irrefutable link between exposure to community violence and other Adverse Childhood Experiences (ACEs) to a host of social, academic, and behavioral challenges including: decreased IQ and reading ability; lower grade-point average; higher school absenteeism; increased expulsions and suspensions; decreased rates of high school graduation; failing to understand directions; overreacting to comments from teachers and peers; misreading context; failing to connect cause and effect; and other forms of miscommunication. A single adverse experience can cause: jumpiness; intrusive thoughts; interrupted sleep and nightmares; anger and moodiness; social withdrawal; and concentration and memory difficulties.

    Longitudinal studies of ACEs such as abuse, neglect, and extreme family instability have also pointed to an impact across the lifespan for those with multiple such ACEs. This impact includes greater risk for health, mental health, social difficulties, and a shorter life expectancy. Early intervention can have a significant, positive effect on these at-risk lifespan trajectories.


    How does SMH help develop trauma-informed school communities?


    SMH supports all LAUSD school communities to be trauma-informed. A trauma-informed school is defined as one in which all adults on campus are able to help children and youth feel physically, socially, emotionally, and academically safe. Throughout the District, SMH professionals provide advocacy and education to school communities regarding what a trauma-informed approach is and how it can be utilized to promote safe and healthy schools, increase attendance, and decrease the necessity of student discipline and suspensions. SMH professionals work collaboratively with students, families, and school communities to ensure that student needs are viewed through a trauma-informed lens and are addressed in a holistic manner. 
    Understanding Trauma

    ACES Too High Blog

    Adverse Childhood Experiences (ACEs) Primer  Video, KPJR Films, LLC.

    Child Trauma Toolkit for Educators, 2008, National Child Traumatic Stress Network, Español

    Complex Trauma in Children and Adolescents, Regional Research Institute for Human Services

    How Childhood Trauma Affects Health Across a Lifetime  Dr. Nadine Burke Harris TED Talk \

    How Does Trauma Affect Children?  Treatment and Services Adaptation Center (TSA)

    Key Concepts:  Toxic Stress, Resilience, Executive Function & Self-Regulation, Videos, Center on the Developing Child, Harvard University

    Psychological and Behavioral Impact of Trauma (preschool, elementary, middle, high school), NCTSN.org

    Q&A About Domestic Violence, NCTSN

    Supporting Students Exposed to Domestic Violence:  A Guide for Teachers, Canadian publication 2007

    Trauma & Resilience:  An Adolescent Provider Toolkit, Adolescent Health Working Group

    Trauma Facts for Educators, National Child Traumatic Stress Network

    Understanding Trauma, SAMHSA


    Adverse Childhood Experiences (ACEs)


    Adverse Childhood Experiences, Centers for Disease Control

    Trauma-Informed Classrooms


    ACEs Connection Network, Join the Movement to Prevent ACEs, health trauma, build resilience

    Best Practices for Supporting and Educating Students who Have Experienced Domestic Violence or Sexual Victimization, National Education Association

    Calmer Classrooms:  A guide to working with traumatized children, Child Safety Commissioner, Victoria, Canada

    Classroom Activities to Build Emotional Intelligence, by Christine Franco, Tool Box Yoga for Kids 

    Compassionate Schools, Washington State

    Creating Trauma-Sensitive Classrooms, National Association for the Education of Young Children

    Psychological First Aid, PFA is an evidence-informed approach for assisting children, adolescents, adults, and families in the immediate aftermath of a critical incident, disaster, or terrorism.

    Resilience Guide for Parents & Teachers, American Psychological Association

    Resources for Schools to Help Students Affected by Trauma Learn, Wisconsin Department of Public Instruction

    The Classroom Calming Corner, Watson Institute  

    The Heart of Learning and Teaching:  Compassion, Resiliency, and Academic Success ,

    There’s no such thing as a bad kid in these Spokane, WA, trauma-informed elementary schools

    Tips for Teachers:  Trauma-Informed Care for Children Exposed to Violence, Safe Start Center

    Trauma Training for Educators, Multi-media presentation, Communities in Schools- Central Texas

    Trauma-Informed, Compassionate Classrooms:  How to Create Optimum Conditions for Learning, Echo Parenting & Education, Los Angeles

    Video:  Resilience, Gabor Maté, M.D.

    Walking Tour for Educators, Lives in the Balance:  Changing the Conversation About and With Behaviorally Challenging Kids

    What is a Trauma-Informed School?  Treatment and Services Adaptation Center (TSA)

    Why Can’t Johnny Adapt? Gabor Maté, M.D.

    Zones of Regulation, alternative to traditional behavior charts, this helps students self-monitor and regulate their emotions and behaviors


    Self-Care:  Preventing Burnout and Secondary Traumatic Stress


    Employee Assistance Program (EAP) * for all LAUSD Staff and Dependents

    Fried:  Why you Burn Out and How to Revive (Book) by Joan Borysenko, Ph.D.

    How to Build a Culture of Good Health, Gabor Maté

    Mindfulness for Educators - Trauma-Informed approach to supporting ourselves and students

    My Self-Care Plan  *LAUSD School Mental Health, Crisis Counseling & Intervention Services

    Professional Quality of Life Scale When you [help] people you have direct contact with their lives. As you may have found, your compassion for those you [help] can affect you in positive and negative ways.

    Psychological First Aid:  PFA for Ourselves  *LAUSD School Mental Health, Crisis Counseling & Intervention Services

    Secondary Traumatic Stress and Self-Care Resources  Treatment and Services Adaptation Center

    Secondary Traumatic Stress:  A Fact Sheet for Child-Serving Professionals, NCTSN.org

    Self-Care for Educators, NCTSN.org

    Self-Care Inventory, National Child Traumatic Stress Network

    Trauma-Stewardship: An Everyday Guide to Carling for Self While Caring for Others  by Laura Van Dernoot Lipsky and Connie Burk

    Video:  Caregiver Burnout,  “Working directly with individuals who have experienced trauma is frequently traumatizing to the caregiver, as well.”  In caring for children who’ve experienced these issues, we have to be mindful of burnout, secondary traumatic stress, and compassion fatigue.  This video features caregivers who are finding ways to maintain their physical and mental wellbeing. 

    Work Life Balance, Mental Health America


    1 We use the following definition of mental health: Mental health in childhood and adolescence is defined by the achievement of expected developmental cognitive, social, and emotional milestones and by secure attachments, satisfying social relationships, and effective coping skills. Mentally healthy children and adolescents enjoy a positive quality of life; function well at home, in school, and in their communities; and are free of disabling symptoms of psychopathology. (Center for Disease Control and Prevention)

    2 Burns, BJ, EJ Constello, A. Angold, and D. Tweed. “Children’s Mental Health Service Use Across Service Sectors.” Health Affairs 14.3 (1995): 149-59.

    3 National Alliance on Mental Illness. “RAISING Mental Health Awareness: The facts.” Retrieved from http://www.nami.org/Content/ ContentGroups/CAAC/FactSheetsforYouth.pdf

    4 Padilla-Frausto, Imelda, David Grant, May Aydin, and Sergio Aguilar-Gaxiola. Three Out of Four Children with Mental Health Needs in California Do Not Receive Treatment Despite Having Health Care Coverage. UCLA Center for Health Policy Research. July 2014

    5 Burns et al.

    6 Merikangas KR, Avenevoli S, Costello EJ, Koretz D, Kessler RC. The National Comorbidity Survey Adolescent Supplement (NCS-A): I. Background and Measures. Journal of the American Academy of Child and Adolescent Psychiatry 2009;48(4):367-369. Retrieved from http:// www.ncbi.nlm.nih.gov/pmc/articles/PMC2736858/

    7 Mental Health Exacts Heavy Toll, Beginning in Youth (2005 June 6). The National Institutes of Mental Health. Retrieved from http://www.nimh.nih.gov/news/science-news/2005/mental-illness-exacts-heavy-toll-beginning-in-youth.shtml