Bringing All Our Tools to Bear: Childhood Trauma and Mental Health in the Age of COVID-19
By Juanita Winston, MPP, Senior Policy Analyst and Deborah Noymer, Graduate Assistant, Center for Community Resilience
As we enter Mental Health Awareness Month and reflect on the April observance of National Child Abuse Prevention Month, we’re called to bring all our tools to bear in addressing the rise in childhood trauma and mental and behavioral health issues wrought by the COVID-19 pandemic. Our nation’s longstanding issues of persistent child abuse and neglect — which affected 1 in 7 children in 2018 — have worsened with safety measures implemented throughout the pandemic. Children have been unable to attend school or childcare, participate in extracurricular activities or access many safety-net benefits that provide critical supports. Teleworking parents have juggled workdays with virtual learning and childcare, while essential workers across industries — particularly those who earn low income — were left with few options for childcare. Parental stress has risen, and children have suffered as a result.
In some cases, the lack of support structures and economic stress prompted violence against children in families that have not faced violence before and worsened existing maltreatment and violence. These factors — in combination with the social isolation, grief, and economic uncertainty brought on by the pandemic — have led to an increase in depression, anxiety, and substance use among youth. Self-harm and suicide, which has increased every year since 2007 among those ages 10 to 24 and is the second leading cause of death for youth ages 10 to 14, are also points of concern. Recent analysis found that intentional self-harm among youth ages 13 to 18 increased 99.8% in April 2020 compared to April 2019, highlighting how the traumatic effects of the pandemic have exacerbated an already-dire reality.
Reckoning with this rising public health crisis will require a multi-sector approach with the backing of local, state, and federal policies and resources. At the Center for Community Resilience (CCR), we use a public health approach and the science of childhood trauma and resilience to inform community-driven policy, practice, and program transformation across sectors and communities nationwide.
Mitigating the Mental & Behavioral Health Effects of Childhood Trauma
We know that exposure to violence in childhood increases the risks of injury, mental illness, future violence victimization and perpetration, substance abuse, delayed brain development, lower educational attainment, and limited employment opportunities. This exposure to adverse childhood experiences (ACE) is compounded by adverse community environments (ACE), including systemic racism, poverty, low quality education, and food and housing insecurity. The consequences of this “Pair of ACEs” have multigenerational impact. For example, children living in impoverished communities are at higher risk of child abuse and child abuse fatalities, and rates of child abuse and neglect are five times higher for children in families with low socioeconomic status compared to those with higher socioeconomic status.
Targeted, comprehensive solutions to address the mental and behavioral health effects of child abuse and community trauma will be critical. Upstream approaches, such as early childhood home visiting and behavioral health promotion, are important prevention strategies that can mitigate causes, reoccurrence, and consequences of childhood trauma across communities. At CCR, our Building Community Resilience collaborative and Resilience Catalysts in Public Health network are working to develop place-based and community-driven policy, program and practice solutions that eliminate the adversity contributing to child abuse, build resilience, and foster equity so that children and their families can thrive. Others across the country are doing the same.
Increasingly, health departments are using their strong understanding of community context to build political will to create health policy solutions that consider neighborhood adversities and systemic racism. In 2016, the Los Angeles County Department of Public Health implemented a program that employed public health nurses to assist social workers with child care coordination and child abuse investigations in foster care. In February 2021, the Washington State Department of Health developed its Essentials for Childhood Initiative (EfC), which aims to reduce and prevent child abuse and neglect, as well as increase family and community resilience. The EfC centers racial and income equity in its efforts to align systems, strategies, and policies to improve how families experience supports, reduce family stress, and increase family resilience.
Trauma-Informed Policies as a Pathway for Progress
To ensure that local, state, and national initiatives like these have sufficient resources to do this important work, federal legislation can and must play a pivotal role in addressing the systemic drivers of child abuse and trauma. In October of 2020, Congresswoman Ayanna Pressley (D-MA) introduced the Services and Trauma-informed Research of Outcomes in Neighborhood Grants for Support for Children Act of 2020, also known as the STRONG Support for Children Act. This legislation aims to support communities in addressing the root causes of childhood trauma through reparative, healing-centered, neighborhood based, gender responsive, culturally specific, and trauma informed approaches that recognize the role that systemic racism and inequities have played in traumatizing children and communities for generations. This Act includes grant funding for local public health departments to identify geographic regions with high rates of adverse childhood experiences, develop strategies to focus on serving children, support public health departments in childcare coordination, and fund community-based organizations.