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A Marshall Plan for Trauma

“We’re only now becoming facile in the language of trauma,” said DC Attorney General Karl Racine, who is heartened by the District’s progress. “This is an opportunity to throw a Marshall Plan out there.”

A $12 billion, post-World War II initiative, the Marshall Plan was designed by the United States to prevent the spread of Communism and to assist European countries in restructuring their battered cities and bruised culture. Many people use it as an analogy to argue that something huge and dramatic must be done to solve a social or economic problem.

DC education and health advocates, parents, students and others have argued such a broad, inclusive plan is needed to deal with a crisis in childhood trauma. Nearly 50 percent of DC children citywide have suffered two or more traumatic events, according to the Centers for Disease Control and Prevention (CDC). Those traumas could include abuse and neglect, parental abandonment, parental incarceration, bullying, homelessness, limited family income, poverty, substance abuse, domestic and general violence. Children aged 6 to 17 who have had two or more adverse childhood experiences (ACEs) are twice as likely to be disengaged from school compared to untraumatized peers, researchers have concluded.

A deeper dive into the performance of District public school students suggests a strong correlation between academic failure and trauma. Consistent with the CDC report, the majority of DC public school students have scored “below proficient” in the past three years on English and math exams. District officials appear reluctant to make the connection.

Trauma has a physical health dimension as well. “Childhood adversity literally gets under our skin, changing people in ways that can endure in their bodies for decades,” said Dr. Nadine Burke Harris, author of the “Deepest Well: Healing the Long-Term Effects of Childhood Adversity.” “It can tip a child’s developmental trajectory and affect physiology. It can trigger chronic inflammation and hormonal changes that last a lifetime. It can alter the way DNA is read and how cells replicate, and it can dramatically increase risk for heart disease, stroke, cancer, diabetes.”

Rather than just deal with trauma’s aftermath, said Judith Sandalow, executive director of the Children’s Law Center DC (CLC), “We have to move upstream and begin to stop some of these problems.”

Imagining a Marshall Plan
What would be the key architectural and content elements of an anti-trauma-type Marshall Plan? How much would it cost, and who would implement or manage it?

Advocates and others interviewed in Part 1 and Part 2 of this series have said that the city must do more than simply increase the number of trained and licensed mental health clinicians in public schools. Some have asserted that an anti-trauma effort requires the assessment of all publicschool children. Others have argued for the implementation of an integrated intervention and treatment model involving children, parents and other significant family members to deal with generational trauma prevalent in the city.

The plan would also include expansion of existing programs like restorative justice, which provides an opportunity for a perpetrator to meet a victim and make amends for any harm while possibly establishing a relationship between the two. The Alternatives to Court Experience Diversion program operated by the Department of Human Services (DHS) in collaboration with the Office of the Attorney General (OAG) is the kind of “evidence-based, high-quality intervention to support children and families [that] should not be reserved only for children who end up in the justice system,” OAG Special Counsel for Juvenile Justice Reform Seema Gajwani told the publication Street Sense. “It should be for families and children who need that support in their schools,” added Gajwani.

Public schools could be restructured, and universal home visits should be mandated. Trauma survivor Finesse Graves believes they are essential. Graves has been through a lot; she was traumatized as a child, forced to travel in and out of drug dens to purchase narcotics for her mother. Later, Finesse went to live with her grandmother who soon died. Finesse became an emancipated minor ultimately ending up homeless and pregnant. She and her daughter lived in and out of homeless shelters; desperate to stabilize her housing, she went back to live with her mother. Graves said a visit to her family’s apartment by officials from Rocketship Rise, her daughter’s Ward 8 charter school, made all the difference for her child. “Once they got to know what we were going through as a family, they knew what [my daughter] needed.”

No citywide anti-trauma Marshall Plan would be complete absent a public health campaign designed to educate people on the nature and prevention of trauma. Such a campaign could be modeled on those in the past few years that have targeted HIV/AIDS, smoking and teen pregnancy.

To provide accountability, focus and coordination, some advocates and teachers have advised the creation of a Trauma Czar, who would consolidate and coordinate all related programs with the goal of ending childhood trauma in the District. “The city needs one person dealing with all of this,” said one Ballou High School teacher.

How much would a Marshall Plan for ending trauma cost? That is unclear. However, it could save money.

The CDC has estimated that on an annual basis the country spends as much as $124 billion dealing with the effects of the “maltreatment of children.” That number includes as much as $3.9 billion for criminal justice, $25 billion in healthcare, $4.5 billion for child welfare, $4.6 billion for special education and $83.5 billion in lost productivity.

Two-thirds of the District’s $14 billion budget goes to cover human or social services costs primarily associated with homelessness, welfare, juvenile delinquency, police services and public education. Programs that cut at the root of these issues could be money savers. “All of [those] social ills are not only bad for people, but costly for everybody,” said Sandalow “There are some simple things [that] would make a dramatic difference.”

Road Maps Abound
While not using the term Marshall Plan, other jurisdictions have focused resources on fighting childhood trauma. These governmental efforts have been supplemented by the work of local advocates, private businesses and nonprofit organizations.

In Georgia, the Atlanta Volunteer Lawyers Foundation’s (AVLF) “Standing with Our Neighbors” program has reduced the number of evictions occurring at Thomasville Heights Elementary School. Twenty evictions were prevented. The program was designed to halt children from leaving the school because their families were becoming homeless. As a result of the AVLF, Thomasville’s turnover rate caused by homelessness dropped from 40 percent to 25 percent in one year. The AVLF has expanded to two new schools and is working with nine other law firms.

The state of Massachusetts established the Trauma and Learning Policy Initiative, a collaboration between Massachusetts Advocates for Children and Harvard Law School, “to create trauma-sensitive schools.” It has been so effective that the state has one of the lowest national percentages of children with ACE scores of two or more adverse experiences.

In Washington state, Teri Barila founded the Children’s Resilience Initiative (CRI), a public-private collaboration directed at reducing trauma’s negative emotional, social and health effects. Barila held community meetings to persuade companies, nonprofits and government agencies to embrace trauma-informed care as a customer service and business model. Under CRI’s guidance, to cite one example, Lincoln High School in Walla Walla implemented a trauma-informed approach in 2009. Its graduation rate increased from 44 percent to 78 percent by 2014.

Tonette Walker, the wife of former Wisconsin governor Scott Walker, led a rigorous and extensive trauma-informed care initiative that involved a cross-sector of state agencies, including not so obvious ones like Workforce Development and the Wisconsin Economic Development Corporation. Among other things the Wisconsin Trauma Project has provided training for caregivers in trauma-informed parenting.

Last year, working closely with Rep. Mike Gallagher (R-Wisconsin), Walker helped encourage passage of House Resolution 443. The bipartisan measure, which received very little media attention, recognized “the importance, effectiveness, and need for trauma-informed care among existing programs and agencies at the federal level; and encourages the use and practice of trauma-informed care within the federal government, its agencies and the United States Congress.”

By contrast, in DC “a cross-sector trauma-informed coalition has not been achieved despite efforts in 2015-2016 to launch Trauma-Free DC,” according to ACE’s Connection, a nonprofit group focused on helping communities recognize the impact of trauma and develop policies and programs to address the problem.

Next Steps
“The [DC] government has taken several miniscule steps,” acknowledged Davon Harris, a senior at Richard Wright Public Charter School for Journalism and Media Arts, who started a campaign for more public-school therapists. “There is no time to waste,” added Harris.

As an example of steps already taken, Harris and others point to a cornucopia of DC laws focused on children and youth: the School Safety Act, the Fair Access to Schools Act, the Youth Suicide Act and the Neighborhood Engagement Achieves Results (NEAR) Act. All of these address trauma’s consequences. None root out its causes. Many have been poorly implemented, lacked citywide coordination or have been insufficiently funded.

A broader solution, according to CLC’s Sandalow, is the immediate installation of a trauma-informed operational and teaching model for all public schools. Such institutions focus on what happened to a child, rather than what is wrong, she explained. Researchers have said that by bolstering children in four prime areas – “relationships with teachers and peers; their ability to self-regulate behaviors, emotions, and attention; their success in academic and non-academic areas; and their physical and emotional health and well-being” – the chances for overcoming trauma and adverse experiences are greatly improved.

Equally important, every state that saw a reduction in trauma among children had implemented a cross-sector, multi-level community engagement campaign that included small meetings, conferences and broadcast public service announcements. “We have made it our mission to do a lot in the community in terms of psycho-education,” explained Satira Streeter, clinical psychologist, founder and executive director of Ward 8’s Ascensions Psychological and Community Services Inc.

Streeter also said media campaigns like the “no spanking” one she ran two years ago are important for helping parents and community leaders understand how their behaviors can either trigger old traumas or create new ones. “Using an empowerment lens, we can say, yes, you’ve been traumatized. How do you not traumatize the children in your life by spanking them, by cursing them out, by hitting them upside the head? How do you not traumatize the woman in your life by hitting her, by talking bad to her? How do you not emasculate the man in your life?” she asked.

Residents “can’t just wait on the government,” she continued. If the government officials will not implement a Marshall Plan for eliminating trauma, as Racine suggested, advocates and civic leaders may have to step into the gap.

“We have to be sure our children come out of this whole childhood thing as unharmed as possible,” added Streeter.

Jonetta Rose Barras is a DC-based freelance journalist. This series was produced with a fellowship from the Fund for Journalism on Child Well-Being, a program of the University of Southern California Annenberg Center for Health Journalism.

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