By Polly McKinney
& Erica Fener Sitkoff
Think back to just a few days ago on Father’s Day. Dads all over the country were awakened to trays of rainbow-sprinkled, syrup-covered toaster waffles prepared with love by their children. While calorie counting tends to fly out the window on holidays, the daily challenge of parenting never escapes the minds of moms and dads. Questions such as “Am I getting this parenting thing right?” and “What will my children be like as adults?” fill their minds, regardless of the date on the calendar.
Parents are always thinking about the factors involved in growing a little baby into a fully functioning adult: Food, water, clothing, education, good health, and love. A child is a great myriad of achievements, experiences, needs, and desires.
Which brings us to our main point: brains.
Brains are the mission control of life, and as such, we need to treat them with care and respect, especially while a child is growing.
Pretty much every experience a child has can positively or negatively affect his or her trajectory into adulthood by virtue of the effect it has on the brain.
You see, it takes about 25 years for the brain to develop fully. 25 years?! Yes. 25 years. In a nutshell, it happens like this: the first part of the brain to grow is all about survival – the “fight or flight” part. This area grows rapidly when children are small, and controls those responses we all use to get what we need – crying when we’re hungry, running when we are scared. The part of the brain that controls reasoning and “book-learning” develops later. It eventually communicates with the fight or flight part to control behavior and rational thought.
So what does all this mean? Well, when a child experiences or witnesses something stressful or traumatic, chemicals are released which bathe the brain and stimulate the fight or flight part. For some children, this can happen in such a way and with such duration that this part of his or her brain grows differently than normal. At the same time, that growth change can slow or impair the development of the reasoning part of the brain. All that can lead to behavioral health challenges for a child and even alter their trajectory in life.
Yikes! The good news is we can help kids who have trauma-related behavioral health issues or those with other behavioral needs in a number of ways.
First, Georgia has an array of projects and programs to address child and adolescent behavioral health needs. Second, other systems touching children, such as education, early care and learning, child welfare and juvenile justice are starting to account for brain development and childhood trauma when they design their services and engagements with children.
All that is happy news, but there is a problem. When kids receive behavioral health services in one system, often there is not an avenue for transition to another system – and let’s face it, many kids move between schools, homes, counties, and agencies with great frequency. On top of that, there are not enough service providers across the state, so coordination of care is even trickier. That means when a child actually gets the right help, there is frequently a danger the initial care will stop when the child changes schools, doctors, or residences…with nobody to pick up the ball on the other side, effectively leaving the child without continuity or help.
For example, when children enter into foster care, they are immediately eligible for an array of assessments and services, including a trauma assessment, screening for health challenges and therapies. Their ability to access such vital services before and after they enter into care is less clear. When children transition back with families, a time when both kids and their parents are most vulnerable, they are often not able to continue to work with the same therapists as when they were in care.
This can happen because children may no longer be eligible for health care coverage once they leave foster care or the oversight of the Department of Juvenile Justice. Their treatment needs also might be defined differently once they return to their families. Another snag can happen when new providers don’t know who the former providers were and have to start from scratch. And, of course, there are transportation barriers. Getting to and from appointments is hard, especially when services are located in another county or far from home.
Let’s remember, there are an awful lot of helpful programs out there,, but when a treatment program is interrupted, progress is often impeded or reversed.
Clearly there are lots of folks sincerely trying to do the right thing to address kids’ behavioral health needs, but we are missing the coordination of our children’s needs to make seamless transitions between systems, agencies, people and locations.
Georgia needs a statewide child and adolescent behavioral health strategic plan.
With state leadership, such a plan could be developed and vetted by an assembly of policymakers, content experts, practitioners, families and advocates – a “reform council” if you will. Currently, such reform councils are guiding significant and meaningful work in Georgia’s criminal justice, child welfare, and education systems. We see no reason to stop there when child and youth behavioral health is so intimately involved in the success of all of them.
Two legislative study committees, the governor’s Child Welfare Reform Council, as well as countless advocates, not to mention the likes of Voices for Georgia’s Children have all recommended this idea. We are a team of professional, data-driven, child advocates, one of whom is also a licensed child psychologist. Many of us (authors included) are also parents who actually love soggy, rainbow sprinkled, syrupy waffles and especially love healthy, joyful children. So if our kids (or your elected officials) call you and ask you what we want for Father’s Day next year, just tell them to double up on the sprinkles and throw in a statewide plan to protect and foster children’s brains so they can grow into happy, productive adults.
By Polly McKinney