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Connecticut has made significant gains to create a system that better identifies and treats children suffering from traumatic stress in the year since the tragedy at Sandy Hook Elementary School. But ensuring children have equal access to mental health services regardless of where they live or their insurance status remains elusive.
"The impact of trauma on children is a public health issue. It's happening all over the state and it's not just high-profile events such as Sandy Hook," said Robert Franks, vice president of the Child Health and Development Institute, noting that 25,000 children per year experience significant traumatic events. "Children are exposed to all sorts of trauma in their homes and communities every day. We need to ramp up our efforts to screen and identify children who are having difficulties and need help."
Today marks the one-year anniversary of the Sandy Hook massacre in Newtown that left 26 people dead, including 20 children. Adam Lanza, the shooter, had a history of mental health problems. The tragedy drew national and statewide attention to the need to bolster mental health services and assist children exposed to trauma.
Research such as the Adverse Childhood Experiences Study has found that misdiagnosed or untreated childhood trauma can impact mental and physical health in adulthood. "We know that many of the public ills we face - everything from homelessness and social problems to heart disease and chronic depression - can be linked to early exposure to trauma that was never treated or addressed," said Franks, who is an assistant clinical professor at the Yale Child Study Center. "The earlier we identify (mental health) problems, the more likely they won't turn into long-term, lifelong chronic conditions."
This week, Newtown families met with Vice President Joe Biden in Washington, D.C., as the federal government announced plans to invest $100 million in mental health centers and facilities nationwide.
In Connecticut, the Sandy Hook tragedy led to the passage of legislation to strengthen the state's mental health system and intensified efforts to train personnel to screen for trauma in pediatric, school, juvenile justice, welfare and other settings. For example:
• A total of 1,303 pediatric health providers and school officials - that's more than a threefold increase in one year - have been trained to identify signs of child traumatic stress and connect children to services.
• The number of law enforcement, child welfare and mobile mental health providers trained to minimize trauma when a parent is arrested and connect children to services has almost doubled to 664 in the past year.
• Close to 670 clinicians at 28 mental health agencies across the state have been trained in trauma-focused cognitive behavioral therapy (TF-CBT), an evidence-based approach to assisting children experiencing difficulties. Eighty percent of children who have been treated with TF-CBT in Connecticut achieve full remission of their diagnosis.
• A total of 181 mental health clinicians with Emergency Mobile Psychiatric Services (EMPS) have received training to screen for child trauma stress. EMPS clinicians provide on-site assessment and assistance to children experiencing a crisis at home, school or in the community.
Despite these gains, challenges persist. "More work needs to be done to ensure all children irrespective of where they live or whether they have public or private insurance have access to the best practices available," said Franks. Offering mental health providers adequate reimbursement rates "so they can afford to provide the quality of care families and children need" is another concern.
"People think of Connecticut as a wealthy state with all these resources. But we also have some of the greatest pockets of poverty in the nation and our urban areas have high rates of violence," he said. "There are such huge disparities in this state. We must leverage the resources we have to meet that tremendous need."
Parents and caregivers can find information on child traumatic stress and TF-CBT locations in Connecticut at www.kidsmentalhealthinfo.com.
This story was reported under a partnership with the Connecticut Health I-Team (www.c-hit.org).