Dr. Nadine Burke Harris (l) and Karina Chicote, Churchill Fellow from western Australia meet after congressional hearing
After watching the hearing on a monitor in the overflow room, Karina Chicote, a Churchill Fellow from western Australia, and I hustled to the hearing room in hopes of speaking to the lead witness, Nadine Burke Harris, MD, the first Surgeon General of the State of California. She was deep in conversation with others, including a young woman who wanted to tell her how invaluable her Ted Talk is to introduce students to ACEs science. When our turn came, Dr. Harris warmly greeted us and spoke to the importance of prevention—an imperative to improve lives as well as stem the costs to multiple systems that deal with the effects of ACEs.
Chicote, manager of place-based strategies for Save the Children Australia, got a hint of the cultural tensions in the U.S. on the 18th anniversary of 9/11, a beautiful day filled with blue skies. Short-lived dust-ups over single vs. two-parent families and immigration flared in otherwise cordial proceedings held in the House Education and Labor Early Childhood, Elementary and Secondary Education Subcommittee.
The hearing — "The Importance of Trauma-Informed Practices in Education to Assist Students Impacted by Gun Violence and Other Adversities" — was held during the first week after a long Labor Day recess. In other parts of Congress, members were returning to controversies around impeachment, gun violence, and budget deadlines. Similar to the hearing held in the House Oversight Committee, this one was civil and bi-partisan in tone—qualities that also characterize how the issue of trauma is addressed at the state and local levels. (Click here to watch the hearing and for the chair’s statement and witness testimonies.)
The witnesses reflected a cross-section of American life—the head of the Chicago Public Schools (Janice K. Jackson), a county level superintendent from West Virginia (Ingrida Barker), an Oklahoma state superintendent (Joy Hofmeister), and the surgeon general in the world’s fifth biggest economy, California (Nadine Burke Harris, MD). Despite the economic, social, cultural, and geographic diversity, there were common threads and recommendations among the witnesses. When asked if they could support arming teachers in response to mass school shootings, no hands were raised.
Rep. Jahana Hayes (D-CT), who represents the district that includes Sandy Hook Elementary School, addressed the long-term impact of traumatic events or “post-event trauma” citing a recent suicide of a parent of a Sandy Hook child who was killed along with 25 other people in 2012. Hayes also said research shows that some children living in communities with high rates of violence experience levels of trauma comparable to military service members. She and other House members are calling for “common sense gun reforms.” The House has passed legislation to strengthen background checks, but the Senate has failed to take up the measures, saying the Administration has expressed its opposition and would veto the bills.
Members of the subcommittee asked witnesses about the typical sources of trauma, strategies to prevent and heal trauma, and the impact of trauma on spending in social services, incarceration, substance use and mental health treatment among other costs. Hofmeister described the impact of the high rates of incarceration of both men and women in Oklahoma—related in part to the opioid crisis—that result in more and more children going into foster care. Barker described the conditions (including the opioid crisis) that lead to reliance on kinship care in West Virginia and high rates of turnover among teachers related to secondary trauma.
Harris said the science behind the impact of toxic stress on the brain and bodies in children is “indisputable.” Because trauma is so prevalent across races and socioeconomic classes and often does not present as problematic behavior, she says universal screening for children and adults in primary care settings is an appropriate and effective public health response. She also described how programs to support children and youth align with the six pillars of mitigating the toxic stress physiology (sleep hygiene, healthy nutrition, physical exercise, mindfulness, mental health, and supportive relationships).
Each witness stressed the importance of every child having at least one caring adult in their lives to buffer the effects of toxic stress. Witnesses described how trauma-informed approaches can enhance academic achievement and reduce teacher turnover, rather than burdening teachers with yet another job to do. Among the programs and strategies mentioned to support traumatized children and improve academics and teacher retention are Communities in Schools, Chicago Public School’s “Summer for Change,” Triple P, Mental Health First Aid, Handle with Care, and Quiet Time, among others.
Rep. Schrier (D-WA), the first woman physician (pediatrician) in Congress and one of the record breaking number of Democratic women elected in 2018, mentioned specific treatments—child parent psychotherapy and trauma-focused therapy. Rep. Donna Shalala (D-FL) who is also newly elected and once served as President Clinton’s Secretary of Health and Human Services, spoke forcefully about the impact of immigration policies and practices related to family separation at the border. She called attention to the recent report from the Office of the Inspector General on the mental health response to address trauma of children in HHS custody.
The impact—both short and long-term—of natural disasters were described by Rep. Susan Wild (D-PA) about Hurricane Maria and by Hofmeister about a tornado that devastated the small community of El Reno, Oklahoma. She said tornado drills after the event require adults to hold the hands children at risk of being triggered. The chair of the subcommittee, Gregorio Killili Sablan (D-Northern Mariana Islands) highlighted the impact of Super Typhoon Yutu when students lost their school and, some, their homes.
Both Chairman Sablan and Wild repeated the statement by Dr. Robert Block, former president of the American Academy of Pediatrics, “Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today.”
The most frequent need identified by committee members (in the majority) was for funding of community efforts, including trauma-informed schools, assessment and treatment for individuals with mental health conditions. Some programs have been authorized but not funded such as provisions related to trauma-informed schools in the opioid law (Support for Patients and Communities Act). Some committee members expressed support for programs such as family leave, quality childcare, and affordable healthcare.
Copies of the chairman’s statement and the testimony are attached as well as available on the subcommittee website.