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Superintendent of Schools and Local Leaders Implementing ACEs Science as a Response to Drug Epidemic

 

Becky Haas and Smyth County  District Superintendent, Dr. Dennis Carter

(This article shows how an entire school district is working to become trauma sensitive.  Often, a single school’s work is reported for advancing trauma sensitive practices, but this effort is unique because it is district-wide.  One of the key drivers to bringing change is School Superintendent, Dr. Dennis Carter.  Beyond encouraging his school district to becoming trauma-sensitive, he also plays a leadership role in strengthening community collaboration to address ACEs.  This article is co-authored by Dr. Dennis Carter, Superintendent of Smyth County, Virginia Schools and Becky Haas, a national trauma informed care author/speaker/trainer, who has had the joy of working with Dr. Carter, his team and the district in their journey toward building greater resiliency. Haas interviewed Carter. )

Smyth County is a rural community located in beautiful Southwest Virginia with a population of approximately 30,500 citizens and an expansive 452 square miles of lush mountain land, pastures, three meandering rivers, and mountains in every direction.  It is an area of beauty, pride, family, and community; however, it is not immune to the problems that face every state within our great nation.   Methamphetamine use and opioid abuse have driven the regional jail costs beyond reason and affordability.  Incarceration costs in 2010 were $675,000 ballooning to $2.9 million in 2019.  From a budgetary standpoint, by spending $2.9 million on jail costs, those are funds that could otherwise be allocated to the education of children, support community services, or for additional resources needed for Smyth County.  Smyth County Sheriff Chip Shuler states, “It would be my hope to see less funds going toward incarceration and used for education instead.  I believe that many of our inmates are the result of traumatic experiences in their lives that have gone undiagnosed and untreated.”

In 2018, Smyth County Community Hospital conducted a Needs Assessment which illustrated barriers, challenges and opportunities for health outcomes.  This assessment indicated that in most of the areas considered, statistics were among the highest within the region.  However, the most astonishing were the Neonatal Abstinence Syndrome (NAS) 2016 birth rates (per 1,000 births).  Virginia statewide tallied 6.7, while Southwest Virginia was 15.4; however, Smyth County was an astonishing 37.8.  This was alarming and provided us a call to action.  Now recognizing we have a staggering number of children being born addicted, school leadership began to wonder in what way could we address this issue?  Through a root-cause analysis, it became evident we had to strengthen the children and our families within our school district in order to heal our community.  We needed to address the cause instead of addressing the outcome.  Strong families help to build strong children, and strong children grow up and build strong communities.     

Haas: Prior to learning about ACEs, how did you, as superintendent, see these challenges impacting students and their families?

Carter: The challenges in public education have increased in recent years.  Behavioral concerns with children entering school for the first time have increased dramatically.  As a school system, we continue to work with the behaviors throughout the primary years and, in most cases, we see the behavior improve.  This effort involves intense interventions such as therapeutic day treatment, wrap around services provided by a local partnership with Mount Rogers Community Services, intensive counseling, parental involvement and collaboration.  In addition, all of our pre-kindergarten, kindergarten, and first grade teachers have been certified in Mental Health First Aid. 

How did you learn about the Adverse Childhood Experiences (ACEs) Study and ACEs science?

We were first introduced to Adverse Childhood Experiences (ACEs) during a professional development with our administrative and instructional staff in 2017 with John Richardson Lauve, from ChildSavers.  During this training, he discussed childhood trauma and the impact of ACEs.  In February 2018 he followed up with a community-wide educational event on the impact of childhood trauma and ACEs.  Over 200 community members attended the event.  This included educators, law enforcement, community services boards, social services, medical providers, and parents.  Additionally, ACEs were addressed during the Needs Assessment and root-cause analysis conducted by Smyth County Community Hospital in 2018.  We then continued the conversation, professional development, and passion for addressing childhood trauma and helping to build resilience within our schools and community with your support.   

As Superintendent, why did you think ACEs science was a "must" for moving forward and how did you begin to implement this district wide?

After being introduced to the Adverse Childhood Experiences Study, our core team — which is made up of Mrs. Kim Sturgill, Director of Pupil Personnel Services, Mrs. Patty Warren, Federal Programs Director and myself — researched to learn more about ACEs science.  Our research provided us with clarity on multiple issues within our school system. Many of the childhood behaviors could be linked back to children with parents who have high ACE scores, or children who are experiencing ongoing childhood adversity themselves.  We could see that the opioid and methamphetamine challenges faced by our community were impacting many of our families as a whole and not just the ones with  addiction.  The problems are varied and complex, but as spokes on a bicycle wheel pull to a center, we saw the issues we were discussing all tied back to a center concept of ACEs science.  

The message John Richardson Lauve provided during his community event enlightened us to the reality of how trauma impacts the children we serve.  The message resonated with every community stakeholder in attendance.  After John’s meeting, a call to action was issued.   We had to take action to reverse these alarming trends and ACEs science now provided us an “upstream” approach to addressing them.  Escalating operational costs for the local jails, families being destroyed by substance abuse, difficult student behavior and NAS percentages had to change!  At this juncture we became affiliated with the Trauma Informed Community Network (TICN) and their work being done around ACEs at the state level.   

In 2019, the Smyth County Schools leadership team began working with Becky Haas, who was then the trauma-informed administrator for the regional healthcare system.  She began to provide additional professional development centered around understanding trauma, building resilience, as well as strategies for educators to deal with children who exhibit difficult behaviors.  She provided two separate training days followed by ongoing support as needed for our administrators and our entire instructional staff.  In 2020, Becky Haas had moved from healthcare to providing trauma-informed care training on a national level and we reached out to her again as a consultant to provide training for all of our bus drivers, administrative assistants, and school nutrition staff.  This training was held virtually due to limitations for in-person events around COVID-19. 

Why do you think not only school district staff but community partners also need to understand about ACEs science?

As we continued our journey to become trauma-sensitive schools district-wide, we realized that, while this is a family issue, it is also a community issue.  To heal the family, we must include the community.  We then enlisted your help again, and you provided the Substance Abuse Mental Health Service Administration’s (SAMHSA) Trauma Informed Approach, Key Principles and Assumptions training for all agencies within Smyth County.  In 2019 we held an event at the Lincoln Theatre, in downtown Marion, VA.  Attendees included judges, court service units, child protective services, medical providers, counselors, businesses, municipality representatives, parents, faith-based organizations, and community members.  The response was tremendous.  Everyone who attended was moved and motivated to make a difference, and begin building a focus on resilience.  

Smyth County, as a small community, is full of pride, a sense of community, strong work ethic, and a passion for helping one another to succeed in life.  Following the partner training, agencies started to find ways to collaborate to address issues.  For example, our Resource Officers, through the Smyth County Sheriff’s Office and Town of Saltville Police Department, developed the L.E.N.S. Program.  L.E.N.S. is an acronym for Law Enforcement Notifying Schools.  If a member of law enforcement is called out to a home for any reason, the School Resource Department Captain is notified.  He then communicates that there was an officer visit with Kim Sturgill, Smyth County Schools Pupil Personnel Director.  The reason for the officer visit to the home is never disclosed and Ms. Sturgill then notifies the principal of the school where the child attends.  This notification alerts the principal to check on the student the next day, provide some additional love, patience, and understanding, but most importantly, be there if the child needs empathetic support.  If the student is not at school the next day, a wellness check visit on the child will occur if contact cannot be made.  This is just one example of how community agencies are now working together to provide support for children and families.     

What are some of the ways that Smyth County Schools are becoming trauma sensitive district wide?

Following the training that Haas provided, each school was asked to identify a method to help build resiliency within their schools.  As Superintendent, I am extremely proud of the programs each school chose to implement. Each strategy was dynamic, unique, and tailored to fit the school climate and culture.  Collectively, we have learned it takes a fundamental and foundational relationship with school staff in order for students to begin to overcome trauma they have experienced in their life.  Many of our elementary schools have developed sensory rooms, as well as calming rooms and safe spaces.  Sensory paths and hallways are now utilized in every elementary school in Smyth County.

Saltville(Picture of Saltville Elementary School’s calming room)

Sensory

(Picture of sensory hallway at Chilhowie Elementary School)

In several schools, administrators asked all faculty members to identify two students to connect with on a deeper level.  This includes getting to know the student and their family, their likes, dislikes, eating lunch with the student, and taking an occasional outing like going fishing or to a ball game. The goal of this is to strengthen relationships and provide students with a nurturing, caring adult at school they can connect with.  We have realized that a relationship that will last will make a difference in the life of the student and can mitigate the effects of ACEs.  While students are benefiting from this effort, we also see our staff are benefiting too.  When I discuss the program with school staff, the discussion is always child-centered and pride resonates through their words regarding the child they are mentoring.  Frequent teacher updates include growth the child has exhibited, how the child is now willing to speak up in class, regularly turning in work, becoming more active in the school community, and many other successes.  To hear our teachers talking reminds me of the pride a parent has when talking about their child.   That feeling does not go away, that relationship does not end and these efforts WILL make a difference in that child’s life.   

Suds

(Picture of Chilhowie High School’s efforts with hygiene products)

clothes

(Picture of Chilhowie High School’s clothes closet)

Another program being implemented in our journey to become a trauma-sensitive district was launched at Chilhowie High School.  Student leadership established a clothes closet for students to pick up garments if they were in need of clothing, free of charge.  They also established a free laundry service for students. Free hygiene products are also provided to any student who needs them.  This effort is completely student driven.  The clothes and hygiene products are obtained by student leaders through donations.  The school purchased a washer and dryer for the laundry service and student leaders daily provide this service for students who need it. 

laundry

(Picture of Chilhowie High School’s student led laundry service)

In the fall of 2020, tele-med and tele-mental health services were made available to students and staff.  Smyth County Schools has partnered with Mount Rogers Health District and local pediatricians to establish mental health services now offered within their medical practices.  This cutting-edge approach allows a soft hand-off as physicians identify issues that may be associated with mental health concerns.  The single visit to the physician’s office helps to facilitate communication between agencies and ease the burden of appointment scheduling for patients and eliminates barriers to accessing mental health services due to lack of transportation because they are located within the physician’s office.  Additionally, processes are now being developed for pediatricians to conduct ACE evaluations as a part of the child’s pre-school health physicals.  The intent of this is not to convey individual results to the schools, but rather to make schools aware of students who may have difficulty transitioning to the public-school setting.  As a school system, our intent is to use this information to provide the child with additional support and wrap around services prior to their first day of school in order to help them find success beginning with the first day. 

As you can imagine, as superintendent, the sense of pride I have for our students, staff, and entire school community who collectively are committed to reducing the effects of childhood trauma is beyond anything I can verbalize.    

Where do you go from here?

Moving forward, Smyth County Schools are collaborating with area stakeholders on other regional programming in order to build community resilience.    

The development of the Appalachian Center for Hope

This effort is led by numerous community agencies to provide residential and day support for women who are pregnant or are parenting and have been incarcerated due to substance abuse or are in recovery.  This program, when fully opened, will offer intense therapy, job skill training, education, internships and assistance with job placement through day and residential treatment.  The goal is to help women find the support they need, through transitional housing, to be successful in re-entry back into the community.  At present, a building has been identified and we are working with state legislators to help secure funding.

Accountable Care Community

The accountable care effort is led in partnership with the regional healthcare system, United Way of Southwest Virginia, and Healthy Kingsport.  This ACC is the first of its kind to unite across state lines covering both Southwest Virginia and East Tennessee.  The four focus areas are Substance Abuse, Tobacco Use, Obesity, and Childhood Trauma and Resilience.

Rural Summit on Childhood Success

This symposium was held in the spring of 2019 and focused on raising awareness to the role ACEs play as a social determinant to health as well as the significance of building resilience within our children. 

RCORP and HRSA

Smyth County Schools is also a partner with the Rural Committee Opioid Response Program and the Smyth County Community Hospital Health Resources and Services Administration Committee.  Both of these efforts are focused on substance abuse and improving health outcomes for our community.  

Attachments

Images (5)
  • Saltville: (Picture of Saltville Elementary School’s calming room)
  • Suds: (Picture of Chilhowie High School’s efforts with hygiene products)
  • clothes: (Picture of Chilhowie High School’s clothes closet)
  • laundry: (Picture of Chilhowie High School’s student led laundry service)
  • Sensory

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