Tagged: Mental Health

Updates from Under the Gold Dome

As of March 16, 2021:

The 2021 legislative session has officially entered its fifth week. There have been over 450 bills introduced with another 200-300 likely to be introduced before session ends this summer. Governor Polis and legislative leadership released the Colorado Recovery Plan, a $700 million package of stimulus funding for roads and bridges, small business support, revitalizing main streets, workforce development, broadband infrastructure, community supports, wildfire recovery and more. Key provisions include $5-$10 million for childcare capacity expansion, $8-$9 million for mental health screenings in schools, and $1-$2 million for the mental health hotline. 

LEGISLATION OF INTEREST

We have identified a list of child-focused policies that are of interest to the Kempe Foundation and are being considered by the Colorado Legislature this session. Below is an update on the status of these policy priorities:

HB 1099: Policies and Procedures to Identify Domestic Abuse.  Each year, approximately fifteen million children nationwide are exposed to domestic abuse and child abuse, which are often linked. In Colorado, nearly forty percent of child fatality cases reviewed by the child welfare fatality review team between 2014 and 2019 found domestic abuse to be a stressor. Due to the episodic nature of domestic abuse behaviors, it is challenging for child welfare caseworkers and others to connect domestic abuse to the harmful emotional and developmental impact on a child. Under current law, child welfare caseworkers do not have established training policies or assessment procedures to identify and assess situations when a child’s parent, legal guardian, or custodian exposes a child to their perpetration of domestic abuse. HB 1099 requires the department of human services to promulgate rules to implement assessment policies, procedures, and training for child welfare caseworkers to recognize and assess situations when a child’s parent, legal guardian, or custodian exposes a child to their perpetration of domestic abuse. The bill passed the House Public and Behavioral Health and Human Services Committee and is waiting to be heard in the House Appropriations Committee.

HB 1097: Establish Behavioral Health Administration (BHA) addresses multiple recommendations from the Colorado Behavioral Health Task Force (Task Force), created in 2019, related to the creation of a Behavioral Health Administration (BHA). The findings and recommendations of the Task Force indicate it is imperative to develop and implement an improved behavioral health system in Colorado. The BHA would be a single state agency to lead, promote, and administer the state’s behavioral health priorities. The bill requires the Department of Human Services (Department) to submit a plan for the creation and establishment of the BHA on or before November 1, 2021 to the Joint Budget Committee, and on or before January 30, 2022 to the Department’s committees of reference. The BHA under HB 1097 would prioritize all aspects of health, including wellness, and early interventions and supports that help people stay successfully and meaningfully connected to the community where they live, work, and play. There have been a handful of amendments clarifying the roles and responsibilities of the Department of Healthcare Policy and Financing and how they will navigate Medicaid and early diagnostic treatment for children. The bill passed the House Floor and is waiting to be heard in the Senate Health and Human Services Committee.

Marijuana. The Colorado Department of Public Health and Environment released a report in July 2020 that found a connection between high potency THC products and negative mental health outcomes. The developing brain is more vulnerable to the effects of THC, increasing the risk of addiction and other harm. As an organization dedicated to the safety and health of children, Kempe supports policies that address the growing risk of high potency THC products. Use of high potency products is also correlated with negative mental health outcomes such as anxiety, depression, and increased instances of psychosis and marijuana is the #1 substance found in youths age 15-19 who died by suicide. In response to these findings, Smart Colorado and Blue Rising are collaborating on a comprehensive bill to put in place stricter limitations on both the medical and recreational marijuana industry. The bill by Representative Caraveo and Senator Lundeen has not been introduced yet, but Kempe does support bringing it forward. The proponents and industry have been engaged in negotiations convened by Speaker Garnett to see if a path forward can be found on the forthcoming legislation.

FY 2021-2022 Budget. The Kempe Foundation successfully secured restoration of the $300,000 cut for the CARENetwork compensation that occurred last year. The JBC also approved the full request for the Child Welfare Training System ($6,797,102 Total Funds) with the Division of Child Welfare and the full funding for SafeCare in the Office of Early Childhood.

GOING FORWARD/NEED TO KNOW INFO AND EVENTS:

The Joint Budget Committee has finished its initial figure setting and on March 19th received the March Revenue Forecast from Legislative Council Staff (LCS) and the Governor’s Office of State Planning and Budgeting (OSPB). Bottom line is the state revenues are in a much better place than this time last year. Both forecasts revised their General Fund revenue projections upward. OSPB increased their revenue projections for FY2020-21 up $425 million and up $390.6 million for FY201-22 compared to the December forecast meaning if the General Assembly held all appropriations constant to FY2020-21 levels, the legislature would have $5.29 billion more to spend or save in FY2021-22. The JBC is finalized the budget and plans to introduce the budget on April 5th.

The Kempe Foundation is committed to advancing child-focused policies. We will continue to provide important policy updates throughout the 2021 Legislative Session. To receive Kempe Advocacy Updates via email, please sign up here.

 

Housing Instability and Childhood Trauma

Across the State of Colorado, there are over 23,000 children and youth experiencing homelessness, according to a 2017-2018 report by the Colorado Department of Education. Although we often think homelessness means people living on the street, that is only true for less than one-fifth of people experiencing homelessness. Most children and youth without a stable, safe place to live transition among different settings, including short-stay motels, doubling-up with friends or family members, sleeping in cars, or in transitional housing or shelters.

The experience of homelessness puts children and their families in situations where they are at greater risk of additional traumatic encounters such as assault, witnessing violence, child abuse, food insecurity and substance abuse. Children in particular are most impacted by the traumatic effects of experiencing homelessness, as these adverse conditions often result in development delays, mental health issues and chronic health conditions.

The National Child Traumatic Stress Network examines the ways that children bear the brunt of homelessness, noting that they are sick at twice the rate of other children and go hungry twice as often as children not experiencing homelessness. Additionally, half of school-age children experiencing homelessness face anxiety, depression or withdrawal. Even more unsettling is the fact that by the time children experiencing homelessness are eight years old, one in three has a major mental disorder.

One Colorado organization working to address the interrelated nature of housing instability and other forms of trauma is Family Tree, a nonprofit human services agency providing innovative, life-changing services designed to end child abuse, domestic violence, and homelessness.

“Experiencing homelessness is particularly disruptive to a child’s education because they are constantly dealing with stigmatization and the stress of not knowing where they’re going to sleep or when their next meal might be,” said Scott Shields, CEO of Family Tree. “When families experiencing homelessness come to us for help, we connect them to programs that offer more than just housing assistance so that the children are provided with the critical resources needed to address their trauma and avoid repeating cycles of poverty across generations.”

An example of this is Family Tree’s Homelessness Program, which provides housing navigation and placement services, comprehensive case management, education and employment services, along with connections to various resources to assist those experiencing homelessness or those at-risk of homelessness.

Additionally, Family Tree’s House of Hope is dedicated to providing safe shelter and supportive services for women with children experiencing homelessness. These families, overwhelmed with the daily struggle of where to stay the night and find their next meal, find a safe place to stay while they begin to get back on their feet.

Another program we’ve been following is Family Tree’s GOALS Program, a Two-Generation (2Gen) housing program for families experiencing homelessness from Aurora and Arapahoe County. While this program is relatively new, it is designed to help stabilize families experiencing homelessness, empowering them to move from poverty and homelessness by focusing on services and opportunities that address the needs of all family members.

“With the GOALS program, we’re focused on empowering families experiencing crisis and trauma to improve their lives and achieve economic independence through proven, integrated services,” continued Shields. “The most important thing we can do is help these families overcome barriers and better position their children for future success.”

To learn more about Family Tree and their work to transform our community through innovative and integrated services, visit www.thefamilytree.org.

 

 

Child Maltreatment and Trauma: Treating the Whole Family

Over the past three months, we’ve been exploring the topic of childhood trauma and its impact on mental health. Child maltreatment is the most common cause of trauma for youth and commonly the adult perpetrators, who were also subject to maltreatment in their youth. The perpetrator’s experience is then transmitted to their family. Trauma may also be the result of other events. Trauma is the reaction to frightening, often life-threatening, and violent experiences and while our focus is on child maltreatment, a traumatizing event may be experienced by any or all members of a family and then may lead to maltreatment, disruption of relationships and impede family functioning. Regardless of the trauma type, every trauma is a family trauma.

The National Child Traumatic Stress Network notes that all families experience trauma differently, and some factors such as a child’s age or the family’s culture or ethnicity may influence how the family copes and recovers from a traumatic event. Trauma changes families as they work to survive and adapt to their circumstances and environment. While this adjustment may be less difficult for some, for others the stress and burden cause them to feel isolated, overwhelmed, and less able to maintain vital family functions.

At Kempe, we believe that every family who has faced trauma deserves access to treatment so that they may heal and recover together. That’s why the Kempe Center’s IMHOFF Clinic takes a whole family approach and provides services for children, as well as their parents, caregivers and siblings who may also be dealing with symptoms related to stress, trauma and adversity.

We recently connected with Dr. Steven Berkowitz, a visiting professor at the University of Colorado Anschutz Medical Campus who is working in collaboration with Kempe to grow the IMHOFF Clinic’s whole family care approach.

Why is a family-focused approach a more effective way to address trauma?

Very often, children who experience trauma have parents or caregivers who were also traumatized in their youth and never received treatment to address the emotional, cognitive and behavioral consequences. Because trauma can be transmitted across generations, we see these children experience the same things that happened to their parents and caregivers. As a treatment provider, it is important to assess everyone in the family to identify any significant issues or psychological symptoms that may be related to an intergenerational history of trauma. In order for the child to successfully recover from their own traumatic experiences, we must take a whole family perspective and treat everyone in the family unit.

What is unique about your work at the IMHOFF Clinic?

We are building the IMHOFF Clinic into a family-focused clinic that provides services for children, youth and adults dealing with symptoms related to stress, trauma and adversity. Our multidisciplinary treatment team works together with children and their families in a much more integrated way. In the past, if we saw a parent or caregiver struggling alongside their child, we would have to refer them to another treatment provider in a completely different location. Here, the treatment is in one place and we offer a range of individualized therapies and pharmacology to any family members who need it.

What are you hoping to achieve at the IMHOFF Clinic?

This group is on the forefront of providing the most comprehensive and evidence-based assessments and treatments that focus on stress and trauma throughout the lifespan. We are working to develop a model program that helps to unify the various departments of the University of Colorado, School of Medicine and Children’s Hospital Colorado in order to better serve the families that come to Kempe for help. We’d also like to develop an effective home-based program for children and families so that treatment can happen in the least restrictive, most normative setting possible, with the goal being to help families live and function successfully at home.

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De-Bunking the Myths of Mental Health

Over 200,000 children and adolescents in Colorado have diagnosable and treatable mental health conditions. Alarmingly, less than one quarter of these children and adolescents receive any type of professional care. Only in recent times are social services and community resources focusing on the prevention of toxic stress, its impacts on mental health, and the promotion of healthy social and emotional development.

On February 7, 2019, we convened a group of pediatric and mental health experts to help educate our supporters and partners on mental health issues facing Colorado’s children and their families. Here, we de-bunk the four most common myths of mental health and share what we learned from this important discussion:

Myth #1: Behavioral health and mental health are the same thing.

Although the terms are often used interchangeably, to do so is incorrect. Mental health focuses on a person’s psychological state, whereas behavioral health is a broader term that includes mental health. Behavioral health looks at how behaviors impact an individual’s physical health and well-being, but does not necessarily address all of the external, environmental factors that may influence an individual’s well-being, such as poverty, discrimination or abuse.

The negative stigma that surrounds mental health has pushed many healthcare and education professionals to reference behavioral health when talking to individuals and families because it’s an easier entry point into a discussion about mental health. Ultimately, the most important thing is to engage people in conversation and identify the appropriate treatment, regardless of how the topic is presented.

Myth #2: Mental health issues are hereditary.

Some psychiatric diagnoses, like schizophrenia, bipolar disorder, depression and ADHD, are likely to be hereditary, meaning they are caused by a gene mutation that is inherited from a parent. But other mental health issues are likely a combination of genetics and lifestyle, which means that certain genes may increase your risk of developing a mental illness, and environmental factors may trigger it.

The vast majority of children and youth in mental health treatment programs have histories of maltreatment, traumatic exposure and chronic stress or adversity. These adverse childhood experiences (ACEs) can damage the developing brain and lead to problems in learning and behavior, as well as increased susceptibility to physical and mental illness. So, although hereditary and genetic factors can influence mental health, our environments, relationships and external supports are significantly more impactful.

Myth #3: If you have a mental illness as a child, it’s something you must live with for the rest of your life.

There has been significant progress in developing trauma-informed and evidence-based treatment programs that can shift negative trajectories and improve outcomes for children. Here locally, Children’s Hospital Colorado is home to a wide array of outpatient, day treatment and inpatient services that provide a coordinated, multidisciplinary approach to evaluation and treatment for children and adolescents ages 5 to 17.

While medical professionals can effectively treat most children, it is more challenging to address the environmental factors that trigger mental health issues in children. There has been a movement toward mental health treatment providers working collaboratively with patients and their families to identify the underlying triggers and help them through crises together. When everyone in the family is provided with the resources and skills to help a child get better, the positive outcomes are considerably more sustainable.

Myth #4: When a child acts out, it is clearly a behavioral health issue.

Dr. C. Henry Kempe often remarked that if you do not understand someone’s behavior, you do not understand their history. When someone acts out violently or aggressively, it is likely because they have experienced a traumatic event or series of events. Breaking the stigma of mental health requires us to look at the issue through a different lens – one that considers an individual’s history and recognizes the myriad of factors contributing to their current well-being. As a community, we can help build up children’s resilience and promote healthy behaviors by ensuring they have supportive relationships and positive environments that nurture their growth and development.


The mental health crisis is one of many threats to the healthy development of Colorado’s children. Over the next few months, Kempe will continue to bring together community partners to help shine a light on these connections and how we can partner as a community to end the cycle of abuse and positively impact child development. We appreciate your support of our efforts to give all children the opportunity to thrive.

 

 

Evidence-Based and Family-Focused Mental Health Care in Colorado

Trauma is a costly public health problem for all Coloradans. Most often, trauma occurs as a result of physical, sexual or emotional abuse, neglect, violence, disaster and other emotionally harmful experiences. Traumatic events induce feelings of powerlessness, fear, hopelessness and a constant state of alert, as well as feelings of shame, guilt, rage and isolation.

Without treatment, children who experience repeated exposure to traumatic events have an increased risk of developing mental and substance use disorders, suicide and chronic physical ailments. They are also more likely to experience increased involvement with the child welfare and juvenile justice systems, and may even face premature death.

We recently connected with Shannon Van Deman, PhD, who leads the Pediatric Mental Health Institute at Children’s Hospital Colorado and asked her to share more about how they are addressing childhood trauma.

 

What is the role of the Pediatric Mental Health Institute?

At Children’s Hospital Colorado, we have a fundamental responsibility to provide mental health care for our patients. Our services are child-centered and family-focused, meaning we work collaboratively with our patients and their families to help them through crises and empower them to develop the resources and skills to get better.

The Pediatric Mental Health Institute is one of the largest providers in the Rocky Mountain region that offers a full continuum of psychiatric care and provide a broad spectrum of psychiatric services, including outpatient, day treatment and inpatient services for children and adolescents. I’m particularly proud of our Medical Day Treatment program, which is a joint venture with Aurora Public Schools. It’s an accredited school program that employs two certified teachers along with two paraprofessionals from the Aurora Public School system. The program is also staffed with nurses, a psychologist, social worker and other medical professionals who work together with youth and families to reach academic goals and improve physical and emotional health.

What do you want Coloradans to know about trauma?

Today in Colorado, suicide is the leading cause of death for children ages 10 to 24, and an estimated one out of six teens has a diagnosable mental health condition. At Children’s, we’ve seen the need for psychiatric treatment go up year over year, and we’ve tripled the number of outpatient services in the last five years. Prevention, early identification, early intervention and treatment are needed now more than ever, and we’ve been working alongside Kempe to ensure Colorado’s health care providers are educated on the complexities of trauma and how it impacts their delivery.

How can we positively shape the mental health of Colorado children?

It is completely normal for children and adolescents to have difficulty managing their thoughts and feelings, but some aspects of our culture have told us we need to face these challenges alone. My hope is that through our work, we will help families engage in more conversations that break the stigma of mental health. It’s incredibly valuable for individuals and families with this lived experience to talk about their challenges and tell their story to others going through the same things. It’s also very important for Coloradans to advocate for child-focused legislation because public policy decisions can dramatically shape the health of children, for better or worse. I encourage anyone who wants to learn more about advocacy for child health to sign up as a Child Health Champion.