At last night’s candidates forum for the school board candidates, we posed the question of where, if at all, the school district failed in its duties to get help for Daniel Marsh and the rest of the community. While obviously not a venue to solve these problems, we were hoping to at least get the issues on the radar of a school district that all too often seems to avoid such thorny topics.
While the answers were varied and will be covered in a separate article, a few key ideas that emerged were the lack of resources, the fact that we have three school psychologists for a population of 8600 students, and that most school counselors are guidance counselors – much as the one who testified, who was trained to help students academically rather than psychologically.
Following our pointed commentary on Monday, it was suggested that the school system should not be slammed over one kid, who is probably a worst case scenario, when the district on a regular basis deals with students who are in crisis, of whom we will never hear because the district’s work was successful.
That said, we have heard that the problem that we face is not a failure of a system that did not have good people working in it to help students, but rather a case where the district does not have enough people to do that job. The district needs more funding to directly support mental health efforts in the schools and that is something where funding from the state and federal government is completely lacking.
The bottom line: more people working to help these kids could have produced better results. For Daniel Marsh, it seems that people were there. However, they were not communicating the problems between agencies, and also Mr. Marsh himself was less than forthright with the severity and nature of his afflictions – but we have to view that as expected and figure out ways to move beyond that.
One of our readers sent us an article that looks at a program developed in the state of Washington that looks at Adverse Childhood Experiences (ACE) and how they affect the developing brain. The article notes that about a decade ago, the state “embarked on an early social experiment to educate people about the impacts of stress on children.”
There is a growing stream of research investigating how adversity, whether it is trauma or chronic adversity based on stress from a harsh environment, “embarked on an early social experiment to educate people about the impacts of stress on children.”
The article notes, “While most of this research is still fairly theoretical, Washington State is one of the few places where it has been applied, if roughly, on a large scale. About a decade ago, the state embarked on an early, uncontrolled social experiment in disseminating and implementing this set of urgent but still-forming ideas about the mind.”
The article notes that “the single piece of research that has most influenced Washington’s efforts is something called the Adverse Childhood Experiences study, a set of findings published in 1998. The ACE study—as those who cite it religiously refer to it—grew out of research on smoking. In the 1980s, a doctor at the Centers for Disease Control and Prevention named Robert Anda was analyzing why some smokers tended to quit in response to public health messages and why others didn’t. In one study, Anda’s research team found that people with a history of depression were more likely to start smoking, and less likely to stop.”
That finding made Dr. Anda examine whether “researchers were missing other links between emotional and physical health.”
At the same time, another physician and researcher, Vincent Felitti, at Kaiser Permanente found “a similar phenomenon while working on a weight-loss program for obese patients. Many of the patients who dropped out of the program and put weight back on, he found, had a history of sexual abuse.”
The two would team up, to devise an Adverse Childhood Experience survey. The article notes, “If anything, Anda and Felitti expected that respondents would dramatically underreport their histories of childhood trauma. But the results shocked the two doctors. “The information was just mind-boggling,” Anda recalls. Twenty-one percent of respondents said they had experienced sexual abuse; 28 percent had suffered physical abuse; 23 percent had grown up with divorced or separated parents, and 27 percent had lived in a household with an adult who was abusing substances. Respondents were assigned an ACE score from zero to 10, with 10 referring to the most childhood trauma. Barely more than a third had an ACE score of zero. And in most cases, patients had experienced not one but multiple adverse experiences.”
Adding to those findings are two key things. First, the patients “came from a demographic that was not especially at risk for early adversity: Most of them were middle- and upper-class San Diegans, 75 percent white and 93 percent high school graduates.”
The other interesting note was the ACE data’s predictive power. They “were able to correlate patients’ responses to the survey with information about their long-term health. Not surprisingly, they found that childhood trauma casts a long shadow over a person’s happiness: the higher someone’s ACE score, the greater his or her chances of eventually performing poorly in the workplace, taking antidepressants, and committing suicide.”
They add, “But childhood trauma didn’t just affect mental health. As a person’s ACE score increased, so did his or her chances of eventually being diagnosed with cancer, heart disease, liver disease, and emphysema. Sometimes these physical ailments stemmed from the risky behaviors that people with histories of childhood adversity were prone to: injecting drugs, smoking, having sex with many partners. But even absent those bad habits, patients who had been exposed to stress and trauma at an early age were simply far more vulnerable to disease.”
It is a fascinating line of research but, in the case of Daniel Marsh, it might guide us to understand the interaction between traumatic childhood events and depression. It might not get us to criminal insanity, but it gives us a better understanding of what may have happened, how we might prevent it in the future, and why some people are able to overcome adversity, but not others.
It is also important to understand the linkage between mental illness and violence. While mental illness increases the likelihood of violence, it does not mean that mentally ill people are necessarily violent.
Dr. Jeffrey Swanson, a professor in psychiatry and behavioral sciences at the Duke University School of Medicine, is one of the leading researchers on mental health and violence.
In a recent interview with ProPublica, he was responding to the issue of mass shooters and he noted, “The risk factors for a mass shooting are shared by a lot of people who aren’t going to do it. If you paint the picture of a young, isolated, delusional young man ― that probably describes thousands of other young men.”
This is an important point as it pertains to Daniel Marsh, because, while Daniel Marsh had warning signs, his warning sides were probably not atypical of many students who would not turn into killers.
Dr. Swanson notes, “People with serious mental illness are 3 to 4 times more likely to be violent than those who aren’t. But the vast majority of people with mental illness are not violent and never will be.” Therefore, he argues, “Most violence in society is caused by other things.”
At the same time, he warns us, “We need to think of violence itself as a communicable disease. We have kids growing up exposed to terrible trauma. We did a study some years ago, looking at [violence risk] among people with serious mental illness. The three risk factors we found were most important: first, a history of violent victimization early in life, second, substance abuse, and the third is exposure to violence in the environment around you. People who had none of those risk factors ― even with bipolar disorder and schizophrenia ― had very low rates of violent behavior.”
He adds, “Abuse, violence in the environment around you ― those are the kinds of things you’re not going to solve by having someone take a mood stabilizer.”
Clearly, we have a long way to go to even understand these factors, but as we move forward we need a school system that works with our mental health system and that has the resources to be able to identify kids at risk – not just for violence, but also for more run-of-the-mill responses to trauma and mental illness.
—David M. Greenwald reporting