Addressing Adverse Childhood Experiences: How SBHCs Can Turn Trauma Around

Leisa Irwin at the 2015 opening plenary in Austin, Texas.

The 2015 National School-Based Health Care Convention started off with an inspiring discussion about how trauma-informed care can change lives—and how school-based health centers (SBHCs) can lead that change.

Adverse childhood experiences (ACE) plague children and adolescents throughout the country and can lead to negative, long-term consequences for their academic success and medical wellbeing. New—and startling—data from the twenty-year ACE study demonstrate the effects of toxic stress on students. The study shows a stunning link between childhood toxic stress and the chronic diseases people develop as adults. (Click here to access the study.)

Leisa Irwin, Executive Director of Paladin Career and Technical High School in Minnesota, shared concrete, real-life experiences in dealing with ACE at her school.

In 2009, after the economic downturn, Paladin experienced a big shift in demographics. Suddenly, the school was dealing with a large number of free or reduced lunch students. The students’ issues seemed insurmountable: poverty, homelessness, drug abuse, hunger.

“I came to this job from the business sector and I didn’t know what to expect. Our students are facing these monumental problems. How did I not know? Why are we not talking about this on a national level?” – Leisa Irwin

Twenty-five percent of Paladin’s students experienced homelessness, and Irwin knew her team had to tackle this first. Irwin explained, “If you don’t know where you are going to sleep or what your next meal is, you won’t be able to focus in school.” The school worked to build strong ties with churches and hotels to find beds for students. A neighboring county even set up homestays for some students.

Still, drug abuse was prevalent and academics were a challenge. After helping to stabilize students’ housing, Irwin began to look more closely at the issues her students faced to determine what were symptoms and what were causes. Her research led her to Jane Stevens and her work on ACE. By understanding ACE, Irwin was able to comprehend how traumatic life experiences were affecting her students.

“In eighth grade, I became an alcoholic. By ninth grade, I was smoking weed. By tenth grade, I was addicted to meth.” – Paladin Student

If any of this sounds familiar to your school, Irwin encourages you to consider giving the ACE exam. Adolescents who score a four or higher have a 20-year lower life expectancy than those who score zero. Those with a score of four or higher also face increased likelihood of chronic depression, alcoholism, and perpetuating violence.

Here’s the good news, said Irwin: “DNA isn’t destiny. By building resilience, students can reverse trauma.” That’s what Paladin and trauma-informed care has attempted to achieve. As Irwin summarized, “It’s important that our kids find hope.” Paladin High School students found that hope when given the power to make decisions. They developed trust with the school and overcame disciplinary challenges.

Trauma-informed care is gaining traction all over the country, and we encourage your SBHC to get involved. For another example of its success, read this Huffington Post article about how suspension rates at a Washington School dropped 85 percent. Additional information about ACE can be found here.


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