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Life, Death, and PTSD in Oakland

How violence and poverty are traumatizing the city's youth.



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Lisa Blair and Paul Organ, administrators at the E.C. Reems Academy of Technology and Arts in East Oakland, can catalog such violence with alarming ease. Blair, the school's chief executive officer and former principal who has worked there for thirteen years, remembers a time when children might encounter the dead body of a drug addict on the way to school. Now it's more likely, she said, that they know deceased victims of gun violence.

In October, according to the most recent data available, Oakland police sensors recorded 331 gunshots; the area in which E.C. Reems is located had the third highest rate of gunfire reports in the city for that month. By the end of November, there had been 84 homicides in the city since the start of 2013, a decrease from last year's rate, but many victims continue to die in East and West Oakland.

When students arrive at E.C. Reems, a kindergarten to eighth grade school with 250 children, many are sleep deprived, Blair said. They may have lain awake listening to the sound of gunfire and spent the night in the bathtub, their mother or grandmother trying to protect them from stray bullets. The lucky ones get breakfast in the morning, but children often come hungry. School days are commonly punctuated by the sound of sirens or gunfire; some years the grounds are locked down multiple times a month, with children sitting on the floor during class as police pursue a suspect on the street or raid a nearby house. Blair is grateful for quiet this year: The school has only locked down twice.

Organ, a psychiatrist by training who was the former head of the Howard University Middle School of Mathematics and Science in Washington, DC, started as principal at E.C. Reems in September. He watches the faces of his students closely; some days they're smiling and happy, but they often scowl or look vacant. The younger children tend to be more cheerful. "By fifth, sixth, seventh grade," Organ said, "you start getting a flat affect. You ask what's wrong, and the kids start crying. You just open the door a little bit and you get this incredible story about what's going on at home."

One young boy, according to Blair and Organ, knew several friends and family members who were shot to death over the summer. Another had to move in with a relative after a landlord tossed his family out of its apartment in the middle of the night. When he arrived at school, a classmate made a remark about his appearance, and the boy responded by striking him. Some students say that their mothers work as prostitutes, or that their parents are in jail or prison, or that whoever is supposed to care for them has otherwise disappeared.

Organ tries to be more principal than therapist, but he knows that most of his students are caught in the undertow of chronic trauma, which can interfere with normal brain development and derail how the body and mind typically handle stress. Some children become hypersensitive to harmless stimuli while others don't respond to threats that should scare them.

Organ recently watched this unfold when police sirens raced past the school. Some students jumped in their chairs, but some ran toward the window and began trading stories of the shootings they'd witnessed. Incredulous, Organ surveyed the students. "Come on, guys," he said. "Have you ever seen someone shot?" Three of the youngest in the group — second and third graders — raised their hands. It turned out one hadn't watched the shooting in question, but saw a body taken away in an ambulance and heard the details from the victim's sister, who had seen everything.

"It's just so matter of fact," Organ said. "That's part of the PTSD. They're just emotionally detached from what's happened."

Based on his experience as a psychiatrist, Organ said it's possible that more than half of the students at his school have symptoms of PTSD, the question is just severity. The school once had more resources for children diagnosed with post-traumatic stress disorder and other conditions. Several years ago, local clinics got government grants to place therapists at the school a few days a week. Withdrawn or disruptive students, who might stare out the window, regularly speak out in class, or fidget uncontrollably, saw the counselor for an evaluation. Sometimes signs of trauma overlapped with symptoms of attention deficit or hyperactivity disorder.

The school contacted a child's guardian if the therapist made a diagnosis. Most parents or caretakers gave permission for the child to receive therapy in the form of one-on-one sessions or learning techniques for relieving stress. The school used a case management system, pairing social workers and counselors with children and their families. This was key because the parents often needed treatment, or at least someone to confide in.

"Much of the time," said Organ, "the parents have been traumatized by street violence, drugs, prison, and unemployment, and they're not available for the children."

Once the grants ended, most of the intervention efforts stopped. Blair and Organ are fundraising to offer similar services again. In the meantime, Blair refers students to Oakland-based clinics, including one at Children's Hospital, but it can be very difficult to start therapy if there's no Medi-Cal or private insurance to cover the cost.

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