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Life, Death, and PTSD in Oakland

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



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Blair and Organ know that this phenomenon isn't something an after-school program or better teachers can fix. The curse of poverty and violence must somehow lift, and until that happens these children need to learn what trauma is, how to recover from it, and when it inevitably strikes again, how to tame the symptoms that ruin their ability to focus, learn, and thrive.

If E.C. Reems were not a charter school, it could access mental health services through the Oakland Unified School District, which doesn't extend those same resources to local charters. Of the city's 49,000 students, more than a quarter attend a charter school.

Several years ago, the district adopted a more holistic approach to dealing with troubled students by staffing schools with a mental health counselor. This year, for the first time, every Oakland school offers mental health services. The district also runs a crisis-response team that identifies children who witness or experience moments of brutality, including the death of a friend or a shooting on school grounds.

The goal is to reach traumatized children within 48 hours of an incident to help them deal with feelings of fear and anxiety, which too often disrupt a student's education.

"Kids can fall through the cracks if they're not reached in time," said Barbara McClung, director of the district's behavioral health initiatives.

Using federal Medicaid money, Alameda County spends about $19 million annually to provide physical and mental health services in Oakland schools. That amount, according to Alameda County data, has increased significantly since 2000, but leveled off in recent years in part due to reduced state revenue. Each school-based therapist has a waiting list.

McClung described the district's intervention model as a "trauma-informed practice," an approach that views behavior and discipline through the lens of how the child might have suffered. This empathy doesn't lead to absolution, but instead values healing, relationships, and responsibility.

The district doesn't know how many of its students have PTSD, but survey data hints at how community violence burrows its way into the lives of children. The annual California Healthy Kids Survey asks students how many have lost a loved one due to violence. In some schools in Oakland, McClung said, more than 50 percent of respondents answer yes.

One therapist at the East Bay Agency for Children treated a client with PTSD who kept repeating a scene in which the main character always got attacked and chopped into pieces. Over time, the child imagined someone coming to the victim's aid, a new ending that helped him gain a sense of control and feel less alone.

The agency's therapists also use cognitive behavioral therapy, which is designed to give patients practical tools, like a safety plan, to defuse anxiety. So if there's gunfire at night or mom and dad start fighting, the child might hold her dog close and practice slow breathing to feel safer.

McClung knows that the lessons of a brief therapy session might help a child in school, but feel less immediate when the patient returns to the same violent block or fractured home. "We're teaching meditation," McClung said, "but that's not necessarily going to work in the neighborhood."

For its part, the district is trying to transform schools with a new set of common expectations. This means showing teachers what trauma looks like and convincing them that not every classroom outburst or minor aggression is a thoughtless affront to their authority. After all, said McClung, punishing a traumatized student is a dangerous form of exclusion; research shows that suspension and expulsion is associated with higher dropout rates and increased chances of a student being involved in crime.

"We have to do everything we can to hold onto them," she said. "They need second chances."

This reflects an emerging national ethos. Increasingly, said Karol V. Mason of the US Department of Justice, it's become clear that poor performance in school, disciplinary problems, and entering the juvenile justice system share a common denominator: "At the core of that, you can generally find some form of trauma."

That compassion guides the district's restorative justice program. Depending on the severity of the offense, it brings together a victim, perpetrator, family, and community members in a controlled setting to discuss what happened and find some form of healing.

"This is a highly traumatized population," said David Yusem, who runs the program. When, for example, a student is asked what led him to steal from a classmate, he might respond defensively. Some students in Oakand refer to slippin' — as in, if you left your computer out and someone took it, that's your fault, you were slippin'.

But eventually the thief might reveal a brother's incarceration or a father's murder, not as a defense but as context for his actions. These confessions, said Yusem, are a reminder of how acute trauma, layered over chronic experiences like poverty and incarceration, can lead to feelings of paranoia and desperation, making it difficult for a child to learn.

There is no therapy involved in restorative justice, but it helps a young person tell the truth about wronging someone else and be held accountable. This can have a profound lifelong effect as research shows that people exposed to violence are at higher risk for becoming criminals themselves. Yusem sums up that devastating cycle simply: "Harmed people harm people."

Hayden (not her real name) sits in an oversize living room chair in her mother's modest East Oakland apartment. The nineteen-year-old is one of countless children who fell through the cracks. After she expressed concerns about using her name publicly, the Express agreed to identify her with a pseudonym.

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