— We owe it to them to create systems that link the medical, mental health, and school community with families to provide additional shelter from the storm.
A bright, young student sits across from me in the office with dark clouds in and under her eyes—describing symptoms of hives, chest pain, and the shortness of breath she felt over the previous week—leading her guardian to take her first to the local hospital emergency room and then to her family doctor, who subsequently diagnosed and prescribed medication for anxiety.
My first question is to ask what she knows about anxiety. Shaking her head, she reflects knowing nothing about this prevalent mental health issue—nor the medication she is about to begin that will alter her mind and body. I ask if it’s all right for me to share what I know in an effort to help her understand the body and brain’s reaction to overwhelming amounts of stress. After receiving her consent, we begin the conversation about different functions of her brain, the fight or flight response, and common symptoms under the umbrella of her new diagnosis. This is one example of many conversations I’ve had with students over the course of the 2015-2016 school year.
Living in a rural area with a high poverty rate, rampant substance abuse, and limited resources, too many students are finding themselves in similar situations. Their lives are difficult and they’re losing parents to addiction and incarceration—or are witnessing/experiencing abuse, neglect, and food insecurity. As a result, they’re acting out or getting ill, with some becoming heavily reliant on taking the edge off with drugs or alcohol, while others receive mental health diagnoses and medications as their behavioral intensity and exposure to trauma are labeled and treated as pathology.
Referrals to therapeutic services that can teach them healthy coping skills to manage their stress/anxiety/depression/mood swings/sleeplessness, etc., could compliment their medical treatment or interrupt early substance use patterns, but are often not provided, or are inaccessible due to a lack of availability or financial barriers.
These concerns, coupled with the fact that students in our state have reported higher-than-national-average rates for alcohol and marijuana use on youth surveys, are churning perfect-storm conditions that may lay a destructive path for future substance reliance and abuse. As the state with the dubious distinction of having the highest per capita opioid overdose deaths, this potential connection warrants a closer look, and the need for increased understanding, support, and opportunities for connection.
According to the National Child Traumatic Stress Network, one in four youth are exposed to one or more traumatic experiences before reaching the age of 16. The outcomes for these youth, as illustrated by the Centers for Disease Control and Prevention-Kaiser Permanente’s Adverse Childhood Experiences (ACE) Study, include a significantly higher risk for future health, mental health, and substance use/abuse problems.
Many youth in our state are crying out for help, and we owe it to them to create trauma-informed, collaborative systems of care that seamlessly link the medical, mental health, and school community with family systems to provide additional shelter from the storm.
— Wendy is a school-based social worker providing mental health and substance use risk reduction services with Morgan County Schools, WV. She can be reached at firstname.lastname@example.org.