Damage control: New study points to need for early intervention in young lives

Beth Gillia, director of the Corinne Wolfe Center for Child and Family Justice, sits with UNM Law School students Alexandra Vincent, Natalie Zerwekh, Elena Rubinfeld and Isabella Pacheco. The law students participated in research and planning for a child and family justice grant and taught in the Marshall Brennan Constitutional Literacy Project, a pipeline project designed to teach students in underserved high schools about constitutional law. (Courtesy of UNM Law School)

Beth Gillia, director of the Corinne Wolfe Center for Child and Family Justice, sits with UNM Law School students Alexandra Vincent, Natalie Zerwekh, Elena Rubinfeld and Isabella Pacheco. The law students participated in research and planning for a child and family justice grant and taught in the Marshall Brennan Constitutional Literacy Project, a pipeline project designed to teach students in underserved high schools about constitutional law. (Courtesy of UNM Law School)

A recently released study shows kids in New Mexico’s juvenile justice system have had enough pain and trauma to create misery for a lifetime.

CANNON: “Astoundingly high rates of trauma”

CANNON: “Astoundingly high rates of trauma”

“We have astoundingly high rates of trauma among our incarcerated youth in New Mexico,” says Yael Zakai Cannon, a study author and law professor at the University of New Mexico School of Law.

While the study statistics are grim, the researchers point to programs already in place that could help even the most damaged kids change their lives and strategies that could help prevent problems for their younger brothers and sisters.

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The report published this spring by the New Mexico Sentencing Commission examined the history of 220 youths, 13 to 18 years old, incarcerated in the state juvenile justice system in 2011.

It measured youths’ trauma and victimization, labeled as adverse childhood events or ACEs, and uncovered that of the 190 young men, almost 75 percent had five or more of these events, while almost 87 percent of the 30 young women had more than five and many had all nine of the trauma measures.

Adverse events were emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, parental divorce and separation, family violence, household substance abuse and household member incarceration.

‘Off the charts’

“Most national ACEs studies identify people with the highest rates of trauma as those who have had four or five of these adverse events in their childhood. Many of New Mexico youth who have been committed to juvenile justice facilities have as many as eight or nine ACEs. That level of trauma puts those youth off the charts nationally in terms of the research,” Cannon says. “Unfortunately, studies link a high number of adverse events to poor mental and physical health outcomes. For example, if you have five or more ACEs, you are 16 times more likely to attempt suicide.”

Those abused and neglected in childhood have higher rates of cancer, heart and other diseases, she says.

In this study, many of the youths had multiple professional evaluations, both medical and legal. That means they had multiple referrals prior to being incarcerated. The study showed about two-thirds of the teens were incarcerated for parole violations.

Cannon says as a lawyer she often sees children and their families downstream after they have tangled with the law.

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She hopes the research helps judges and lawyers work more closely with health-care providers and other professionals to identify children who have suffered trauma earlier and better serve their clients, their families and their futures.

In February, the law school announced a $2.6 million grant from the W.K. Kellogg Foundation to attract, prepare and mobilize a diverse group of lawyers to pursue justice and racial equity and to achieve improved health and well-being for New Mexico’s most vulnerable children and families.

The project is a collaboration with strategic community partners, including UNM’s Health Sciences Center, to address unmet legal needs that harm the health and well-being of children and families living in poverty in New Mexico. The project will be headed by the UNM Law School’s Corinne Wolfe Center for Child and Family Justice.

DAVIS: “A new model for understanding delinquency”

DAVIS: “A new model for understanding delinquency”

Brain ‘is damaged’

Another study author, Dr. George Davis, a child and adolescent psychiatrist with the New Mexico Department of Children, Youth and Family Services Juvenile Justice System, says the study quantifies what experts have known.

“I’ve always known this is true, but the amount of early childhood adversity is astounding,” he says. “It’s beyond what anyone has admitted. This contributes a new model for understanding delinquency.”

The trauma reported, called toxic stress, damages the brain at crucial stages for its development, especially brain regulatory centers that control impulses, emotions and behaviors, he says.

“Their brains look different. Their machinery is damaged,” he says.

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Those brain pathways that seek positive rewards have misfired so often that a child in this situation seeks different stimulation to process what is reward and what is not.

“Early childhood adversity dysregulates a kid. Instead of those normal rewards of love and close friendship, they seek out more intense forms of reward. Trauma drives substance abuse and delinquency,” he says.

Davis says he’s convinced that if childhood abuse and neglect could be eliminated, the state could close the juvenile justice system in 15 years: “It’s environmental. Not genetic.”

Survival strategies

He says the study statistics are particularly compelling, because by the time children are incarcerated, most have been in the state’s child welfare system for many years.

When people self-report abuse and neglect they often leave out painful experiences. “These kids are the most resilient group you will meet. They have already survived enormous adversity. Delinquency itself is a survival strategy.”

Denial is another survival strategy: “This is an improved methodology from self-reporting. When we ask a kid about abuse or neglect, they won’t admit it. They’ve already drunk the Kool-Aid. They think they deserved to be hit.”

He says 97 percent of incarcerated youth have substance abuse issues. “We know substance abuse doesn’t go away. It’s a lifelong problem and risk. Adult offenses are often driven by substance abuse disorder. When they come out of incarceration, what’s going to help them so they don’t get in trouble in the future? We have to play the long game.”

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“Due to the lack of substance abuse treatment generally in New Mexico and because of the limitations of the science of substance abuse treatment, many leave with ongoing substance abuse issues,” he says. “Since the motor for substance abuse is early abuse and neglect, the only definitive treatment is preventive.”

HSI: “Families are able to recover and regroup” (Marla Brose/Albuquerque Journal)

HSI: “Families are able to recover and regroup” (Marla Brose/Albuquerque Journal)

Promising results

Davis says a collaborative medical home model that another study co-author, Dr. Andrew Hsi, developed and directs has promising results.

For 25 years, Hsi has been medical director of the UNM FOCUS early intervention program that provides support and services for families of children from birth through 3 years at risk for or experiencing a developmental delay.

The reasons could include prenatal exposure to drugs or alcohol, including being premature, low birth weight and family factors like substance abuse, mental illness, violence or unsupported teen parenting.

“We try to reach the family while the parents are interested in their kids’ lives, while they still dream of a white picket fence for their families,” Hsi explains. The program includes medical care for the entire family, home visits and referrals for resources.

Hsi says he’s read and watched enough news about violent children and teens in New Mexico. He plans to take action.

He says when the health care system doesn’t have the capacity or willingness to work with families at high risk “it is like watching trains run off the tracks. I’m not willing to just watch it happen. The sooner they are identified, the sooner we and the families can team up to keep lives on track.”

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With evidence from the study and grant support, he and his colleagues are beginning a demonstration program that would continue to follow children and their families into adulthood.

“The medical community at UNM-HSC is willing to lean in and help,” he says.

Hsi says he’s been at it long enough to see his patients become parents and he sees changes for the better.

One mother, who experienced significant trauma as a child, came into the program with substance abuse and gang-related problems, but she managed to help her children become successful. Her second child is graduating from high school and has high hopes of a military career, he says.

“Families are able to recover and regroup and do things better for their kids.”

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