Podcast: Mental Health Intervention in Childhood
What if social emotional health was taught in schools, just like reading or math? What if children experiencing trauma were taught mindfulness and about their brains? In this episode of the Oliver Wyman Health Podcast, Bryce Bach, Principal in the Health & Life Sciences practice at Oliver Wyman, chats with the Momentous Institute’s Jessica Trudeau, Executive Director, and Laura Vogel, PhD, Director of Therapeutic Services. Momentous Institute is a non-profit organization in Dallas that provides innovative education and mental health services to over 5,500 children and family members facing a variety of life stressors. The school has a unique dual curriculum – one that focuses on both academics and social emotional health. Below are some memorable takeaways from our conversation.
For this episode and more, check out the Oliver Wyman Health Podcast page, featuring executive conversations on the business of transforming healthcare, available on iTunes, iHeartRadio, Soundcloud, Google Play Music, Stitcher, and Spotify.
New: Ask Alexa, "Play Oliver Wyman Health Podcast."
Small Stress Has Big Mental Health Impact
When you experience a big trauma like a house fire or a car accident, it can be life shattering. But cumulative daily life stressors that come from, say, raising a family in poverty or living with systemic racism actually impact your brain as though you’ve experienced one significant trauma, said Laura. The impact of stressors on the developing brains of children is different than it is for adults. The result? Children growing up in a highly stressful environment can’t always discern whether a situation is truly threatening or not, often operating in a state of constant neurological arousal that follows them well into adulthood.
“When someone at a young age experiences chronic stress or traumatic experiences, different brain chemicals are released. Cortisol begins impacting lower brain regions. Then, the mid-brain’s amygdala and limbic system become impacted. When lower regions of the brain are impacted, higher regions like the cerebral cortex become less efficient,” explained Laura. “We find children who have experienced chronic trauma may stay in this hypervigilant, 'over reactive' state where the middle part of their brain remains in ‘fight, flight, or freeze’ mode.”
When children whose brains have developed during traumatic events are no longer in a stressful environment, but at school or on the playground, they appear to overreact to situations other children wouldn’t typically find distressing.
“Their brains are sort of taking over, reading things as danger cues, even when there may not be any,” said Laura. “So, we’re trying to help both kids, but especially the adults who work with them, understand that often the most worrisome behaviors – the ones teachers tend to put a lot of focus and attention on – may be much more complex than we originally thought, not just ‘misbehavior’ as we’ve traditionally defined it."
Teaching Neuroscience to Three-Year-Olds
When children and their families first come to the Momentous Institute, they learn about what’s happening holistically to their brains to equip them with coping skills necessary to thrive and achieve their full potential.
Children learn that their memories come from the hippocampus – even though they may not be able to pronounce the word just yet – their emotions come from the amygdala, and their problem-solving skills come from the cerebral cortex.
Teaching Teachers
Teachers at the Momentous Institute focus on the causes of behavior, not just the aftermath of behavior.
“When a child is yelling at me or has just thrown something across the room, I have to ask myself, is this really just pure defiance, or is this child’s behavior telling me they need something? Usually this tells me, ‘I'm afraid. I'm overwhelmed. I'm just trying to protect myself,'’’ said Laura. “When I view behavior that way, I'm much more likely to problem solve and come up with a helpful intervention. But if I view it as defiance or disrespect, I'm typically only going to respond to behavior correctively, sometimes punitively.”
Punishment or consequence – an approach commonly implanted in traditional schools nationwide via, say, being sent to “time out” or to the principal’s office — may positively influence a child’s external behavior in the moment, but ignore the long-term “why” behind this behavior.
“We help kids slow down and say, ‘Right now, your body's having a really big feeling and your brain is flooded with emotions. Let's do some things to help our brains calm down and feel settled,’” Laura explained. “Our students are much more likely to respond to a personal approach. Instead of feeling like they’re being attacked or criticized, they just think, ‘Okay, it's my brain. Let’s do something together to help my brain.’”
“Punishment typically doesn't teach us anything,” Laura emphasized. “It’s not that we just allow big behaviors to occur without some sort of consequence, but the end game is about how we're talking about it. Learning doesn’t happen when we are shaming a child. And ultimately, consequences are about teaching a skill a child has not yet developed.”
Combatting Mental Health Stigma is a Learning Process
Students at the Momentous Institute continue schooling through the fifth grade before launching into one of over 60 different middle and high schools. Seven years later, 96 percent of alumni are graduating high school on time, 81 percent are enrolling in college, and 84 percent of those are persisting into their second year, said Jessica. With impressive results like these, Momentous Institute’s expansion outward to provide mental health services across the greater community may seem like a sure fit. Unfortunately, doing so is a slow process.
.jpg)
“Based on some of these longitudinal results, we made a determination to disseminate our model and practices via training and research. We certainly discussed building out more schools and therapy centers. But the decision was to utilize training, rigorous research, and evaluation to disseminate practices and encourage other systems to adopt those practices into their existing curriculum.”
Laura highlighted the need for more stigma-free mental health conversations – ones that aren’t a shameful process, but a learning process.
“We've learned we have to slow down and do a whole lot of listening before we can do much intervening. When most members of a community don't know anyone who’s ever utilized mental health services, that only adds to mental health’s stigma,” said Laura. “When communities see we’re not going to leave, we’re going to stay, and we’re going to be a part of what you’re doing, we begin to build trust. But that takes time to build up.”
Laura emphasized the importance of transforming age-old emotional health perceptions that separate mental health from physical health. “We need to be thinking about human beings as integrated wholes,” she said. “We believe it's possible to shift how we think about education, raise up this population of children and adolescents in our community, and support them to achieve their full potential. And not settle along the way.”