On February 9, 2017, President Donald J. Trump signed an executive order stating the purpose of the order would help reduce and prevent crime within our “inner cities.” Among the host of things the order calls for, it primarily allocates more power to police officers and more supports to protect law enforcement. In its present form, the order lacks any explicit support for the citizens of these communities, nor does it provide any protection for children who have witnessed violence and continue to live in violent environments within these communities.
President Trump states, “we will protect all Americans,” however his order in its current status is silent on how to help our most vulnerable children heal. The lack of public discourse around the emotional health of children who live in neighborhoods of concentrated poverty suggests that there is no relationship to poverty, children’s mental health, crime, and negative adult outcomes Yet, in 2009 the Department of Justice reported, “Children exposed to violence are also at a higher risk of engaging in criminal behavior later in life and becoming part of a cycle of violence.”
Research has found that the current funding stream does not produce successful outcomes. Incarcerating children in juvenile justice programs, or in psychiatry wards, increases the probability of costly adulthood behavior. “Zero Tolerance” policies in schools have created a “school to prison pipeline” resulting in approximately 68% of males in state and federal prison not having graduated high school. These children are better served in community mental health programs.
Children living in poverty suffer more, and have fewer resources to build resilience to traumatic experiences. Researchers Evans and Cassells state, “The economic and human costs of early childhood poverty are immense, ranging from dramatic achievement gaps and elevated psychological distress to greater morbidity for every major chronic physical disease, eventually resulting in premature mortality.” Mental Health is listed as the 4th most expensive chronic disease in our country.
Affected populations are not isolated to childhood; related behavioral challenges evolve along with children as they age and include outcomes such as incarceration, psychiatric related hospitalizations, and unemployment. These outcomes have the power to destroy communities through the erosion of individual self-worth, and the demoralization of hope. Indeed, the National Institute of Health reports there is a positive connection between suffering a traumatic life event in childhood and the likelihood of developing a serious mental illness such as schizophrenia, bipolar disorder, post-traumatic stress disorder or major depression later in life.
Whereas Trump’s Executive Order focuses primarily on strengthening law enforcement as a way of preventing crimes, it’s important to highlight a central component of the Affordable Care Act. “ACA” defines Population health as, “Preventing problems before they occur reduces human suffering and preempts costly punitive responses to these problems from education, law enforcement, child welfare, mental health, or juvenile justice system.”
Increasing reimbursement opportunities for population health initiatives has driven mental health professionals, educators, and medical professionals to develop preventive and early intervention services to children, which directly address issues early in their evolution rather than seeking to control their later manifestations. Prevention and early intervention services do that work of decreasing and in some cases curing the problem before it takes root.
If we are to improve the lives of children living in areas of concentrated poverty we cannot take this approach. One child witnessing or being victimized by community violence is enough to warrant actions. All children deserve the chance to live healthy and productive lives.
The development of future generations is reliant upon an inclusive care based approach rather than an exclusive, penalizing reality. This task is a moral one for our new administration, and the question is will they meet it?