Abstract
Native American communities across the nation are known to suffer disproportionatly from the effects of historical trauma, concerning both overall well-being and academic achievement (Wiechelt et al., 2019). The Miccosukee Indian School in North Miami, Florida is a small institution dedicated to educating the community's Miccosukee children, and the focus of this intervention. The primary aspects of the intervention include the assessment of students' mental health using The Patient Health Questionnaire Adapted for Adolescents (PHQ-A), and the education of teachers in working with children affected by trauma using The 2020 National Child Traumatic Stress Network's Child Trauma Toolkit for Educators. By providing children with a strong sense of community and emotional support, The Native American Mental Health Association of the Southeast aims to reduce the prevalence of anxiety and depression in Miccosukee children, in turn improving their quality of life.
Project Activities
The intervention will initially involve baseline data collection. Statistics on academic achievement such as standardized test scores and graduation rates will be collected and all students will be screened for depression and anxiety. The Patient Health Questionnaire Adapted for Adolescents (PHQ-A) will be distributed during the last 20 minutes of class to screen students in sixth grade and older through self-reporting. For students below this age, the assessment will be conducted by the NRC representative during roughly 20-minute individual sessions. These individual evaluations will take place over the course of three days in much the same way other health assessments are conducted in schools such as scoliosis screenings. This addresses the data-collection portion of the statement of need.
Following this data collection is the more "hands-on" portion of the intervention. Teachers will take part in weekly workshops designed to educate them on recognizing and addressing generational trauma. This will be guided using The 2020 National Child Traumatic Stress Network's Child Trauma Toolkit for Educators, a resource designed to inform teachers on how to best support children struggling with trauma. This document stresses the importance of consistency, clear rules, logical consequences over disciplinary action, and providing a dedicated safe space for students to talk about their feelings and experiences (NCTSN, 2020). This supports the goal of providing trauma-informed education and support to The Miccosukee Native peoples of North Miami.
Project Goals
The goal of this intervention is to reduce the mental health impact of historical trauma in Native American school children from North Miami Florida. This will be measured using The Patient Health Questionnaire Adapted for Adolescents (PHQ-A), before and throughout the intervention. By providing children with a strong sense of community and emotional support, The Native American Mental Health Association of the Southeast aims to reduce the number of health disparities associated with historical trauma, from drug addiction to heart disease.
Public Health Framework
As emphasized in The Trauma-Informed Philanthropy guide, this project uses an upstream approach, focusing on prevention over treatment. Many consequences of ACEs such as chronic disease often take years to develop, (CDC, 2019) and the long-term objective of this project is to reduce the prevalence of adverse health effects within the Native population of South Florida. Regarding mental health, this trauma-specific intervention aligns with the tertiary level of prevention (Cawley et al., 2016 p. 20). It is likely that many within the target audience have already been impacted by childhood trauma to some degree, displaying symptoms such as irritability, withdrawal, and poor academic performance. This intervention uses a multi-sector approach within education and behavioral health to treat these immediate symptoms as well as prevent further adverse health outcomes in the future.
Levels of The Social-Ecological Model
Like many well-developed interventions, this project incorporates multiple levels of the Social-Ecological Model. The organizational level is addressed through the universal, trauma-informed instruction of all teachers at Miccosukee Indian School. The collaboration of teachers and students, as well as students with their peers, addresses the interpersonal level of the model. Finally, the individual level is incorporated as we work to educate students in emotional regulation as well as the beauty of their culture. This multifaceted approach helps teachers effectively support students as they practice managing difficult emotions in addition to improving students’ self-efficacy and self-esteem.
Trauma-Informed Principles
The main trauma-informed principle built into the program is the utilization of screening, assessment, and treatment services. All students in this high-risk population will be assessed for anxiety and depression using the Patient Health Questionnaire Adapted for Adolescents (PHQ-A). Alongside this assessment, teachers will be trained in trauma-informed approaches to addressing behavioral issues as well as day-to-day activities. Because so much of the trauma this population has experienced is rooted in cultural discrimination, many of the trauma-informed activities implemented will celebrate the extraordinary culture and traditions of the Miccosukee people.
References
2021-2026 CHIP Broward 3-12-2021 LTD edits. (2021). Retrieved February 25, 2022, from http://broward.floridahealth.g...roward_3-12-2021.pdf
Bartlett, J. D., Griffin, J. L., Spinazzola, J., Fraser, J. G., Noroña, C. R., Bodian, R., Todd, M., Montagna, C., & Barto, B. (2017, November 13). The impact of a statewide trauma-informed care initiative in child welfare on the well-being of children and youth with complex trauma. Children and Youth Services Review. Retrieved March 17, 2022, from https://www.sciencedirect.com/...2z2EI8A2hyYz6FkSvp1O
Centers for Disease Control and Prevention. (2019, November 5). Adverse childhood experiences (aces). Centers for Disease Control and Prevention. Retrieved February 8, 2022, from https://www.cdc.gov/vitalsigns/aces/index.html
Nctsnadmin. (2020, December 15). Child trauma toolkit for educators. The National Child Traumatic Stress Network. Retrieved February 9, 2022, from https://www.nctsn.org/resource...ma-toolkit-educators
Patient health questionnaire for adolescents (PHQ-A. (n.d.). Retrieved February 9, 2022, from t htps://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/health-services-providers/thsteps/ths-patient-health-questionnaire-instr.pdf
Review of Academic Achievement at the Miccosukee Indian School. (n.d.). Retrieved February 8, 2022, from https://www.oversight.gov/site...IE00122014Public.pdf
Tribes, U. S. and E. (n.d.). Improving tribal nation–specific mortality numerators in... : Journal of Public Health Management and Practice. LWW. Retrieved February 9, 2022, from https://journals.lww.com/jphmp...lLQPeqx7LfxQdbHcoEYQ
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