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Improving Life Outcomes for Children with History of Mental Health Challenges and Trauma

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A new report indicates that nearly half (46 percent) of the nation’s children birth through 17 years of age report having experienced at least one traumatic event in their lifetime.  Potential traumas include abuse and neglect, incarceration of a parent or caregiver, being a victim of or witnessing community violence, being subjected to racial/ethnic prejudice, living with family members who have mental or substance use disorders, or the death of a parent or caregiver.

The report based on data from Health Resources and Services Administration’s (HRSA) National Survey of Children’s Health (NSCH) which provides national and state level estimates of key measures of child health and well-being.

SAMHSA’s Children’s Mental Health Initiative (CMHI) promotes treatment and support for children, youth, and young adults who experience serious emotional disturbance (SED) or serious mental illness (SMI). According to CMHI National Evaluation data[1]:

  • 82 percent of children, youth, and young adults in systems of care have experienced at least one traumatic event before entering services;
  • 41 percent of those with a trauma history have had suicidal thoughts, compared to 24 percent without a trauma history; and
  • 23 percent of those with a trauma history have had a suicide attempt, compared to 13 percent of those without.[2]

Children who experience trauma and receive treatment through systems of care show significant improvements in their behavioral and emotional health, improved school attendance, and fewer problems at school. Evaluation data after one year of treatment show the following:

  • Rates of suicidal thoughts among youth who experienced trauma and received treatment through systems of care reduced 68 percent, and suicide attempts reduced 78 percent.
  • Displays of externalizing behaviors (not following rules, exhibiting aggressive behavior, or expressing behaviors that are difficult to manage) reduced 17 percent.
  • Internalizing symptoms such as withdrawing from others and being anxious or depressed reduced 22 percent.

CMHI National Evaluation data of children in systems of care who have experienced trauma showed significant improvements in school functioning. One year after intake:

  • 48 percent of children and youth had reduced school absences;
  • 41 percent improved their school performance; and
  • 15 percent improved their competence in school and classroom tasks.

The trauma-informed care framework includes recognizing the prevalence of trauma; recognizing signs and symptoms; responding by integrating knowledge into policies, procedures, and practices; and resisting re-traumatization. The National Child Traumatic Stress Initiative (NCTSI) raises awareness about the impact of trauma on children and adolescents as a behavioral health concern. Through this initiative, a collaborative network of experts furthers the development and dissemination of evidence-based clinical interventions for systems that serve children, adolescents, and families.

SAMHSA’s “Helping Children and Youth Who Have Traumatic Experiences” short report has been released in observance of National Children’s Mental Health Awareness Day 2018: “Partnering for Health and Hope Following Trauma.” Access the complete SAMHSA report here:


[1] The Children’s Mental Health Initiative’s National Evaluation looks at outcomes data on systems of care funded between 2009 and 2016.

[2] Both the difference in suicidal thoughts and suicide attempts between those with and without a trauma history are significant.

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The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (HHS) that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.

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