All foster children experience the trauma of separation from their birth parents — and too many others have experienced other adverse experiences like neglect or abuse. In light of these challenges, Michigan’s child and family service agencies are working to provide the mental health services foster kids desperately need.

According to the Centers for Disease Control and Prevention (CDC), “Adverse childhood experiences (ACEs) can have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity.” ACEs include traumas like domestic violence, sexual abuse, substance abuse in the home, the daily experience of racism, or separation from a parent due to divorce, death, imprisonment, or loss of parental rights. 

“Almost 100% of the foster care children have experienced some form of trauma, different traumas at various levels,” says Michael Williams, president and CEO of Orchards Children’s Services, a child and family services agency with locations in Genesee, Macomb, Oakland, Washtenaw, and Wayne counties. “Leaving your family is traumatic for any child. Neglected children sometimes don’t have as many traumatic episodes as the ones that were abused, but nonetheless, it affects all of them.”

The Michigan ACE Initiative shares that children who experience ACEs can develop the resilience needed to live healthy, happy, and productive lives. And many Michigan organizations are helping them do just that through behavioral health services.

Eastern Michigan: EMDR and an emphasis on education

In addition to making traditional therapies available to the foster children it serves, Orchards Children’s Services has found Eye Movement Desensitization and Reprocessing (EMDR) to be an effective way to help kids build resilience after experiencing trauma. This evidence-based form of psychotherapy uses eye movements or other bilateral stimulation while processing traumatic memories. EMDR helps the brain to alter the emotions, thoughts, and responses associated with the traumatic experience. 

Orchards has trained all its therapists and staff working in child welfare in EMDR. Williams says EMDR helps children immediately rather than waiting on time-consuming, continuing diagnoses.
Michael Williams.
“EMDR helps us to find solutions to help that child to better understand how to deal with the trauma or any of the emotional issues that he or she has experienced,” he says. “Some children do better with talk therapy, based on their ability to have cognitive understanding of some of the issues that they face. I think in order to be effective in treating them, you need to have both options available.”

Northwest Michigan: summer camps, horsing around, and traditional therapies

With offices in Gaylord, Harbor Springs, and Traverse City, Child and Family Services of Northwestern Michigan (CFS) supports the mental health needs of its communities, particularly foster children and foster parents. In addition to traditional therapies, CFS offers an Equine Assisted Therapy program, summer camps, group therapy, and support groups. In the near future, CFS will introduce trauma-informed parenting classes for foster parents and other child caregivers. Many of these services are available virtually.
Michelle Nichols.
“We’re going to also resurrect our support group for adoptive parents, foster parents, and possibly other parents,” says Michelle Nichols, site manager and family resource specialist with CFS. “It’s more of a prevention effort to try to keep children in their placement as long as possible.”

CFS contracts with mental health providers like Megan Morrissey, a therapist who often works with foster kids.

“Almost all children in foster care meet the criteria for post-traumatic stress disorder,” Morrissey says. “Many of them also have attachment disorders, which is the preliminary to developing personality disorders in adulthood and puts them at significant risk for substance use disorders, as well as other things that are not necessarily mental health conditions but are connected, like being victims of domestic violence in adulthood.”

Morrissey notes that many children in foster care also experience high levels of anxiety and depression. Because of these underlying mental health issues, children in foster care may experience difficulty sleeping, nightmares, wetting the bed, and food-related issues like hoarding food, stealing food, overeating, chronic indigestion, overeating, or undereating. They often express emotional dysregulation, which can manifest as not being present (dissociation), lack of motivation, withdrawal, or temper tantrums.

“Foster parents are going to be the ones who see the vast majority of symptoms,” Morrissey says. “Often, children who are in foster care have a history of being bullied and a lack of social skills because those aren’t being demonstrated for them at home. That can result in a lot of social anxiety, a lot of self-consciousness. Children who’ve experienced a lot of trauma can be either hyper-aware of their bodies or don’t feel their bodies. They are numbing up.”

Lansing-based agency builds trust, works on attachments

Based in Lansing, Child and Family Charities (CFC) has sent five of its practitioners for training in Trust-Based Relational Intervention (TBRI) at the Karyn Purvis Institute of Child Development. These five will, in turn, train CFC’s other staff members in the modality, which is designed to meet the complex needs of children who have experienced adversity, early harm, toxic stress, or trauma. These kids often find it difficult to trust the loving adults in their lives, so they act out.
Dr. Andrea Calabrese.
“It’s a trauma-based model of looking at behavior differently — less shaming and more supportive for not only the child, but teaching the parent how to be more supportive, listening to the child, and understanding where the behavior is coming from,” says Dr. Andrea Calabrese, CFC’s chief operations officer.

Calabrese notes that kids who have been abused or neglected often have difficulty with attachment issues. Removing children from their birth homes can exacerbate those attachment issues. Calabrese shares that foster children also experience ambiguous loss, a loss felt strongly when their loved ones are alive but not present.

“Some of our children act out violently. Some of our children withdraw. Some of our children self-harm, from ingesting substances and burning or cutting themselves to putting themselves in serious situations, such as human trafficking,” Calabrese says. “A lot of these behaviors come from disrupted attachment.”

TBRI seeks to heal the child’s ability to make healthy attachments by building trust.
Mary Corrigan.
“Sometimes foster parents come in thinking, ‘Well, I’ll just love them. And as a result, this child’s behavior will change.’ Love is a good starting point. But it’s a slow trajectory,” says Mary Corrigan, CFC behavioral health therapist. “Foster parents hate when I say this, but I tell them to keep parenting but let go of the results. The ongoing support we provide them is crucial to them continuing to have a healthy perspective.”

State of Michigan “very attuned” to foster childrens’ mental health needs

At the state level, the Michigan Department of Health and Human Services (MDHHS) Bureau of Children’s Coordinated Health Policy and Supports (BCCHPS) enhances access to and oversight of behavioral health services for children who receive Medicaid, including foster children. MDHHS also provides incentive payments to community mental health systems at the regional level for these children.
Dr. Jeanette Scheid.
“There also are trainings and conferences that foster parents can come to and hear from other foster parents and from local, regional, and national experts,” says Dr. Jeanette Scheid, medical consultant at MDHHS’ Children’s Services Agency. “Our mental health systems are also very, very attuned to the importance of the systems of care principles that include family-driven, youth-guided principles for parents, broadly speaking, and parents who are in the foster parent role.”  

MDHHS also requires foster parents going through the licensing process to take formal training that addresses foster children’s mental health needs, the impact of trauma, and the emotions and behaviors that these children express. In addition, MDHHS provides Foster Parent Navigators who not only help potential foster parents with licensing but also offer them ongoing support.

“As a society, we all share the value of supporting the health and wellbeing of children,” Scheid says. “We have three main goals in child welfare — permanency, safety, and wellbeing. We’re trying to work on lifting all of those up. Part of doing that is identifying and addressing mental health needs as early as possible.”

Estelle Slootmaker is a working writer focusing on journalism, book editing, communications, poetry, and children’s books. You can contact her at Estelle.Slootmaker@gmail.com or www.constellations.biz.

Michael Williams photos by Steve Koss. 

Andrea Calabrese photo courtesy of CFC. Michelle Nichols photo courtesy of Michelle Nichols. Mary Corrigan photo courtesy of Mary Corrigan. Jeanette Scheid photo courtesy of MDHHS.

Source link

The post Michigan’s foster children face mental health challenges – but these agencies set them up to succeed appeared first on Minds Valley.

North Country Community Mental Health (NCCMH) outpatient therapist Judy Crockett spoke with MI Mental Health about what the agency is doing to provide support for Michigan’s tribal community. Serving children and adults, NCCMH provides 24/7 mental health crisis intervention services, promoting a philosophy of partnership within its communities.

Crockett is from the Eagle clan (Migiizi Nododem) and a tribal member of the Grand Traverse Band of Ottawa and Chippewa Indians in Peshawbestown in Leelanau County. Having served over 30 years in Indian Country in various roles including a caseworker with Indian Child Welfare, a family court therapist, and a child protective services supervisor, she is very familiar with the unique issues the tribal community faces. 

As an outpatient therapist, Crockett assists the agency in providing mental health services to clients with Medicaid and referral services to make sure those in need can receive additional health services, including psychiatry services. 

According to Crockett, Michigan’s tribal community has specific needs, many stemming from historical trauma. 

“It is important to acknowledge the lasting effects of historical and current trauma,” she says. “It is important to understand that many tribal elders and middle-aged adults experienced devastating child removal and active U.S. policies to decimate our native families. Our Elders continue to deal with these horrific experiences that rendered them largely unable to trust people who are not from their communities.”

“It is important to understand that many tribal elders and middle-aged adults experienced devastating child removal and active U.S. policies to decimate our native families.” ~ Judy Crockett
In order to address these needs, a certain level of trust is needed. 

“Our rights as citizens of our nations and to determine our ability to preserve our culture, languages and families are paramount,” she says. “Many non-native professionals would need to earn the trust of tribal communities and be prepared to learn the profound effects of historical and current trauma our communities have experienced. This should compel professionals to be respectful learners if there is consideration to work in tribal communities/tribal affiliated families.  We walk in two worlds; we walk on two roads, it is said, as we live and function both on the ‘white road’ and ‘red road.’ Many of us skillfully straddle both in response to living in a non -native society. Some Indigenous people remain understandably mistrustful and eschew all foreign influence.”

Michigan has 12 federally recognized tribes. Crockett estimates her tribe has 4,000 members, with roughly 1,600 to 1,800 of those members living in Grand Traverse, Antrim, Charlevoix, Benzie, Leelanau, and Kalkaska counties, the same six counties served by NCCMH. Across the United States, there are over 560 distinct tribal nations. 

While traditional best practices are generally effective in non-native mental health treatment, Crockett says these methods aren’t singularly beneficial for tribal communities.

“Currently, many native communities have traditional healers that provide effective healing ceremonies in conjunction with therapy. Tribal communities have worked hard to regain their sense of community and advocate for themselves,” she says. “When we see advances on the national political realm to dismantle the protections of keeping our children with their communities and families and out of the control of non-native adoptions and foster placements, it is critical for us to fight that. [There is a need for] understanding that the well being of our tribal communities has positive outcomes for the hearts and minds of each individual and their families. When they feel safe and protected, our people thrive.”

“Our lifeways should be respected, and many nations are retaking their own autonomy and agency.” ~ Judy Crockett

Working in a non-tribal agency, Crockett experiences specific challenges, including lack of representation in leadership and lack of cultural education and awareness. 

“Clients of color may feel pressure to educate their therapist about their culture,” she says. “We may need to implement far more frequent trainings and opportunities to learn about other cultures beyond the annual cultural competency or implicit bias training. We may be afforded a great opportunity to benefit those on our caseloads who had the immense courage to come to us for help.”

Looking ahead, Crockett hopes the native community’s life ways, ceremonies, and cultural teachings are both acknowledged and celebrated as effective treatments. She hopes to see more therapists and mental health professionals utilize these when working with tribal families.

“This includes the legal system, medical system, and religious systems,” she says. “Our lifeways should be respected, and many nations are retaking their own autonomy and agency. These efforts serve to ensure our tribal communities are afforded safe, reliable futures without fear of dismissal and disregard.”

Sarah Spohn is a Lansing native, but every day finds a new, interesting person, place, or thing in towns all over Michigan, leaving her truly smitten with the mitten. She received her degrees in journalism and professional communications and provides coverage for various publications locally, regionally, and nationally — writing stories on small businesses, arts and culture, dining, community, and anything Michigan-made. You can find her in a record shop, a local concert, or eating one too many desserts at a bakery. If by chance, she’s not at any of those places, you can contact her at sarahspohn.news@gmail.com.

Photo of drummers by Taylor Scamehorn.
Photo of the Jacobs by Harold Powell. 
Photo of Judy Crockett and logo courtesy North Country CMH.

The MI Mental Health series highlights the opportunities that Michigan’s children, teens and adults of all ages have to find the mental health help they need, when and where they need it. It is made possible with funding from the Community Mental Health Association of Michigan, Center for Health and Research Transformation, Genesee Health System, Mental Health Foundation of West Michigan, North Country CMH, Northern Lakes CMH Authority, OnPoint, Sanilac County CMH, St. Clair County CMH, Summit Pointe, and Washtenaw County CMH.

Source link

The post Michigan’s tribal community has specific mental health needs, many stemming from historical trauma appeared first on Minds Valley.

Genesee Health System takes action for the unhoused

In addition to providing mental health care through its behavioral health urgent care center, Genesee Health System (GHS) helps connect clients experiencing homelessness to housing through its Community Housing Program. And their commitment to this community doesn’t stop there. GHS actively collaborates with the Flint-Genesee County Continuum of Care, the Genesee County Youth Corp., Communities First, and the Shelter of Flint. After the May 2021 approval of the county’s mental health millage, GHS held community events asking for suggestions for what to do with the money.

“As a result of these surveys, in April of this year, GHS also awarded $200,000 worth of grants to five local homeless shelters,” says Bill Doub, community housing supervisor for GHS, which is Genesee County’s Community Mental Health provider.

Being homeless creates stressors that can lead to or exacerbate mental illness. With affordable housing becoming less and less available and more individuals and families finding themselves on the street, in shelters, staying with family, or living in government subsidized motels, the need for mental health supports is also rising. According to the U.S. Department of Housing and Urban Development (HUD), in 2019, 7.77 million renter households across the U.S. were “worst case needs,” meaning they paid more than half of their income for rent. 

Homelessness and housing instability are associated with a range of stressors and even traumas: from exposure to the elements and stigma to an increased risk of violent victimization. All of these factors have the potential to negatively impact mental health. A study published in 2022 by researchers from the University of Michigan Institute for Healthcare Policy and Innovation found that 50.3 percent of hospitalizations among the unhoused were for mental, behavioral, and neurodevelopmental disorders — ten times higher than for the general population. Children are particularly vulnerable to the psychological effects of housing instability,

“For many of our clients who are paying just a standard room-and-board $700 a month, this is worst-case housing, where they’re paying over 65 percent or better for their housing,” Doub says. “Social security went up to $914 for a lot of our consumers. What’s 70% of that, roughly speaking? I can tell you right now that it ain’t enough.”
“I was born in upstate New York. I have lived in the Battle Creek area for 55 years. I fell on hard times and live on the street.” Kevin Robert O’Brien, 59.

Crisis Intervention keeps the unhoused out of jail

Many Michigan community mental health agencies are also offering help with crisis intervention. The combination of homelessness with substance use or untreated mental illnesses has been shown to be a recipe for crises. In some Michigan counties, CMHs train law enforcement officers how to better handle mental health crises.

“For a long time, police had the option of taking a person to the hospital, taking them to jail, or maybe releasing this person who’s having trouble,” Doub says. “At the same time, they know at their gut level maybe ‘I’m gonna send you back home’ is not a good idea.”

Another way CMHs have partnered with law enforcement is through technology that links the officers with mental health professionals who can guide them in handling a mental health crisis. GHS helps train Genesee County’s Crisis Intervention Team, where mental health professionals accompany police officers on calls. 

 “We now have a listing of resources that we provide to police officers,” Doub says. “They’re getting training in mental health services and all the resources that are available to the community. And they’re also going to have a mental health professional who’s going to be going with them when they respond.” 

In 2020, the Center for Civil Justice introduced a homeless court in Genesee County. Homeless courts are a way for people experiencing homelessness to resolve misdemeanor offenses without having to go to court. Oftentimes these misdemeanors stem from homelessness or mental illness, and jail is not a solution. 

“It’s almost as though you’re penalized for being homeless. You’re taken to jail because you’re acting out versus, ‘How can we get you help?’” Doub says.
“After moving from Texas, I was raised in Detroit by my grandmother. I moved to Battle Creek after meeting a girl on Facebook. I live in the Battle Creek Shelter even though it’s not safe.” Charlie McDonald, 32.
OnPoint meeting needs in Allegan County

The mental health professionals, social workers, and other support providers at OnPoint provide mental and behavioral healthcare for residents of Allegan County. They also assist clients with substance use disorders (SUDs), developmental disabilities, and emotional disturbances in children. OnPoint’s crisis program offers 24/7/365 crisis services to direct people in crisis to assessment, counseling, and hospitalization. 

OnPoint also manages the Homeless Assistance Program (HAP) for Allegan County, which serves people who are experiencing homelessness or at risk of experiencing homelessness. First, an initial housing screening helps the HAP staff to determine which programs and services are a good fit for the individual or family coming to them for services. Next, housing assessment helps to ascertain barriers to housing access the applicant may be facing. The last step is to connect the applicant to community resources and services that can help them keep or find a home — and stay in that home long-term.

For those who need a little extra help, HAP offers case management. The Housing Search Packet, a resource provided by OnPoint and the Allegan County HAP Team, provides information about subsidized and income-based housing options, homeless shelters in nearby areas, housing search tips, and links to those community resources. One section of the packet lists housings for seniors or persons with disabilities.

HAP offers an array of programs for short- and long-term housing assistance. The Emergency Shelter Program pays for a one-week stay in a hotel. The Emergency Solutions Grant provides financial assistance for a security deposit and up to six months’ rent. Permanent Supportive Housing and Rapid Rehousing programs specifically target those who have experienced homelessness for an extended period and who live with a diagnosed mental illness or SUD. Rapid Rehousing can provide a maximum of 24 months’ rent; and Permanent Supportive Housing has no limits.

“I am a Battle Creek native, kind of) homeless, but am staying with a friend. I rely on the services at the drop-in center.” Debra Martin, 66.According to MCAH’s most recent data, 30,805 people in Michigan experienced homelessness in 2020. People in families had better mental health outcomes than their single counterparts. Among Michigan’s hardest hit groups experiencing mental illness were homeless adults over the age of 65 (44%), single adults over 25 (45%), and veterans: 49%.

Doub believes these numbers may in truth be higher because people don’t always disclose that they live with a mental illness.  

“Some of them will talk about it — some of them have difficulty talking about it,” Doub says. “We know among the veteran population, PTSD is considered as a prime explanation for why folks have difficulty coping in the community.” 

Until Michigan’s communities find better policies and programs to address the root causes of homelessness — systemic racism, low wages, lack of affordable housing, and lack of residential opportunities for those with debilitating mental and physical illness — Michigan’s CMHs, like GHS, are doing their best to support the mental health of their neighbors who lack a home.

“We’re not just a mental health system that plays with Medicaid dollars,” Doub concludes. “We are an active partner out in the community.” 

Source link

The post Michigan’s community mental health providers serve the unhoused appeared first on Minds Valley.