• By Nancy Cambria St. Louis Post-Dispatch 

    Carrie Jost never thought landing her dream job in a school working with children would be traumatizing.

    And yet several years ago, she was hiding in her office, turning off the light and crying. She couldn’t figure out why she was so sad and panicking. It took time, faith and professional help, and now she knows.

    In her job then as an occupational therapist at a charter school, she was regularly watching frustrated teachers yelling at students. Sometimes the yelling started as early as 8 a.m. She felt as if she had to get away, so she fled to her office.

    “I didn’t realize what was wrong with me,” Jost said. “I didn’t realize I was getting triggered.”

    Jost said that after getting help she realized she had been suffering from post-traumatic stress from unrecognized trauma in her early childhood. She was being retraumatized at a school where the students came from impoverished homes and were probably dealing with their own trauma. The yelling was hurting everyone.

    Jost is now happily employed with St. Louis Public Schools and openly shared her story last month at a meeting of nearly 120 representatives from 26 schools and districts.

    They gathered at the University City High School library to champion the establishment of “trauma-informed” schools in the region.

    The ultimate goal is to help everyone in a school community understand how trauma impedes learning and affects behavior, and to discuss ways to deal with it so children, teachers and schools can succeed.

    Many educators say the institutional changes in schools can have a profound effect. Some are as simple as lowering a voice and physically taking a step back during a disagreement to avoid a flight-or-fight response in a child who feels threatened. And some are as politically complex as giving an obstinate, threatening student a pass to go to a quiet room to calm down, rather than issuing a suspension.

    Supporters argue that such approaches to learning increase attendance, participation and test scores, and decrease gang membership, suspensions and expulsions.

    “You can’t just teach a child when they have experienced things that most of the people in this room can’t imagine,” said University City schools Superintendent Sharonica Hardin, citing homelessness and hunger among her students. “And yet, schools have historically been forced to navigate these issues with no support.”

    Trauma-informed schools have been around for nearly a decade. Boston schools, for example, are considered a national model. In 2014, Massachusetts lawmakers passed comprehensive “safe and supportive schools” provisions to address trauma among public school students.

    In the past year, the concept has gained remarkable traction in the St. Louis region, in part because of a regional health initiative called Alive and Well STL. It was launched in the summer of 2015 just a few months before the Ferguson Commission called on the region to address toxic stress and trauma in children as a way to tackle inequity.

    Raising awareness

    Alive and Well STL was created by the St. Louis Regional Health Commission to combat the vast health and life expectancy discrepancies among some of the region’s poorest and wealthiest ZIP codes.

    People living in the poorest places were dying on average 18 years earlier than those living in the most prosperous ones, from a prevalence of high blood pressure, heart and kidney disease, asthma, stroke, cancer and depression. A now-massive body of research suggests toxic stress from poverty and trauma can alter brain, neurological, physical and behavioral development, significantly increasing the odds of chronic disease in adulthood.

    Alive and Well STL intended to bring awareness and solutions regarding trauma and toxic stress to the region. In that early work, officials acknowledge that they didn’t plan on dealing with schools. But then, schools began calling.

    “They wanted help,” said Emily Luft, a program director with Alive and Well. “They wanted information. They were seeking us out.”

    The initiative clearly was influencing teachers, school counselors and administrators, said Jerry Cox, a psychotherapist who has been working on the issue with schools in St. Charles County. Many realized that their students’ outbursts, fidgeting, learning issues, absenteeism and even shyness were deeply tied to trauma, he said.

    Cox said studies indicated one-fourth of students from all socioeconomic backgrounds have experienced at least two incidents of trauma in childhood, and those students are 2½ times more likely to fail a grade in school.

    “It’s not just the child who grew up in predominantly urban communities where 95 percent of kids in the building have free and reduced lunch,” he said. “It’s also kids living in O’Fallon or Warrenton or Jefferson City.”

    Teachers and staff are also not immune to the adverse effects of trauma, he said. Studies suggest they and social workers as a group typically have experienced more incidents of trauma, and that’s what drives them to help others, Cox said.

    In the span of less than a year, Alive and Well is now helping a combination of 26 schools and districts to become trauma-informed. The group includes St. Louis Public Schools, 11 city charter schools and suburban Rockwood and Parkway schools.

    A tough sell

    Recent efforts are following the early lead of Tiffany Anderson, the former superintendent of Jennings schools who several years ago spoke out about the trauma and stresses experienced by her students in a predominantly poor region of St. Louis County.

    In partnership with Washington University School of Medicine, the small district secured a $60,000 grant from the Missouri Foundation for Health to make Jennings the region’s first fully “trauma-informed” school district.

    Since then Alive and Well’s efforts have been supported by significant public and private funding. In June, the Missouri Foundation for Health pledged $1 million to the initiative to continue its work. Alive and Well will also probably help schools in St. Louis and St. Louis County as part of $6.1 million in federal grants recently awarded to the region to better deal with trauma.

    Last spring, the concept got the attention of state lawmakers who passed a law directing state education officials to begin pilot programs in five yet-to-be-determined schools across the state.

    Marsha Morgan, a consultant from Kansas City, said that buy-in from principals was critical and that schools needed to be willing to look at all aspects of how they run their day. That includes doing away with classroom policies that forbid students from getting up and moving around, or exclude students from decision-making.

    Many schools have created quiet, safe places for students and staff to go to center and calm down. Some, such as University City High School, have student and staff ambassadors trained by Alive and Well to provide support and resources to peers.

    Yet, trauma-informed thinking can truly test people, Morgan said. Rethinking policies such as suspensions, or giving students permission to leave the classroom for a break, are not an easy sell to teachers and staff.

    “We have so much work we need to do,” said Hardin, the University City superintendent. “We are not where we need to be. If we don’t understand this is a regional issue, that is a problem for St. Louis.”