By Tami Silverman, President & CEO, Indiana Youth Institute

An increasing number of our children and youth have mental health disorders, encountering challenges with school, within their peer groups, and at home. Unfortunately, most of them are not getting the care they need. Signs of mental health disorder may be difficult to recognize, and unfortunately mental health disorders continue to be stigmatized. These, combined with a lack of access to services for many, create substantive barriers to care. More must be done to combat widely-held myths, connect children with treatment, supports, and services, and work to build strong support networks for all our young people.

A February 2019 study in JAMA Pediatrics estimated that 7.7 million American children, one in every 6 children, have at least one mental health disorder. According to the Centers for Disease Control (CDC), ADHD, behavior problems, anxiety and depression are the most commonly diagnosed mental disorders in children, and some of these conditions, such as anxiety and depression, commonly occur together. The JAMA Pediatrics study also showed that roughly half of children do not receive any kind of treatment from a mental health professional.

Last year, 11.6% of Hoosier children received treatment or counseling from a mental health professional, a significant number, and yet still only a portion of Indiana children in need. The National Survey of Children’s Health indicates that 5.2% of Indiana children have ever been diagnosed with depression, and 11.0% have been diagnosed with anxiety. We know that accessibility remains an issue in Indiana. Among our neighboring states, Indiana has the lowest ratio of mental health providers available to serve the population, approximately 1 per every 700 people, and nearly 60% of the state’s population lives in designated mental health professional shortage areas.

Identifying mental health issues may be less obvious than physical ailments, such as broken bones, asthma, or diabetes. Occasional bouts with emotional distress, anxiety, stress, and depression are normal experiences for all children and youth. It can be difficult to distinguish between behaviors and emotions that are related to typical child development, and those that require extra attention and concern.

The national nonprofit Child Mind Institute describes seven myths about childhood mental illness that need to be debunked. These include recognizing that childhood mental illness is not caused by personal weakness or poor parenting. Children and youth cannot overcome mental health problems through willpower, nor will they grow out of their disorder. Instead, understanding that most psychiatric disorders begin before age fourteen provides additional incentive to screen and intervene during childhood. Children who receive early interventions and treatment have a good chance of managing or overcoming their symptoms.

How do you know when a child’s behavior is cause for concern? You should always seek immediate help for a child or teen who harms themselves or others or talks about wanting to do so. While short term stress, anxiety or depression can be developmentally appropriate, the National Institute of Health (NIH) advises that you should also seek help if a child’s behavior or emotional difficulties last more than a few weeks and are causing problems at school, at home or with their friends. Young children may exhibit symptoms such as intense worry or fear, frequent tantrums, complaints about frequent stomach or headaches with no known medical cause, and a lack of interest in playing with other children. Symptoms in teenagers include a loss of interest in previously enjoyable activities, spending increasing amounts of time alone or avoiding social activities, sleeping too little or too much, and engaging in risky, destructive or self-harming behaviors. The NIH recommends talking with your child’s teacher and consulting your pediatrician, asking either for a recommendation to a mental health professional who has specific experience in dealing with children, when and if possible.

Caring adults and a strong support network, including family members, teachers, coaches and mentors, can serve as protective factors for mental health. Indiana’s Family and Social Services Administration Division of Mental Health and Addiction manages our state’s Systems of Care, a model framework used to coordinate services and supports. Schools throughout the state continue to expand their services and expertise, understanding the importance of prevention, intervention, positive development, and communication to families.

While many agree that progress has been made regarding how mental health is viewed, stigma and negative connotations still keep far too many children from getting critical care and support. It is important to understand and work to reduce the barriers of stigma and access to mental health care. It is equally, if not more important, to understand that, for most youth, childhood mental disorders are episodic rather than permanent. Just as with physical illnesses, keys include ensuring children in need can receive appropriate screening and treatment. We would not ignore a child’s physical ailment, and it is time that we consistently take the same approach to their mental health.

(Tami Silverman is the President & CEO of the Indiana Youth Institute. She may be reached at iyi@iyi.org or on Twitter at @Tami_IYI. IYI’s mission is to improve the lives of all Indiana children by strengthening and connecting the people, organizations, and communities that are focused on kids and youth.)

By Tami Silverman, President & CEO, Indiana Youth Institute 

It’s basketball season in Indiana. The Pacers are playing their hearts out, March Madness is around the corner, and high school hoops are heating up. Basketball, like so many sports and activities, offers a way for young people to connect, compete, and have fun. Coaches also often play a defining role in youth growth and development. Basketball and MENTOR champion Bill Russell said it well when he once described our collective responsibility toward kids: “There is no such thing as other people’s children.” 

It is also KIDS COUNT Data Book season. As in previous years, in this 25th Anniversary Edition of the KIDS COUNT Data Book, the Indiana Youth Institute provides objective, reliable information on the status of Indiana’s children and youth. Looking at the whole child, and our whole state, we examine indicators in the categories of family and community, economic well-being, education, and health. 

A child’s development is critically impacted by their home life, yet many kids face harmful family and community challenges. The data shows one out of every 11 Hoosier children (9.2%) have lived with someone who had a problem with alcohol or drugs, slightly higher than the national average of 8.5%. In 2017, parental drug and/or alcohol abuse was the primary cause behind the majority of Indiana Department of Child Services cases in which children were removed from their homes, and this rate continued to rise over previous years. The rate of child abuse and neglect again increased in our state, placing Indiana as having the third highest child maltreatment rate in the country. On a positive note, our understanding of Adverse Childhood Experiences (ACEs) continues to grow, equipping youth-serving professionals with additional tools to help all children.  

Children who experience poverty, especially during early life or for extended periods of time, are at risk for adverse health and developmental outcomes. Our data shows that economically, the basic needs of most Indiana children are being met, and the number of children living in poverty has decreased over prior years. Housing costs in Indiana are relatively low, placing us 10th nationally. At the same time, there are significant racial and geographic differences in the share of Hoosier families with children living in poverty.  

High-quality early childhood education, math and reading proficiency, and school engagement contribute to college and career readiness. Expansion of high-quality early childhood education remains a state priority, yet the number of Hoosier three-and four-year-olds are enrolled in pre-K fell slightly, and Indiana lags when compared to the national average of enrollees. Meanwhile, on average, Indiana 4th and 8th grade students scored better in math and reading than their peers nationally.  

Postsecondary success improves individual outcomes, builds stronger communities, and strengthens the economy. Our data shows the commitment made by schools, community agencies, and the state to make college and career planning a priority has contributed to a slight increase in the number of Hoosier 12th graders (80.7%) planning to pursue education after high school, whether through a college/university, community college, apprenticeship program, or career-technical college. Our data also indicates students and families are making plans and preparations for college and career earlier than in previous years.  

Childhood physical and mental health affects other critical aspects of a child’s life, including school attendance and performance, and can have lasting effects on a child’s future health and well-being. Our data unfortunately confirms Indiana children and youth face a variety of health challenges, with too many kids dealing with substance abuse, lack of health care, inadequate insurance, and/or poor health habits.  

Infant mortality remains a critical concern. Indiana infants are more likely to die in their first year than those in 42 other states, and black infants are more than twice as likely to die before their first birthday than white infants. Children with health insurance tend to be healthier than their uninsured peers. Indiana ranks 40th nationally in covering kids, with 93.7% of Indiana youth having some type of health insurance (the national rate is 95.0%). 

Tragically Hoosier youth are more likely to consider suicide and engage in suicidal behavior than those in other states. Indiana ranks 2nd out of 34 states in the percentage of students who made a suicide plan and ranks 3rd out of 36 states in the percentage of students who seriously considered attempting suicide. Nicotine use among Indiana students also remains concerning, and this year we saw an increase in the average percentage use of electronic vapor products in all middle and high school grades.  

To improve the well-being of our children and youth, we must first understand their current reality. All of Indiana’s 1,573,409 children deserve a safe, productive, healthy environment where they can learn, grow, and thrive. IYI’s 2019 KIDS COUNT Data Book is a starting point for community conversations and activation. Let’s all act to improve the well-being of our children.   

 

 

Three-year grant from Lilly Endowment Inc. will support program integration to activate communities, expand The Promise and build hope for widespread postsecondary achievement.

Indianapolis, IN — The Indiana Youth Institute is excited to share the news that Promise Indiana and its talented staff will be joining our organization.

Since 2003, we have worked throughout Indiana to build college and career pathways. The addition of Promise Indiana adds a network of communities that are focused on building a culture that encourages students to pursue higher education. To date, more than 13,000 elementary students around the state have started a CollegeChoice 529 direct savings account through The Promise, with more than $10 million in total savings for postsecondary education.

“Our schools and communities have told us loud and clear that college and career readiness needs to begin earlier –  ideally in elementary school. Promise Indiana is an innovative and successful program that builds future identity from a young age. We are delighted to add this thriving program to our existing services,” said Tami Silverman, President and CEO of the Indiana Youth Institute.

As the number of local Promise initiatives has grown, so too has interest from other communities around the state. Through Lilly Endowment’s support, IYI will lead the activation of 18 new Promise Indiana communities during the next three years. “Communities are searching for strategies to help students succeed in the classroom and in life. The Promise model is community-centric and designed to help students shape identity and build hope for their future,” said Clint Kugler, Co-Founder of Promise Indiana.

The transition will begin immediately. A formal launch is planned for IYI’s Kids Count Conference on November 27 and 28, 2018. We expect the integration to be completed by early 2019.

With support from the Indiana Education Savings Authority and Lilly Endowment, Promise Indiana began its operations in 2013, as part of the Wabash County YMCA, which has served as the home and backbone organization for the Wabash County Promise. Twenty-four additional communities have launched local initiatives in the five years since the Wabash County effort began.

Indiana Youth Institute (IYI) has been focused on college and career for 15 years, with a track record of launching successful initiatives, including Trip To College Alerts and the annual College and Career Conference.  Founded in 1988, IYI is a statewide organization that champions kids and strengthens communities through services and tools that focus on professional education, organizational capacity building, data and impact solutions, and statewide engagement and advocacy. IYI places an emphasis on increasing P–16 student success including graduation rates and postsecondary planning, achievement, and attainment.

The homeless enrollment in Indiana public schools has increased by 34.2% since the 2010-11 school year.

Who Is Considered Homeless? Under the McKinney-Vento Act, schools are required to keep track of the number of children whom they know lack a fixed, regular, adequate nighttime residence. Students experiencing housing instability may be living in motels, trailer parks, campgrounds, transitional shelters, or sharing housing with others because of economic hardship.

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Urgent, complex challenges affect children across Indiana, including high infant mortality rates, persistent achievement gaps, and the soaring impact of parental opioid use. There are successful prevention and intervention programs operated by youth-serving organizations throughout the state, many of which engage government, philanthropic and corporate partners. The complexity of many social problems, such as preparing all children for success beyond high school, calls for shared community investments of time and treasure that are beyond the scope of any single sector. Solving these complex problems will require expansion of partnerships and collaborations and reduction of siloed services. A growing body of evidence shows the key to lasting improvements in the well-being of Indiana children will be the proliferation of prolonged cross-sector partnerships.

The collective impact approach holds potential for tackling large-scale social problems. First defined by the Stanford Social Innovation Review in 2011, this framework brings together multi-sector stakeholders with a shared desire to address a large-scale social problem. It has been received with enthusiasm and widespread, rapid adoption. But with implementation and effectiveness varying greatly across initiatives, many question whether “collective impact” is simply a trendy update to the term “collaboration.” David Shapiro, CEO of MENTOR, notes, “Once something gets popularized and trendy, it also gets watered down and given a million meanings.”

The collective impact framework offers a fundamentally different approach based on discipline, high performance and constant adaptability. Stanford’s model outlines five key conditions that differentiate the approach from other collaborations or partnerships: a common agenda, shared measurement systems, mutually reinforcing activities, continuous communication, and the presence of a backbone organization.

Experts stress that three conditions must be in place before launching a collective impact initiative: an influential area champion, adequate financial resources and a sense of urgency for change. There must also be a core understanding that collective impact work takes time, patience and financial resources. Having worked with successful collective impact initiatives centered on youth mentoring, Shapiro stresses the importance of coming together around a critical issue. He states, “We are all trying to solve very hard problems. No one is saying that you are failing because you haven’t solved them the way that you’ve been trying to solve them. We’re just trying to figure out if there are new ways to continue to push on the solutions together.”

Promise Indiana, a nonprofit based out of Wabash, functions as the backbone organization for community-driven efforts to instill the hope, culture and habits needed to create pathways for all children to go to college. This initiative engages many sector partners including: government, nonprofits, schools, higher education institutions, community foundations, businesses, philanthropic partners and individual donors. In fact, the community applies to the program as a unit. Clint Kugler, Promise Indiana’s founder, explains that the program succeeds by “connecting current systems and creating a network of community champions.” To date, 17 Indiana communities have committed to this collective impact project, with several more planned to join in 2018.

Policymakers and funders can support increased impact by encouraging a collective impact approach to large-scale social issues. Stakeholders from all sectors must be invited to the table, and they must arrive with a learning mindset and a willingness to compromise in service of the overarching goal. The best collective impact initiatives include space to customize for local context. In addition to leaders from the public and private sectors, it is important to engage individuals who are directly impacted by the issue being addressed, those with the lived experience. As individual community members, we can all attend school board meetings, city council meetings and community gatherings to offer our perspectives and generate that critical, shared sense of urgency.

Collective impact is not simply a new buzzword to describe collaborations and partnerships of all types. Instead, if implemented with intention, the framework holds potential to create lasting change. Leaders are recognizing that solving complex social problems is more effective when isolated programs and interventions become systems of shared vision and coordinated effort. Collective impact work is time-intensive, messy and sometimes uncomfortable. Yet when we are talking about the well-being of our future workforce and leaders – our kids – collective impact is also an approach that can provide the insights, connections, energy and optimism needed to tackle our biggest challenges.

We all benefit when the next generation is healthy, safe, well-educated and economically secure. Indiana can be a wonderful place to be a child, but when we look at overall child well-being, it ranks as the 28th state in the nation. A deeper look at the data shows the disproportionate challenges and barriers to success faced by some children.

The Indiana Youth Institute (IYI) recently published the 24th annual KIDS COUNT Data Book, part of a national effort to measure childhood well-being at the local, state and national levels using data in areas including health, education, economics, safety and family.

The 2018 Indiana KIDS COUNT Data Book shows improvements over last year in children’s health insurance coverage and teen pregnancy rates. Meanwhile, significant challenges remain in the areas of economics, safety and education. Furthermore, substantial inequities appear in most indicators when the data is disaggregated by race, place and income.

In his 2018 State of the State address, Gov. Eric Holcomb set the goal for Indiana to become the best state in the Midwest for infant mortality rates by 2024, challenging us to work together to improve conditions for infants. The governor rightly labeled our current infant mortality rate as “unacceptable.” Indiana is ranked 41st nationally, with our babies being 24 percent more likely to die before their first birthday than infants nationally.

Indiana’s black infants are twice as likely as white babies to die before their first birthday, with this disparity widening over the prior year. Tony Mason, CEO of the Indianapolis Urban League, says “There are many socio-economic and health factors that put black infants at a higher risk of infant mortality than white infants. On a state level we need to address the issues of food access and quality care.” Jeni O’Malley, director of public affairs for the Indiana Department of Health, highlights numerous programs aimed at infant health, including the new Liv pregnancy mobile app launched in November.

Child maltreatment is also rising with increasing substantiated cases of abuse and neglect, hotline reports and placements in foster care. Over the past five years, Indiana has seen a 58 percent increase in the number of children in foster care with 58 percent due to parent drug and/or alcohol abuse.

Leaders in government, education and community services all stress the importance of collective efforts, purposeful and consistent partnerships, to increase educational outcomes for all kids. Superintendent of Public Instruction Jennifer McCormick says “Math and reading growth and proficiency impact student success, which is why we have placed an important focus on these subjects in Indiana. Compared to our sister states, we have made great strides.” Yet students of color and those with low incomes and other risk factors, such as homelessness, have lower educational proficiency rates. As Gov. Holcomb states, “We need to move those kids who are at the back of the line—the most disadvantaged among us—to the front of the line,” beginning with increasing access to quality pre-K programs.

Clearly, the conditions necessary for children to thrive are complex. Children growing up in poverty are significantly more likely to experience stress and deprivation that hinders development and school readiness, health and other outcomes. Indiana’s child poverty rates decreased, with 19.5 percent of Hoosier children living in poverty as of 2016, down from 20.9 percent in 2015.

Jennifer Walthall, secretary of Indiana’s Family and Social Services Administration, says her agency believes a two-generation approach provides the best solutions for reducing child poverty because it” addresses the needs of both children and adults in their lives together.” Mason points to providing youth with access to quality education and employment skills as key to breaking the cycle of poverty. Access to such multi-faceted interventions is vital for children of color, as black Hoosier children are three times more likely to live in poverty than their white peers (42.2 percent vs. 13.9 percent).

To ensure all Hoosier children have the opportunity to reach their full potential and become productive and responsible adults, we must understand and work together to improve the conditions that support their success. Our goal with the 2018 KIDS COUNT Data Book is to spark conversations and action throughout the state. Whether working in a region, county, city, school district or neighborhood, the data can help further such efforts.

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(Tami Silverman is the president and CEO of the Indiana Youth Institute. She may be reached at iyi@iyi.org or on Twitter at @Tami_IYI)

ADDITIONAL RESOURCES:

The news offers daily reminders of the complex challenges our communities, state and country face in the opioid crisis. Governor Eric Holcomb made attacking the drug epidemic a pillar of his inaugural policy agenda. Indiana University has announced its Grand Challenge to respond to the addictions crisis, committing $50 million to finding solutions. Indiana’s social service, emergency service, criminal justice, health care, and public health providers are working to respond to the relentless array of ongoing, interconnected needs arising from the crisis. Collaborations among local, state and federal agencies are developing new cross-cutting partnerships and interventions. At the Indiana Youth Institute, we are concentrating on identifying and addressing the short- and long-term consequences of the opioid crisis on Hoosier children.

For the past three years the number of children in Indiana’s foster care system has increased steadily. Experts, including Mary Beth Bonaventura, director of the Indiana Department of Child services, agree these increases are directly linked to the opioid problem.

“We have more children in care than we’ve ever had in history, nationwide and in Indiana, Bonventura said. “With all cases counted, (we have) close to 29,000 kids in care in some way shape or form.”

In 2016, 52 percent of children DCS removed from a home were removed due to parental substance abuse. When substance abuse is included as a secondary cause, that rate rises to nearly 80 percent.

Who cares for the kids caught in this crisis? In Whitley County, 2 percent of children live with foster parents, and 6.2 percent of children live with their grandparents. Bonaventura states in Indiana nearly 51 percent of all DCS foster care placements are with relatives. A September 2017 Pew Charitable Trusts study shows parents of adult children who either struggle with substance use disorder, or have died from an overdose, are raising an increasing number of their grandchildren.

Child placements with relatives, also called kinship care, can be a formal placement from the state or an informal arrangement between the parents and the relative caregivers. In fact, the Pew research estimates that for every foster child formally placed with a relative as a primary caregiver, there are 20 more in informal kinship arrangements. Tina Cloer, president and CEO of Children’s Bureau, Inc., says “I get calls all the time from people all over the city and state who have now inherited their nieces and nephews, their grandchildren, their friends’ kids, because they’re struggling with addiction.”

About 39 percent of grandparents caring for grandchildren are older than 60, 21 percent live below the poverty line and 26 percent have a disability. Like all children in care, children in kinship care have been found to lack adequate access to primary care, immunization, vision, hearing and dental care services. Despite these challenges, the American Academy of Pediatrics stresses the benefits of kinship care, including increased stability and well-being, reduced trauma, and an increased likelihood that siblings will stay together.

We can help grandparents and family members caring for these young victims of our state’s addiction crisis. Kinship care is often unexpected and unplanned. Many families are unaware of available help. For instance, grandparents and families who become licensed foster families can access services and financial supports. Organizations such as Grandfamilies.org provide valuable information on applicable laws and resources. Cloer works with many faith-based and community groups that are reaching out to grandparents caring for their grandchildren with basic needs items such as diapers, formula and clothing. As employers, we can offer flexible schedules for those suddenly faced with caring for these children. Schools and youth organizations also need to be sensitive to kinship care arrangements.

Any comprehensive solution to Indiana’s opioid crisis must include the impacted children and family members. Most child welfare experts agree that an increased focus on the impacts on the youngest victims is warranted. While we look for policy and systems change at the state level, at the local level we can immediately step in to help families providing kinship care. Actions taken now can help prevent this crisis from lasting into the next generation.

For more information on the impact of opioids on children, see IYI’s Issue Brief on the opioid epidemic’s impact on Hoosierchildren.

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Tami Silverman is the president and CEO of the Indiana Youth Institute. She may be reached at iyi@iyi.org or on Twitter at @Tami_IYI. IYI’s mission is to promote the healthy development of Indiana children and youth by serving the people, institutions and communities that impact their well-being.
Download data on children in foster families and children living with grandparents.

syringe, pills, and spoon

Youth are the hidden victims of the opioid epidemic.

Nationally, the issue has grown so severe that in 2017, the Commission on Combatting Drug Abuse and the Opioid Crisis submitted a letter to the president requesting that the opioid crisis be declared a national emergency. In Indiana, there were 1,271 deaths from drug overdoses in 2016, a 33% increase from 2011. Drug overdoses have risen so sharply in Indiana that they now kill more Hoosiers than car crashes and gun homicides combined.

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Youth Working at a Coffee Shop

Employment can be a valuable opportunity for youth.

In addition to the immediate benefits of earning a paycheck, employment experiences can deepen understanding of a young person’s dreams and career interests, facilitate conversations about financial literacy, teach important workplace skills, and provide opportunities to learn about responsibility, time management, and good work habits.1, 2 Employing youth also provides benefits to the hiring entity, such as the development of a strong talent pipeline.

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