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.)

Hoosier youth are the hidden victims of the opioid epidemic. The statewide crisis has a negative impact on child well-being, families and communities. Prevalence Hoosiers are more likely to die from a drug overdose than car crashes and gun homicides combined. In 2017, Indiana’s rate of fatal overdoses was 25.7 per 100,000. This is significantly above the national average of 22.4, ranking Indiana’s overdose death rate as the 15th highest in the nation.

  • In 2017, 1,138 Hoosiers died from an opioid overdose, a rate of 17.1 deaths per100,000 Indiana residents.2
  • In 2016, opioid overdose deaths were most common among white (89.8%), followed by black (8.9%) and all other Hoosiers (1.3%).
  • 83 out of the 92 Indiana counties had at least one

Read the Issue!

Indiana ranks 48th for child abuse and neglect which puts children’s safety at risk and impacts future well-being across a lifetime.

Reporting

The Indiana Child Abuse and Neglect Hotline serves as the central reporting center for child maltreatment allegations.

  • The total number of calls made to the Indiana Child Abuse an dNeglect Hotline in 2018 was 203,602, an increase of 30.6% since 2012.
  • In 2018, the Indiana Child Abuse and Neglect Hotline handled 242,994 reports; this has increased by 36.9% since 2012.
  • Every adult in the state of Indiana is a mandatory reporter of child abuse and neglect. Any adult who has reason to believe that a child has been abused or neglected is required to call the Department of Child Services: 1-800-800-5556.

Read the Issue!

Hoosier youth health is threatened by the harmful effects of tobacco use. Youth vaping is on the rise and is associated with a likelihood of increasing the use of both e-cigarettes and cigarettes in the future.

Harmful Effects

The use of any type of tobacco product is unsafe for young people. Tobacco use is the leading cause of preventable disease in the United States. All types of tobacco products are harmful and any exposure to tobacco smoke can cause immediate and long-term damage.

  • 3,700 Hoosier children under 18 become new daily smokers each year.
  • Nearly 9 out of 10 smokers start before age 18.4• Youth are sensitive to nicotine addiction and feel dependence earlier than adults. Nicotine addiction prolongs tobacco use and leads to severe health consequences.
  • As the brain continues developing until age 25, adolescent use of e-cigarettes containing nicotine can harm the part of the brain responsible for mood, learning and impulse control.

Read the Issue! 

By Tami Silverman, President & CEO, Indiana Youth Institute

April is Child Abuse Awareness Month, and 2019 is the year Indiana must take significant additional steps to protect our youngest and most vulnerable residents. Indiana has the third highest rate in the country of substantiated child abuse and neglect cases per 1,000 children. That’s far too many Hoosier kids.

Last summer, the Child Welfare Policy and Practice Group (CWG) conducted a six-month assessment of DCS, publishing their findings along with 20 specific recommendations. The recommendations range from improving treatment and support for families struggling with substance use disorder, to enhanced coordination among state agencies, to transforming the culture at DCS to encourage better staff decision making and responsiveness. Since the report was released, local and state leaders have pressed for action and additional ways to keep our kids safe. A number of responsive bills have since been proposed in the Indiana General Assembly, and the Governor’s budget includes increased funds to address the Department of Child Service’s (DCS) high caseloads, low salaries and turnover rates. We need to build upon these proposals.

A child may be declared by an Indiana court to be a Child in Need of Services (CHINS) if they are seriously impaired or endangered by abuse or neglect, and the child’s parents are unable or unwilling to correct the problem on their own. In 2017, 29,630 Hoosier children were designated as Children in Need of Services (CHINS), more than twice the number of kids so designated just three years earlier. Scott county has the highest rate of CHINS, followed by Perry and Spencer counties, while Hamilton, Hendricks and Washington counties have the state’s lowest rates. These children often face court hearings, new foster homes, and school transitions. In such cases, a court-appointed special advocate (CASA) or guardian ad litem (GAL) volunteer plays a critical role, ensuring that our most vulnerable children have with them a supportive adult to speak up for their best interests. Indiana has certified CASA/GAL programs in over 80 of our 92 counties. Yet nearly 6,000 children are waiting for a CASA/GAL volunteer.

Interestingly, new research shows that one of our state’s on-going efforts to increase child well-being, increasing access to high quality pre-K, can also help reduce child abuse and neglect. The Child Trends study examined records from children in Early Head Start programs in 14 states. While they were not expecting to find this result, the researchers discovered that participating three-year-olds experienced less family conflict and parenting stress, more supportive parenting and home environments, and better child cognitive and self-regulation skills. These positive factors made the preschoolers 10- 22% less likely to become involved with the child welfare system before age 16. It is understandable, and encouraging, that by engaging parents and helping families develop supportive habits, high quality pre-K programs can also reduce child abuse and neglect rates.

In addition to encouraging the passage of promising new legislation, and supporting increased funding and impactful community programs, we must remember that protecting our children is a responsibility we all shoulder. Every Indiana adult is a mandatory reporter of suspected child abuse and neglect. The Indiana Child Abuse and Neglect Hotline, 1-800-800-5556, is available 24 hours a day, 7 days a week, 365 days a year. Reports can be made anonymously.

In the words of the late President Kennedy, “Children are the world’s most valuable resource and its best hope for the future.” Throughout April, communities across the state will be holding prevention and awareness events. To find out what’s going on in your community go to the Prevent Child Abuse Indiana’s website at https://pcain.org/. This month, and every month, we must do more to provide the basic need of safety to all Hoosier children.

(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 

“When I was a child…” We all have likely said this, wrapping ourselves in nostalgia about what we perceived as a carefree, easier time. In many ways, to have been a child decades ago was less complicated. While today’s students have access to technology, information, and opportunities like never before, they also have unprecedented levels of stress, anxiety and depression. High-stakes testing, hyper-competitive sports and activities, and ever-present social media all add to the developmental stressors of growing up and finding where you fit in. We also better understand the compounding nature of childhood traumas, such as living in an environment exposed to substance use disorder, child abuse or maltreatment, neighborhood violence and poverty.  

Increasingly, educators are asked to identify and address behavioral health needs of large numbers of students. The Indiana Department of Education’s (IDOE) new Indiana Social-Emotional Competencies (Competencies) address the social and emotional needs of students in grades Pre-K through 12. IDOE’s Competencies start with five core standards: self-awareness, social awareness, self-management, relationship skills, and responsible decision-making, and add to that sensory integration and the mindset. This program is designed to advance student social and emotional development and has been proven effective in promoting academic achievement, reducing conduct problems, improving prosocial behavior, and reducing emotional distress. This is a positive development, as data related to the social and emotional well-being of many of Indiana’s students indicates concerning unmet needs. 

Distressingly, in Indiana, suicide is the 2nd leading cause of death for youth ages 15-24 and the 4th leading cause of death for youth ages 5-14. Research shows 1 in 5 Indiana high school students – which translates to approximately 200,000 of our children – seriously considered attempting suicide in the past year, and data from the past several years shows that percentage continues to rise. Indiana ranks 2nd out of 34 states measured in the percentage of students who made a suicide plan, and 3rd out of 37 states measured in the percentage of students who seriously considered attempting suicide. Experts and teens list several reasons for these trends, including insufficient access to mental health screening, poor access to mental health services, and resistance to seeking care.  

School suspensions and expulsions are commonly used to discipline students for disruptive behavior. However, many disciplinary techniques negatively impact student achievement, increase students’ risk of dropping out and increases the likelihood of involvement with the criminal justice system. Furthermore, in Indiana, black students are disproportionately subject to this type of intervention. Black students are 2.3 times more likely to receive in-school suspension, 4 times more likely to receive out-of-school suspension, and 2.2 times more likely to be expelled than their white peers. Students engaged in social and emotional learning programs routinely report increases in their optimism, improved social behavior, better self-control and decreased aggression. There also is evidence that equity focused interventions, such as social and emotional learning programs, along with alternatives to suspension, help reduce the discipline gap, mitigate the above negative impacts, keep students in school and improve overall school climate.  

It is encouraging to see that school climate, and school safety, has been a focus of the current legislative session, including strong support for funding programs that increase access to mental health services. Students who feel unsafe at school are more likely to miss days of class, and students who witness school violence are more likely to experience physical and mental health problems. In 2018, 25.9% of Hoosier high school students did not feel safe at school. Black high school students (33.4%) feel less safe at school, than their Hispanic (29.2%) and white peers (24.5%). Students who identify as lesbian, gay, or bisexual are 2.6 times more likely to miss school because they felt unsafe at school or on their way to or from school in the past month, than their heterosexual peers.  

IDOE’s investment in addressing the social and emotional, as well as academic, needs of our students will likely pay dividends for years to come. Studies show that on average, every dollar invested in such programs yields $11 in savings from juvenile justice crime, higher lifetime earnings and increased mental and physical health. It is also clear that social and emotional learning programs are even more effective when schools partner with afterschool and community programs and families. Indiana Youth Institute is honored to partner with IDOE to support the rollout of their Social and Emotional Competencies. The intersection of social and emotional well-being, school safety, and student success is clear, and we all benefit when all Indiana students are prepared to succeed.  

(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.   

 

 

Children thrive when they are surrounded by stable, consistent and meaningful relationships with caring adults.

Research shows that a quality mentoring relationship can have a resoundingly positive impact on young people’s lives. Youth with quality mentoring experience better educational, vocational and psychosocial outcomes than their unmentored peers. For all its benefits, unfortunately, one in three young people will grow up without ever having a positive mentor.

Read the Issue! 

By Tami Silverman, President & CEO, Indiana Youth Institute

What’s not to love about the Holidays – school vacation, extra cookies and treats, and of course, presents? But, like adults, children can easily become stressed or over-stimulated around the holidays. There are a few easy ways to make the season enjoyable, and meaningful, for our kids.

  1. Prepare kids in advance – talk to your children about what gatherings or events you will be attending, who they will see there and how long they will last. Letting kids know what to expect – and what you expect of them – will help prevent meltdowns.
  2. Teach the joy of giving gifts – children often focus on the gifts they hope to receive. As adults, it is our job to help them learn the importance of thinking of others. Engage children in selecting or making gifts for others. Ask children of all ages what they would like to give to those special people on your list – you may be amazed at how observant and insightful young children and teens can be.
  3. Give to others beyond your friends and family – whether it’s volunteering, participating in a toy drive, or giving children a few dollars to donate to a charity of their choice, this is the perfect time to encourage young people to learn about the needs of their community, state and globe.
  4. Keep as many routines as possible – children thrive on stable bedtimes, healthy food, and plenty of exercise. Try not to schedule more than one major holiday event per day and allow downtime between events. If family commitments don’t avoid daily breaks, build them in before and/or after each gathering.

Finally, give yourself a break. Have fun with the important traditions and say “no” to the activities with lesser significance to your family. Set aside time to play games, watch movies, or simply laugh with the children in your life. It is often the unexpected giggles or unplanned moments that make lasting memories.

teenager vaping

Indiana’s children face many significant health issues, with our opioid crisis and an alarming increase in nicotine use being two of the most urgent. Our state needs all its children to be healthy and have the opportunity to become the strong workforce and leaders of tomorrow.

Children are often the unseen victims of the opioid crisis, with kids of all ages both directly and indirectly affected. Family and community opioid abuse often affects younger children, while older youth may combat opioid addiction themselves. Hoosier children whose parents struggle with substance use disorder are more likely to experience abuse or neglect than other children.

Research shows a clear connection between parents’ substance abuse and child maltreatment, and the number of Indiana kids negatively affected by substance use disorder is growing. Parental substance abuse is the primary factor in more than half (52.2%) of Indiana cases where a child was removed from their home. The addictions crisis also has contributed to a crisis in foster care for the state, with the number of children in foster care having risen 50.2 percent from 2012 to 2015.

Although we may not hear as much about Indiana’s alarmingly high rates of tobacco use, the toll it is taking on our kids is no less dire. The use of any type of tobacco product is unsafe for young people. Experts agree that whether a teen smokes or vapes, the nicotine is both addictive and damaging to their developing brains.

Youth are sensitive to nicotine addiction and feel dependence earlier than adults. Each year, over 3,500 Hoosier children under 18 become new daily smokers. Nearly 9 out of 10 smokers start before age 18, and three out of four teen smokers become adult smokers. The brain continues developing until age 25 and adolescent use of products containing nicotine can harm the part of the brain responsible for mood, learning, and impulse control.

Today, the most commonly used tobacco product among teens are e-cigarettes. When adolescents use vaping products, they are both more likely to use cigarettes, and more likely to increase their use of cigarettes and vaping products over time. Teens who would otherwise be deterred from tobacco cigarettes may be attracted to e-cigarettes because of their unique qualities such as flavorings, design, and perceived social acceptance. The top reasons why teens use e-cigarettes are the use of the product by a friend of family member, availability of flavors, and the belief that vaping is less harmful than other forms of tobacco.

Smoking and substance use are just two of the health issues impacting young Hoosiers – overall, we rank 34th in kids health. We can, and must, do better. We will not change these trends without investing in our kids and our communities. Distressingly, we are 49th out of the 50 states in per-capita spending on public health issues like smoking, drug addiction and obesity.

The Indiana Youth Institute is part of a broad coalition of health, business and youth leaders that are coming together around a plan that calls for improving health outcomes by raising the state cigarette tax as part of next year’s biennial budget. A $2 increase in the state cigarette tax—which is currently under $1 and even lower than Kentucky—would significantly lower the appeal of cigarettes to young, price-sensitive people. It also would generate $360 million in the first year alone that could go toward funding opioid treatment and prevention, educating and protecting youth from e-cigarettes and smoking, addressing our state’s infant mortality concerns and strengthening the Healthy Indiana Plan.

Kids and families benefit from these initiatives. We have the potential to move from bottom ten states in public health spending to the top 10. By raising cigarette user fees in next year’s budget, we can make meaningful and transformative investments to improve our kids’ health.

Our kids are our future. They have limitless potential. Let’s ensure they have the good health needed to become Indiana’s next generation of citizens, innovators, and leaders.

(Tami Silverman is the president and CEO of the Indiana Youth Institute)