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Bystander distress, moral injury affects children’s mental health

Laurie Roberts

Counseling alone cannot address the current crisis in children’s mental health.

I’ve provided psychotherapy to children and adolescents for 33 years. It’s not possible to talk a child out of their emotional response to the travesties apparent in our society. Examples include homelessness, the ongoing pandemic of opioid and other “excess deaths” and childhood poverty, amid the escalated and antagonistic political climate.

The mental health of children is often harmed by psychological injuries that have been ignored by adults. Veterans’ service providers are continuing to expand our understanding of causes of post-traumatic stress disorder. Moral injury is understood to be a cause of PTSD, referring to unaddressed moral distress from witnessing or engaging in actions that transgress one’s moral beliefs and expectations.

Most state courts recognize the legal validity of the emotional distress suffered by bystanders when a close relative is severely injured or killed by another person’s negligence. This is considered negligent infliction of emotional distress upon a bystander. Children are naturally innocent and open, and are thus more vulnerable to emotional distress when witnessing the unaddressed suffering of other members of society. I believe the increased emotional concerns we are witnessing among our youths stem in part from moral injury that we adults have learned to ignore. I believe we are unintentionally but negligently inflecting emotional distress upon our children by failing to address suffering among members of our society.

Children’s mental health has been harmed by our society ignoring in practice the “character” we teach them to “count.” This was recognized by the U.S. Supreme Court 60 years ago, citing the harms of segregation to white children in Brown v. Board of Education. We teach children that we value responsibility, fairness, caring, citizenship. It is destabilizing to them when they see these character traits ignored in practice. We are all aware that the increasingly antagonistic political climate has contributed to the increase in anxiety and depression among young people. Jesuit Friar Thomas Reese has suggested the pope should add toxic political rhetoric and political lies to the list of sins.

What can be done?

Children’s mental health can be improved by easily adopted solutions that are cheaper than the status quo. As an example, decades of research show that spending on newborn home visitation programs returns as much as $9 to the economy for every $1 spent. This program brings a health worker to visit families with a newborn at home to help create a safe and nurturing home for the family. This program increases employment and decreases homelessness and drug use by parents. Interventions can also be provided that give cost savings. Housing First was implemented in Utah and effectively addressed the homelessness crisis. Recent estimates are that it is twice as expensive to continue with our current inhumane treatment – we are paying more to be cruel! Our county has struggled to address this issue. Any forward movement in collaborative problem-solving will contribute to greater resilience of our nation and diminish the toxicity of our politics.

Colorado is right now considering how to spend additional American Rescue Plan money. I urge La Plata County to set an ambitious goal of eliminating homelessness in our county in 2021. I urge the county to invest the majority of its money in workforce housing. ARP money is not taken from our county or city government budgets. However, by investing in Housing First, we will benefit from cost savings in future county budgets. Those savings can be used to target remaining children’s mental health needs, perhaps including a robust implementation of newborn home visitation programs – which would lead to further cost savings.

Children’s mental health will benefit from addressing the suffering in our community. Let’s take this opportunity to demonstrate responsibility, fairness, caring, citizenship. Let’s spend half as many tax dollars for better results by investing in programs like Housing First and newborn home visitation.

Laurie Roberts is a nationally certified school psychologist who lives in Bayfield.