More than a third of Cortland County’s adolescents have an “adverse childhood experience” in their past, a study shows, and those kids are four and five times more likely to have suicidal thoughts, or use substances such as nicotine.
Educators and health providers can use that data compiled by the Rural Health Institute in several ways:
•To show teens just how many – or how few – of their friends engage in risky behavior.
•To lobby for funds and resources to address mental health in adolescents.
•Helping school policy makers set priorities and determine which programs to enact.
For more than 20 years, the Rural Health Institute, formerly Cortland Area Communities That Care, has surveyed seventh through twelfth graders in Cortland County. Since 2019, every school district in the county has participated in the annual survey – 1,600 to 2,000 students.
Carrie Whitney, who teaches health and psychology at Homer Central School District, said she uses the survey’s data to help bring her lessons closer to home. She is currently doing this in her unit on tobacco, alcohol and other drugs, she said.
“I speak to them about national numbers, but then I bring it back to Cortland County to help with perception and what their thought processes are,” Whitney said. “They perceive that everybody is smoking marijuana, and then I can show them the results, where in reality it’s only 13% of students.”
The initial surveys focused on substance use, but that’s been dropping for so long that researchers have broadened the survey to consider drug use as a symptom of a larger problem.
The new survey asks questions about social connections, social media use, disabilities, gun access, mental health support, and provides recommendations. It also asks about adverse childhood experiences, which the U.S. Centers for Disease Control and Prevention defines as preventable, potentially traumatic events that happen to children.
The concept of ACEs stems from a 1990s Kaiser Health study, where women with ACEs were found to have adverse medical issues, said Lisa Hoeschele, executive director and CEO of Family & Children’s Counseling Services
“It was literally transforming their bodies and their brains, and actually having an impact on their physical health,” Hoeschele said. “Just take that same concept, and recognize what effect those ACEs can have on behavior and mental health.”
The data on ACEs cover three categories: neglect, abuse and household challenges, such as divorce or changes to caregiver relationships.
“It changes the conversation from ‘this kid is acting out,’ to ‘this child has an illness that needs to be addressed,’” Hoeschele said. “It makes us look at family dynamics and mental health issues with children in families as a systems problem, not an individual behavioral problem.”
More than one-third, 33.4%, of Cortland County youths have experienced at least one adverse childhood experience, the data from the survey shows. The most common: witnessing significant changes to caregiver relationships; living with a parent who has mental health concerns; and feeling unsupported, unloved or unprotected.
Youths who reported having an ACE were about four times as likely to report suicidal ideation than their peers. More than 14% of students with an ACE reported vaping, while less than 5% of students without ACEs reported having vaped.
“It’s interesting to see the correlation between things,” Whitney said.
“We can talk to mom and dad, and say ‘this is what your child is experiencing; this is why it’s perhaps causing this behavior that you’re not happy about,’” Hoeschele said. “‘Let’s talk about how we change the system, so your child can handle those issues more effectively and appropriately.’”
The survey also helps determine what policies and programming should be implemented into schools, she said, and determines what issues aren’t being addressed. One program implemented as a result was the offering of early recognition screenings for mental health issues.
The data also serves as a concrete way for Hoeschele to state her case to outside vendors for financial support in schools.
The data is helpful to a variety of community agencies, said Susan Williams, a family and community liaison at Homer Junior High School, because most of them rely on grant funding.
“We know, without a survey, that the needs on the ground are tremendous, and kids are experiencing significant mental health issues,” Hoeschele said. “This is data we can use to say ‘we know this is the case where we are working… there’s outside confirmation of the fact that those needs are there, and your funding could help us address those needs.’”
