Tuesday, October 3, 2023

If we cared about mental health, we would stop isolating kids

Image: Child behind door. Text: Stop isolating kids!
We can’t have a discussion about children’s mental health without talking about trauma caused by schools forcing kids into isolation.

And we can’t say we support children’s mental health while letting isolation continue.

Children should not be subjected to practices that harm their mental health.


Isolation is harmful and unsafe

Restraint and isolation (also called seclusion) cause severe psychological and emotional harm; suicidal ideation; anxiety; and depression.

Research shows that up to five years after restraint, children experience intrusive thoughts, recurrent nightmares, avoidance behaviors, and mistrust.

There is no educational, behavioral, or therapeutic benefit to the practice.

It does NOT keep schools safe. It harms our most vulnerable children and causes physical injury and mental distress to staff and other children who witness it.

It is also used in ways that are not legal

Last year, the US Justice Department ordered the Spokane School District to end the practice after finding the district discriminated against students with disabilities by illegally, inappropriately, and repeatedly restraining and isolating children with disabilities, depriving them of equal access to education and the opportunity to succeed. In a separate investigation, Disability Rights Washington found similar patterns at schools across the state.

State data show restraint and isolation are overwhelmingly used on:

  • Students with disabilities
  • Students who are Black
  • Students with a history of trauma

Often: The students with disabilities and students with a history of trauma are also Black students. Data shows strong racial disproportionality.

Often: Students with disabilities are also students experiencing trauma, especially if they are:

  • Repeatedly subjected to restraint & isolation
  • Bullied
  • Experiencing chronic sensory overload
  • Experiencing chronic stress

Not all behavior is a “choice”

Students with disabilities and those with a trauma history are often punished for stress responses. It happens when they are overwhelmed and dysregulated – in flight, fight, or freeze mode. They need support to regulate.

This involves connection and relationship. Feeling safe.

Often, that is not what they get. Schools tend to attempt behavior modification or force compliance. And when those don’t work, forcibly removing and locking up the child.

  • Rewards or punishment don’t work when a child is dysregulated
  • Forcing compliance doesn’t work when a child is dysregulated
  • Forcibly restraining and locking up a child pushes stress to a new level

The first 2 practices require the brain to be unstressed for the information to even process. The third escalates the brain’s stress response.

Once stress lights up the brain, people have weak control of thoughts, emotions, and action. Kids haven’t fully developed that part of the brain yet and need support even when regulated. So, if a child hits flight, fight, or freeze mode, step one needs to be de-escalate.

Restraint and isolation make things much worse.

Why is isolation bad?

First, isolation is not a situation where a child chooses to be in a quiet space to self-calm. It is also not a timeout, which requires an unlocked setting and monitoring and is sometimes written into behavior plans.

Isolation is legally defined in the Washintgon Administrative Code to mean restricting a child to a room or enclosure from which they can’t leave. Often, they are locked in a small cell or closet. Often staff first physically overwhelm and restrain the child.

State data indicate that restraint and isolation are used repeatedly with certain children. Most instances involve disabled children. Most instances involve young children, in preschool through the early grades. Black boys are disproportionately restrained and isolated. Children in foster care and children experiencing homelessness are also over-represented.

Forcibly isolating a child does not help them regulate. After the outburst, the quiet does not indicate a calm child. The quiet is an emotionally shutdown, possibly dissociated, child. They are experiencing a whole new level of stress.

Repeated instances create chronic stress.

Children subjected to repeated isolation live in a cycle of flight, fight, or freeze; further escalation; shutdown; and repeat.

They are not learning skills and strategies to regulate themselves.

Research suggests that such chronic stress causes brain changes that may contribute to anxiety, depression, and addiction.

Stress affects all systems of the body, puts health at risk, and undermines well-being.

Repeated use of restraint and isolation can lead to PTSD.

A recent review of state practice showed children were often isolated not because of imminent danger, but because the adult was trying to force them into compliance. This violates state law.

But most urgently, it harms children’s mental health.

Washington policy makers and educators need to acknowledge that for some highly vulnerable children school is not a place of refuge. School is where they are harmed.

Where are we going wrong?

It tracks back to the brain.

With restraint and isolation, the adult’s response isn’t de-escalating the stress response. It doesn’t involve co-regulating with the child. And it isn’t working with the child to address why they were triggered.

It is adding stress. It is pushing the child into chronic stress, and that is a very unhealthy place to be.

The practice does not align with how the brain functions, and it is not trauma informed.

What are some strategies?

To start, adults who work with children can change their mindset: The child isn’t giving you a hard time. The child is having a hard time.

Then, adults can help the child regulate, in the moment. This is where co-regulation comes in. Breathe deeply and calmly. Their breathing and heart rate will match yours. Acknowledge their emotions. Listen to them and repeat what you hear. Some people respond to counting things they see or smell.

There is a whole profession devoted to helping people pull out of panic. Resources are easily available.

The point is: The child must feel safe before their brains can regulate.

As they come out of flight, fight, or freeze, they may want to do a quiet activity. Or get some fresh air. Or splash water on their face. Offer them choices. Stay emotionally connected. Be safe for them.

And when their brains are ready to regulate, talk about what happened. What set things off?

For ongoing support:

  • Help the child resolve what triggered them. Collaborate with them
  • Help the child develop self-regulation and self-care strategies
  •  Make sure supports are in place (and honored) if the child has a neurodevelopmental disorder or other disability

School strategies include:

  • Multi-tiered systems of support (MTSS) – including for students using special education services. MTSS helps to ensure students benefit from nurturing environments and equitable access to instruction and supports that are differentiated to meet their needs. Training and support in MTSS have been available for years.
  • Universal design for learning (UDL) – an inclusive approach that anticipates diversity and plans for accessibility. It meets kids where they’re at and is based on how the brain functions. Training in inclusive practices like UDL has been a major focus of the special education department of the Office of the Superintendent for Public Instruction for several years.

  • Coaching on supportive interventions

  • Schoolwide expectations for a supportive school culture – including for students using special education services.

Just don’t lock the kids up.

We know it is deeply harmful to children’s mental health. It is used in discriminatory ways that deny children with disabilities equal access to education and opportunity to benefit.

We have easily available options that start with de-escalation and co-regulation – and change in mindset. 

You can't mess with kids' health and then come back later and say you care. Not when we know better.

Resources:


ACTION:

STATE: This issue came before the state legislature last winter, passed the House, but hit resistance in the Senate. If you want restraint and isolation to end, let your state legislators know. You can look them up here: https://app.leg.wa.gov/districtfinder

Or, you can comment on the bill (it will send a message to them).

LOCAL: Please also contact your local school board members. They can stop the practice locally. You should be able to find their contact information on your school district website.

FEDERAL: The Keeping All Students Safe Act was also reintroduced in Congress. 

On the House side, Washington Representatives Derek Kilmer, Suzan Delbene, Pramila Jayapal, and Marilyn Strickland co-sponosed.

On the Senate side it was co-sponsored by Washington's Senator Patty Murray. 

If you support, please let your Congress members know. You can look them up here:


 - Written by Ramona Hattendorf, Director of Advocacy, The Arc of King County