School Climate and Children’s Health

Students with Low Levels of School Connectedness, by Race/Ethnicity, 2013-2015

Image of Graph for School Connectedness

A positive school climate is an important factor that defines effective schools. When school climate is positive, students are more likely to succeed academically and engage in healthy behaviors. A key measure of school climate is level of school connectedness, which takes into account if students feel happy, safe, close to people, and a part of school, and that teachers treat them fairly.

Improving school climate is a promising strategy to narrow achievement gaps among groups of students. However, student groups experience school climate differently. For example, in California, higher percentages of African American/Black and American Indian/Alaskan Native students report low levels of school connectedness in 2013-2015 (15% and 14%, respectively) compared with Asian and White students (both 8%). In addition to race/ethnicity, gaps also exist by parent education level and sexual orientation. By creating an inclusive, safe, and academically challenging school climate and utilizing targeted interventions for some groups, we can expect improved academic and health outcomes for all students.

California law now requires school districts to address school climate as part of the Local Control and Accountability Plans. Learn more about policy and practice recommendations to nurture a strong school climate.

This data release is a part of Kidsdata’s Youth in Schools series. In partnership with WestEd, we are featuring data from the California Department of Education’s California Healthy Kids Survey.

Data in Action

See Kidsdata at the Positive Behavioral Interventions and Supports (PBIS) conference in Sacramento on September 25th where we will discuss identifying inequity to target interventions.

Recently Released Data

We are continuously updating our data. Click the links below to see the latest:

Weight

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Youth in Schools Data Available on Kidsdata

Kidsdata announces a comprehensive suite of data, Youth in Schools, including new and updated indicators across more than a dozen topics from the viewpoint of California’s students and school staff. These data are available for state, county, and school district levels, and student-reported data are easily customizable by grade level, gender, race/ethnicity, sexual orientation, parent education level and level of school connectedness.

Youth in Schools data come from the 2013-2015 California Healthy Kids Survey (CHKS) and California School Staff Survey (CSSS), the largest statewide surveys of school climate, risk behaviors, and protective factors in the nation. This data release is made possible by a partnership with WestEd who developed and administered these surveys for the California Department of Education.

The educational environment is one of the core foundations that shape children and is crucial to ensuring optimal health and well being. Positive school climate, supportive student services, and safe campuses are critical factors for promoting strong emotional, healthful and academic futures for our children.

Explore behaviors, identify disparities, and take action with hundreds of findings about Youth in Schools at your fingertips. A few findings for 2013-2015 include:

We began releasing some of these data earlier in the year, and you’ll be hearing more from us as we highlight important findings from Youth in Schools.

List of Youth in Schools Data

For indicators that are new to Kidsdata – look for the [NEW] notation.

Access to Services for Children with Special Needs

Bullying and Harassment at School

Children’s Emotional Health

Gang Involvement

Health Care

Nutrition

Physical Fitness

Pupil Support Services

School Attendance and Discipline

School Climate

School Safety

Youth Alcohol, Tobacco, and Other Drug Use

Youth Suicide and Self-Inflicted Injury

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Children of Immigrant Families

Children Living with One or More Foreign-Born Parent, 2016

 

Children with Foreign Parent Graph

Federal immigration policies and rumors about impending policies have a bigger impact on children in California than on children in most other states. In California, nearly half of children have at least one foreign-born parent. In contrast, this group accounted for about one-quarter of all children in the United States. In California, odds are youth sense the rising fear and uncertainty of family stability at home or in their community, which over time can have negative impacts on emotional and physical health.

The direction of current immigration policy may have unintended consequences beyond harming child health and well being. Without immigrant parents, the United States would have about one-million fewer children (PDF, pg. 10), adding to an already documented shortage of children relative to adults. Fewer children means increasingly serious consequences for supporting the future labor force and sustaining an aging population. Each child — regardless of country of origin — is more important to our future than ever before. The health and well being of all children should be our nation’s priority.

Learn more »

Data in Action

Children’s Partnership and the California Immigrant Policy Center share research findings and identify actions to support healthy development of children in immigrant families in The Effect of Hostile Immigration Policies on Children’s Mental Health.

Recently Released Data

We are continuously updating our data. Click the links below to see the latest:

Immigrants

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Maternal Emotional Health Topic New to Kidsdata

Kidsdata and the California Department of Public Health (CDPH) have partnered to share important new measures of maternal mental health before and after a live birth from the Maternal and Infant Health Assessment (MIHA) survey. A woman’s emotional well-being during this time is central to her health and to her infant’s development. Depression during and after pregnancy is a serious medical condition that requires culturally appropriate and trauma-informed support and treatment.

Guest authors, Christine Rinki and Amina Foda, Research Scientists with the California Department of Public Health, share important findings about symptoms of depression among women who recently gave birth in California:

Symptoms of depression during and after pregnancy

According to a recent Data Brief (PDF) from the California Department of Public Health’s Maternal and Infant Health Assessment (MIHA) survey, about one in five women who give birth in California experience symptoms of depression during or after their pregnancy.

Although relatively minor changes in mood the first few days after childbirth are common, depression that arises during or after pregnancy is a mood disorder characterized by intense feelings of sadness, anxiety or despair that last for two weeks or longer and prevent women from doing their daily tasks.

If untreated, depression during or after pregnancy increases the risk of cognitive and emotional development problems in infants, and may result in fundamental changes in the brain that can have lasting effects into childhood. Depression occurring after the baby is born can negatively impact women’s breastfeeding practices and ability to bond with their infants. Importantly, depression at any point during or after pregnancy increases the risk that women could develop chronic depression or die by suicide once the baby is born, which in turn have profound impacts on children.

Thankfully, with the appropriate care, most women can experience full recovery. Best practices to address maternal mental health include screening for depression throughout prenatal and postpartum care, and increasing the availability of services that are affordable, culturally and linguistically appropriate, and that acknowledge the history of trauma common among women with depression.

Prenatal and postpartum symptoms of depression in California

In California, 14.1% of women experienced prenatal symptoms of depression and 13.5% experienced postpartum symptoms of depression. Many, but not all, women who experienced symptoms of depression would be diagnosed with clinical depression.
There was substantial geographic variation among counties with data. Prenatal symptoms of depression ranged from 8.5% in San Mateo County to 20.2% in Stanislaus County, while postpartum symptoms of depression were 9.8% in Yolo County and 18.8% in San Joaquin County.

Prenatal Symptoms of Depression

Prenatal Symptoms of Depression Graph

See data on postpartum symptoms of depression »

Prenatal symptoms of depression: Important, but often overlooked

Despite the serious risks associated with prenatal depression, including low birth weight, premature delivery and changes in infant brain development, its importance is often overlooked. MIHA results (PDF) indicate that prenatal symptoms of depression often precede postpartum symptoms of depression in women. In California, 53% of the women who experienced prenatal symptoms of depression went on to report them in the postpartum period. In contrast, only 7% of women without symptoms of depression during pregnancy experienced them after pregnancy. In order to have the best chance of improving outcomes for the mother and infant, routine screening and treatment for depression should begin early in pregnancy, a time when women have increased contact with the health care system.

Disparities in prenatal symptoms of depression

Though symptoms of depression during and after pregnancy can affect women regardless of their background or circumstances, some groups in California experience them at disproportionately high levels. Women who are Black or Latina had higher rates of symptoms of depression compared to other racial or ethnic groups. During pregnancy, symptoms of depression were twice as common for Black (19.9%) and Latina (17.1%) women compared to White (9.5%) and Asian/Pacific Islander (10.3%) women. Reports of prenatal and postpartum symptoms of depression were highest among women with incomes below poverty (20.7% and 18.2%, respectively), and declined as income increased.

Prenatal Symptoms of Depression by Race/Ethnicity

Prenatal Symptoms of Depression by Race/Ethnicity

See data on disparities in prenatal and postpartum symptoms of depression »

Programs that address perinatal emotional and mental health

The Maternal, Child and Adolescent Health Division of the California Department of Public Health strives to improve maternal emotional and mental health by tailoring primary prevention to address the social factors that lead to poor emotional and mental health and to promote individual protective factors. Additionally, many MCAH Division programs screen for symptoms of depression using validated tools, and provide appropriate referrals and support for women in need of care. For example, the Black Infant Health Program conducts group sessions with complementary case management that provide social support while helping women develop skills to reduce stress, enhance emotional well-being and develop life skills in a culturally affirming environment that honors the unique history of Black women. The California Home Visiting Program funds home visiting models throughout the state that use a strengths-based approach to enhance the mother-baby relationship. Home visitors address family needs such as financial struggles, relationships, and navigating the health care system, while support groups and mental health consultation directly address emotional well-being.

Striving for equity in perinatal emotional and mental health

The underlying causes of the maternal mental health disparities identified in the MIHA Data Brief are multifaceted. For example, Black and Latina women in California experience higher levels of risk factors for depression such as poverty and childhood hardships compared to other racial and ethnic groups. Institutional racism (the practices of social and political institutions that result in unfair treatment of Black, Latina and other minority groups) likely plays a role in explaining the concentration of risk factors, and the subsequent racial and ethnic disparities in depressive symptoms. Achievement of emotional and mental well-being for all California women during and after their pregnancies can have profound societal impacts. Action to address social factors can improve outcomes for low-income and minority families.

 

Recently Released Data

We are continuously updating our data. Click the links below to see the latest:

Maternal Emotional Health

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Access to High Quality Health Care for California Children

Guest author, Holly Henry, PhD, is a Program Officer at the Lucile Packard Foundation for Children’s Health. She works to improve the system of care for children with special health care needs. Dr. Henry focuses on promoting effective care coordination, a practice that links children and their families with appropriate services and resources to support optimal health.

Every child deserves high quality health care that is accessible, family-centered, culturally competent, coordinated, continuous, compassionate, and comprehensive. Unfortunately, our current system of care for children is deeply fragmented and health needs are not being met. One approach to strengthening coordination of care is providing care through a medical home. The medical home recognizes the family as a constant in a child’s life and emphasizes partnership between health care professionals and families. It facilitates collaboration between patients, clinicians, medical staff, and families. More importantly, a medical home extends beyond the four walls of a clinical practice – it includes specialty care, educational services, and family support.

Receipt of Care Within a Medical Home, 2016

In 2016, 42% of California children received care within a medical home compared with 49% of children nationally. Receipt of care within a medical home varies across the state. The counties with the highest and lowest percentages of children receiving care within a medical home, among counties with data, are also noted in the graph above.

Children receiving care from a medical home have fewer outpatient visits and families report better child health status. Families also report increased satisfaction with their child’s care. For children with special health care needs this can also mean decreased length and frequency of hospitalizations and lower out-of-pocket spending.

All children would benefit from being cared for within a medical home. See how your county is faring.

Data in Action

Learn more about care coordination and how it can help reduce health care fragmentation. The Lucile Packard Foundation is hosting a webinar on care coordination for children with medical complexity on July 26 at 10 am PST. Audience Q&A is highly encouraged. Attendees can listen via web or phone. Learn more and register.

Recently Released Data

School Provides Services for Students with Special Needs (Staff Reported) [NEW]

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Childhood Adversity Data Available by County, City and School District

Children with Two or More Adverse Experiences (Parent Reported), 2016

ACEs by County

Adverse childhood experiences – such as family separation, abuse, exposure to violence, and poverty – can have negative, long-term impacts on the health and well being of a child. According to the American Academy of Pediatrics, separating children from their parents, for example, removes the buffer of a supportive adult or caregiver who can help mitigate stress and protect against chronic conditions like depression, post-traumatic stress disorder, and heart disease. The more intense, repetitive and long-lasting the events experienced, the greater and more sustained their impact.

Childhood adversity data based on parent responses about their child’s experiences are available on Kidsdata.org. The data come from the 2016 National Survey of Children’s Health, and cover many California counties, cities and school districts. For example, Placer County, which has among the lowest rates of childhood adversity in the state, can be explored further by looking at Roseville, a city within the county, or by school districts within the county. See what childhood adversity data are available in your local area by clicking the + icon next to the county name.

Data in Action

Consider attending the 2018 ACEs Conference & Pediatric Symposium: Action to Access, October 15-17 in San Francisco. The conference explores problems of access, and how to reduce children’s exposure to adversity and its traumatic effects. It is co-hosted by the Center for Youth Wellness and ACEs Connection.

Join a community of advocates and practitioners committed to reducing childhood adversity and increasing resilience, visit acesconnection.org.

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The Mental Health Journey of a Mother and Daughter

Mental health disorders affect as many as 1 in 5 U.S. children each year. The vast majority of mental health problems begin in adolescence, with depression being the most common. Many young people who need mental health treatment do not receive it. Sadly, even if mental health problems are identified, children often face challenges with stigma.

We are pleased to feature mother and daughter guest authors, Olga and Magaly. When Magaly was 11, her mother found suicide plans on her phone. Six years later, they continue to navigate the challenges of Magaly’s diagnosis of depression and psychosis. Their journey touches upon the importance of early identification, access to care and the struggles for support.

Here is their story.

Raising a daughter with depression and psychosis
Olga is a Family Resource Specialist at Support for Families in San Francisco.

Magaly was 11 years old when she planned to kill herself. I had noticed cuts on her arm for some time but she always told me they were scratches from falling. It wasn’t until the cuts went from a criss-cross to deep straight lines that I knew something was wrong. I looked through her phone and found detailed plans, ranging from which friend would get her belongings to notes saying goodbye to loved ones. She left in the middle of school that day, walking around for hours, looking for a highway to jump off. The earliest doctor’s appointment available was for the following Monday, which was extremely frustrating. I spent that weekend watching Magaly’s every move, but also careful not to alarm or scare her. I didn’t want her to run away.

On that Monday, Magaly was diagnosed with major depression and psychosis. She finally told us about the strong voices inside her head. She said she had been hearing them for as long as she could remember. It was then that I realized why, as a baby, Magaly would cry any time she was left alone. She once turned purple from crying when I left her momentarily to use the restroom. It was the voices that were scaring her.

Sending your child to a behavioral health center is not the same as to a regular hospital. That same day they put Magaly in the ambulance for transport and I was not allowed to ride with her. It was a state policy. Parents are only allowed to see their child during visiting hours, the rest of the time the doctors just call you with updates or requests for medication approval. I remember Magaly calling me from the center, scared and begging to come home. “Mom this is my fault, I’ll try to behave, please, I’ll do anything to come home,” she pleaded. What else could I tell her except to hang in there and that I would come during the next visiting hours.

For Magaly, every day feels like she is carrying a big stone on her back. I know this is why it’s not easy for her to do the simple everyday things like get out of bed, shower, and go to school. She always has this extra weight with her. This is something she will struggle with for the rest of her life.

There is a stigma around mental health that often feels like blame for you and your child. From the policies that dictate when a parent can be with their child during treatment to the way we question parents of children with mental illness, the entire experience can be extremely isolating. What parents need is support. From a peer-to-peer perspective, it is helpful to talk with parents about how to manage the stress. When we meet others who are surviving it gives the rest of us hope. From caregivers, parents need a safe place where their concerns are heard, not criticized. From our health care system, we must demand mental health services for our children. We cannot wait until they are planning suicide to intervene and we must find ways to care for our children beyond being stabilized in a hospital.

Magaly turns 18 in June, and with that comes the usual mother-daughter challenges. You know everything when you’re 18, right? She doesn’t trust me as much. Sometimes she won’t tell me how she’s feeling because she knows I’ll take action. These days I’m trying to step back more and let Magaly learn to ask for help on her own. I know she will be the best advocate for herself and other children just like her.

Living with depression and psychosis
Magaly, 17, is from San Francisco. She is a student at Galileo Academy of Science and Technology and a published poet.

The voices in my head are weird. Right now, there are five of them, two boys and three girls. The voices can be like whispers; those are constant. It sounds like a hissing noise, like a window that is open a crack on a windy day. The voices can also be clear, speaking distinct phrases. I’ll see a tree and the voices will say, “You can hang yourself from that tree.” My inner monologue is louder but sometimes the voices can defeat it. When that happens, I have to yell out loud to hear myself.

When I was 11, my mom found my suicide plans on my phone. I had done internet research beforehand and made three options for myself: 1. Take pills, 2. Get run over, 3. Slit wrists. When I was evaluated at the Children’s Crisis Center, they kept asking me how many times I had thought about killing myself, and how many times I had felt depressed. I remember staring at a plastic water bottle and thinking about why they make water bottles, who came up with that idea. I completely disassociated from what was happening; they were sending me to a hospital and I just wanted to ignore everyone. I was diagnosed with major depression, psychosis and post-traumatic stress disorder.

The hospital felt like a prison. Nobody was allowed to wear shoes with laces or hoodies with strings. The walls were painted a light yellow and the windows were covered with curtains held back with Velcro. I felt trapped and terrified. When I called my mom she told me, “We didn’t want to send you there. It probably doesn’t look like a prison.” But she wasn’t there, she didn’t know.

I’m not sure when I started to hear the voices. My mom told me I couldn’t be left alone when I was a baby. I remember having panic attacks and now I realize it’s the voices. When I really think about it, I actually have no memories of not being depressed, it’s always been there. Sometimes when people ask how I’m doing, I want to lie and say I’m fine. If I told people how I really feel, they would send me to a hospital.

Sometimes I consider suicide for the stupidest reasons. The voices will say, “You gotta do this, you gotta do this now.” I’ll feel it for a minute, maybe an hour, sometimes for a whole day. That’s when I use my inner monologue to remind me why I need to live. I think of my sister and how much she needs me. I think of Kasia, my mentor from the Big Sister, Big Brother program. They are rocks. Support from friends, school and home all help. These days I feel depressed but in a different way, it’s not numb like before, I can feel other things at the same time. That’s good because it means I haven’t gone the other way, the point of no return.

Special thanks to Olga and Magaly for sharing their story.

Recently Released Data

We are continuously updating our data. Click the links below to see the latest:

Health Insurance Coverage (Regions of 65,000 Residents or More), by Age Group

Health Insurance Coverage (Regions of 10,000 Residents or More), by Age Group

Medicaid (Medi-Cal) or CHIP Coverage, by City, School District and County (Regions of 65,000 Residents or More)

Receipt of Care Within a Medical Home (Regions of 65,000 Residents or More) [NEW]

School Health Centers

School Provides Adequate Health Services (Staff Reported)

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Three Mental Health Bills for California Children

Mental Health Awareness month is a time to note that the emotional health of children is an integral part of overall health, as physical and mental health are intricately linked. Mental disorders affect as many as 1 in 5 U.S. children each year and are some of the most costly conditions to treat – mental health problems among young people under age 24 cost the U.S. an estimated $247 billion annually. Unfortunately, the majority of young people who need mental health treatment do not receive it, and mental health problems in childhood often have negative effects in adulthood.

The California Legislature has proposed several bills that address children’s mental health, from increased training and peer supports to early prevention and funding parity. Three current bills worth noting:

SB 906: Medi-Cal: mental health services: peer support specialist certification
This bill establishes a statewide peer support specialist certification program for health providers. The peer support specialist would have the experience and the formal training to promote mind-body recovery for adults or transition-age youth.

SB 1019: Youth mental health and substance use disorder services
This bill creates financial parity for children’s mental health and adult mental health funding. It requires at least half of all funds allocated to the Mental Health Services Oversight & Accountability Commission under the Investment in Mental Health Wellness Act of 2013 be used to expand mental health services for minors.

AB 2686: Early identification of pupil mental health issues: in-service training for certificated employees and classified staff
This bill requires each school district, county office of education, and charter school to provide in-service training to certificated employees and classified staff who provide instruction to or have regular personal contact with pupils in K-12th grades on the early identification of pupil mental health issues.

Kidsdata is a source for policy options that could promote children’s emotional health.

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How to View Data by School District

Curious to know how children’s health differs by school district? Data such as emotional health, school attendance and discipline, and drug use are available at the school district level. It’s just three easy steps from the left side of the visualization:

1. Click the “+” sign next to your county of choice

2. Click the “+” sign next to “School Districts” and all available school districts will appear

3. Select your district of interest

Data in Action

The Kidsdata team will be at the California School-Based Health Conference on Friday, May 18, in Sacramento, CA. The event brings together providers, educators, advocates, and other leaders in the school-based health care movement across the state. Be sure to stop by our booth to say hello!

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Rate of Depression is Double for Gay, Lesbian, Bisexual Youth

Depression-Related Feelings Among Gay, Lesbian, Bisexual Youth, 2013-2015

An alarming 61% of youth who identify as gay, lesbian or bisexual have felt depressed in the previous year in contrast to 29% of their peers who identify as straight. These students, who are in grades 7th, 9th, or 11th grade or are in non-traditional programs, felt so sad or hopeless almost every day for two weeks or more that they stopped doing their usual activities.

Disparities among youth who experience depression-related feelings vary widely across student groups. Students with particularly high percentages of depression-related feelings include those in non-traditional schools, those with low levels of school connectedness, those whose parents did not graduate from high school, and American Indian/Alaskan Native or Hispanic students.

The tables below call attention to disparities among groups of students in California. Use the links to see additional data by county and school district.

Depression-Related Feelings Among Student Groups, 2013-2015

By grade level »

By level of school connectedness »

By parent education level »

By race/ethnicity »

This data release about emotional health is a part of Kidsdata’s Youth in Schools series. In partnership with WestEd, we are featuring data from the California Department of Education’s California Healthy Kids Survey.

Data in Action

The Stanford Center for Youth Mental Health and Wellbeing featured how to overcome cultural barriers to mental health care access at its Adolescent Mental Wellness conference.

The Kidsdata team will present on chronic stress and emotional health among California’s youth at the California Mental Health Advocates for Children and Youth Conference.

Recently Released Data

We are continuously updating our data. Click the links below to see the latest:

Youth Suicide and Self-Inflicted Injury

Suicidal Ideation (Student Reported), by Grade Level

Number of Youth Suicides, by Age

Youth Suicide Rate

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