By Renetta Burrell Perry
According to a 2015 survey of children in the City of New Orleans between the ages of 10-16, it was found that close to 40 percent had witnessed first-hand some form of violence, whether community or domestic, and many (around 18 percent) had witnessed a murder. Sadly, over half of the children surveyed had endured the pain of having someone close to them murdered. Though extremely disturbing, these statistics represent a hotbed of psycho-societal issues that run rampant throughout our schools and plague our children. In an ideal world, these issues would be recognized early-on, assessed and treated, leaving children with the skills and fortitude to move on and focus solely on their futures. However, in a city the size of New Orleans where resources are grossly underweight in comparison to these societal ills, the pendulum swings in a much different direction. Enter the Center for Resilience, an innovative, pioneering school designed in response to the lack of out-of-school intensive support for children with tremendous emotional and behavioral challenges.
Starting out over four years ago as the New Orleans Therapeutic Day Program, the Center for Resilience partners with Tulane University Medical School Department of Child and Adolescent Psychology and is a non-profit organization operating with funding from the Orleans Parish Schools (who are their main contract for students) and philanthropic donations. The school is the only one of its kind in the State of Louisiana, providing services to children who are referred by their home schools. Students receive all of the services on site and as a result, receive academic services with teachers, counseling services, sessions with individual therapists and daily group therapy. In addition, if families opt into it, children can also receive all of their medication management through the medical director who is an on-sight psychiatrist. Children spend their entire day at the school and the goal is to build the skills necessary for them to transition back to their home school.
“Love, But not Tough Love”
The feeling that children attending the Center for Resilience are in capable and caring hands, is overwhelming as Liz Marcell Williams, Ed.D and CEO brings her extensive wealth of knowledge and experiences as a former special education teacher to the Center where she says “we are about love, but not tough love.” Describing a typical day in the Center as opposed to a regular school setting, she says, “we focus on healing and wellness. We think that healthy relationships are the cornerstone to that, so we’ve intentionally created an environment that is built on unconditional, positive regard for our children. This is a place where it is ok to have mistakes and to fail and to have a fresh start the next day. So, we’re a non-punitive organization. We implement exclusively restorative practices as the quote/unquote consequences for behavior. And we believe that children do well if they can, so we’re about thinking of what their learning skills are and how we can address those so we can build up the skills necessary so that they can go back to their home schools and be successful in that setting.”
Williams describes the typical protocol for students and parents who have been referred to the school and how many of them who have become numb to the violence that surrounds them, need deep probing into the layers of issues that ultimately lead to behavioral problems. She uses the “iceberg metaphor” when describing this, saying, “not a lot of our kids here have true mental illness, but they have psycho-social stressors. We use the iceberg metaphor all the time around here. Oftentimes in the school’s conceptualization of behavior you’re looking at the stuff that you can see above the water, if you’re thinking of an iceberg: cursing, running around the school building, not completing work, getting into fights with other kids or with adults, difficulty building friendships; these are the reasons that kids get referred here.” Explaining her school’s approach, she adds, “in a therapeutic setting where we have a clinical and a medical staff who are able to do psycho-social assessments, do family histories, we start to understand what’s behind those behaviors. So, going back to that metaphor – what’s all the stuff underneath the iceberg.”
“And we find certainly that we’re able to do accurate diagnoses whether there is anxiety present or depression…and we’re able to understand those things and we’re also able to get into this child’s experiences. So, we say all the time here, unsurprisingly, not a lot of our kids here have true mental illness, but they have psycho-social stressors, exposure to community or domestic violence, or victims of those things themselves, multiple incidents over time so they have really chronic stress. There are kids who have lost loved ones, whether it’s due to violence or long-term incarceration, there’s a caregiver that means a lot to them who is no longer with them so there’s a lot of grief that they’re dealing with. And we’re able to really start thinking about how to address those behaviors. And we’re also able as a small setting to ignore some of the stuff that’s really hard to ignore in a school setting.”
Few Resources – Huge Need
In a city where close to 40 percent of its young children have witnessed violent crimes, including murder, it is curious that the Center is the only one of its kind. When asked about her opinion on this, Williams says,” I think there are a number of answers to that question. Certainly there was a move to privatize healthcare in our state which meant that a lot of the programs that had been state run were shut down and a lot of the state run programs were addressing needs that had been identified like behavioral health, that certainly was the issue with NOAH (New Orleans Adolescent Hospital) and some of the programs at Southeast Hospital and things like that. So, I think that’s one reason. Another reason is we struggle to attract mental health providers because as a state we have one of the lowest Medicaid reimbursement rates and that’s a challenge that we see.” She adds, “when you look at agencies that are doing very comparable work in other states and other cities, they are able to come close to a sustainable operating budget through Medicaid revenue and through charging their local school district and we have the challenge of figuring out what a funding model looks like in a decentralized system of schools on top of the lower Medicaid reimbursement rates.” Williams continues her assessment, adding that the lower Medicaid reimbursement rates and eligibility requirements are a deterrent for many professionals in the industry, therefore stifling the variety of mental healthcare options in the city. She explains, “it is true that we have a lot of professionals who do mental health work, but we don’t have a real variety of the types of services that are offered. So there’s a proliferation of mental health agencies that do the community based services like seeing a child in their home or at their school twice a week, but when you have a child that exceeds that level of care and for whom those things aren’t making a difference then we really don’t have options except for a medical placement in a psychiatric residential treatment facility and we don’t have any of those in Orleans Parish. So sometimes parents won’t even consider that as an option. And for some kids that’s too restrictive of a placement. We have this huge gap between the community services and then the hospital placement.”
When asked about the success of her school, it is clear to see the abundance of pride for the tremendous accomplishments she, her staff and the children have been rewarded with. “We track a whole lot of data around here and we’ve served over 60 students since we first launched. We have children leave the program for a whole host of different reasons so until this year we were only a K-8 Program. We had some children age-out, we have some children whose parents decide they want to pull them from the program and put them back in a generalized school, but of the children who complete our program and whose schools implement a transition plan, over 80 percent of them have successfully transitioned back and that was our target number. We recognized that existing in a city and a state that doesn’t have that real continuum of Mental Health Services and Placements that for some kids this might be the right place for them to be for a longer period of time and that other students might need something even more intensive, so we didn’t want to say that we expected a 100 percent success rate but we feel good about where we’ve landed and we track our parent and our partner school satisfaction rates as well, twice a year on surveys and we have about an 88% satisfaction rate with most of those partners and that has been consistent for about four years.”
It is obvious that because of the tremendous impact this school has had and will have on the community the Center for Resilience is destined for a bright future. As they track their students’ post-transitioning success, Williams is looking for students to also transition into society, graduating from high school and being able to thrive in their respective adult lives. In the short term, the goal is to create successful transitioning back to their home schools. She says, “a lot of our kids come here because they don’t know how to have healthy relationships. Many of them don’t have really positive friendships, they don’t have good social skills, peer interactions… They’re not necessarily happy in a school setting. We would like to send kids back to school with the belief in themselves that they are not bad kids and an understanding of what their needs are and how to advocate for them and then the ability to build relationships that are healthy and are supportive for them.”
The Center for Resilience will move to a new home on the site of Children’s Hospital in Uptown New Orleans and in the 2019-20 school year they will serve children in grades K-9. They will continue in their task to make sure all children with behavioral health needs have access to the appropriate services and placements. Adds Williams, “we can serve children from anywhere. That was another byproduct of transitioning to a non-profit, that we didn’t have any restrictions on where a child might be coming from, however, obviously based on our funding model we need to have a contract to ensure that the services are in place. So yes, we are open to children from anywhere contingent upon that school or district’s agreement to contracting for services and currently that means we contract with Orleans Parish School Board and any of the local education agencies in Orleans Parish.
For more information, visit the Center’s website at: www.cfrla.org
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