It’s National Mental Health Awareness month, and I keep thinking about Antoine because I may have broken his heart.

Years ago I volunteered at a residential treatment center for foster children, in a cottage that housed ten young boys. They were “seriously emotionally disturbed,” the threshold classification for placement in that center. Most had survived multiple foster homes, sometimes punctuated by stays in psych hospitals, only to become “unplaceable” and almost certainly unadoptable.

During my weekly visits, some boys avoided me while others checked out the Pokémon cards or Legos I brought, only to wander off within minutes, endlessly distracted. But Antoine, 11, always sat by me, rapt and loyal. He built plastic cities, or painted his arms in Wonder bread polka dots, or listened to Harry Potter by the hour. Clever, powerful and entirely winning, Antoine had a monk-like focus, even when all hell broke loose in the cottage. He particularly loved an oversized book on the Titanic; we imagined life on every deck, the sound of the ocean, the smells of the boiler room (but never the ending). Antoine and I hung out in a corner of the common room every Tuesday, week after week. In that chaotic place, it was one thing we both could count on.

And then one day he wasn’t there: he had to spend the day in court. Before this third birthday he’d been taken from the custody of his grandmother because she extinguished cigarettes on his body and sexually abused him, but I didn’t know anything about his current status.

Meanwhile, emboldened by Antoine’s absence, 9-year old Shawn grabbed the Titanic book, sat with me for a while and soon lost interest.

The following week Antoine was back, but he refused to speak to me. I asked him why, I joked, I begged, and then gave up. The next week, same thing: wouldn’t look at me, wouldn’t answer, wouldn’t touch anything I left behind for the boys to use. I asked his counselor what was going on, but he was calming a crying boy, inconsolable after losing a basketball game. I finally got Antoine’s attention long enough to apologize for sharing the Titanic book with another kid, but he never, ever spoke to me again. By April, he was gone, transferred to another group home.

What became of that extraordinary child, so keen, so persistent? His stubborn silence told me he was nothing like the other boys, that he was proud, vigilant, in control. Perhaps by sharing my time and his book with the other boy I had betrayed him, like so many others with whom he’d felt just a little bit safe. Who knows how many adults broke him, even after his physical scars healed.

How do children communicate their pain? And are we listening?

One out of five children has a diagnosable mental disorder, and it’s estimated that 80 percent of foster children have significant mental health issues. Quiet kids like Antoine may not advertise their trauma history with antisocial behavior, but former foster youth in general are five times more likely to suffer from post-traumatic stress disorder (PTSD) than the general population, and even exceed the rate for American war veterans.

The effects of trauma, especially complex and repeated trauma experienced by so many young people in foster care, are varied: dissociation, depression, anger and anxiety. Children may lack self-regulation and appear to overreact or underreact. Chronic stress affects cognition and executive functioning, and is a predictor for long-term physical health, as well as substance abuse and other suffering.

In celebration of National Mental Health Awareness month, let’s listen to children, without judgment, and remember how many are exposed to violence, in their homes and in their streets and schools. They are longing to trust, no matter what they say or do.

The National Child Traumatic Stress Network has excellent information and resources. To commemorate national Mental Health Awareness Month, let’s mend hearts, not break them.

 

This article was originally posted to The Huffington Post on 5/15/2017