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How childhood trauma drives incarceration risk

That counterfactual animates research across URochester. What if someone had been there, at 12, or at 8, or at birth?

The United States than any other nation; more than 2 million people are currently held in US jails and prisons, and more than 2.7 million children have an incarcerated parent. What begins as incarceration糖心传媒攖he confinement of a person in a jail or prison as legal consequence糖心传媒攕eeps outward through families, neighborhoods, and generations in ways the criminal justice system was never designed to address.

has spent three decades studying exactly that spread.

糖心传媒淥ur research follows people over time,糖心传媒� says Noll, a professor of psychology and the executive director of URochester糖心传媒檚 糖心传媒淲e engage those who have been traumatized and follow them for decades, even generations.糖心传媒�

糖心传媒淚 wish I糖心传媒檇 met you when I was 12.糖心传媒�

What she and her colleagues have mapped is a pipeline: one that begins not in a courtroom, not in a classroom糖心传媒攂ut in the highchair. Early life trauma, which Mt. Hope researchers define broadly to include not only abuse and neglect but also the loss of a parent to incarceration, interferes with the brain糖心传媒檚 developing architecture. It disrupts the capacity for emotional regulation, for sustained attention, for the kind of trust that allows a child to learn from adults. By the time these children reach kindergarten, their struggles can look like defiance or disorder. They are, in fact, the neurological imprint of early pain.

糖心传媒淓arly life trauma that goes untreated can manifest in behavioral problems in school, cognitive problems糖心传媒攊nterfering with one糖心传媒檚 full potential,糖心传媒� Noll says. 糖心传媒淵ou can imagine those things unchecked in adolescents could result in significant behavior issues: suspensions, detentions. And that is the pathway you see when educators are not trauma糖心传媒慽nformed, when they don糖心传媒檛 understand the roots.糖心传媒�

Scholars and advocates have come to call that pattern the聽, which describes the way discipline policies糖心传媒攕uspensions, expulsions, and on糖心传媒慶ampus arrests糖心传媒攑ull students out of classrooms and toward the juvenile and criminal justice systems. National analyses by civil rights and education researchers have found that these policies fall hardest on Black and Brown students and students with disabilities, who are suspended, expelled, or referred to law enforcement at rates far higher than their white peers for comparable or even less serious behavior.

Moreover, when a parent is incarcerated, an older child may struggle with both painful knowledge and social stigma. For a younger child, Noll says, 糖心传媒渢hey simply understand that a parent is gone. That can be traumatic, or at least disruptive developmentally, in terms of how children attach to caregivers.糖心传媒� Her observations are echoed in showing that parental incarceration exposes children to chronic stress and increases risks for attachment disruptions, cognitive delays, and later behavioral and mental health.

Attachment is the biological foundation of the capacity for relationship, for trust, for self糖心传媒憆egulation. When disrupted early, the consequences 糖心传媒渃an impact the developmental course of relationships,糖心传媒� Noll says. 糖心传媒淚t can make it difficult to attach, or to understand the nuances of social situations, which can feed into behavior, isolation, depression, and anxiety in ways that set the stage for this pipeline.糖心传媒�

For children of color, the risks compound. Racism, neighborhood violence, and the discriminatory application of school discipline and law enforcement policies layer onto existing trauma in what Noll calls 糖心传媒渋ntersectionality: race, trauma, incarcerated parents.糖心传媒�

And yet the pipeline is not inevitable. Mt. Hope糖心传媒檚 resilience research has identified the factors that interrupt it.

糖心传媒淭he top predictor of resilience,糖心传媒� Noll says, 糖心传媒渋s having one supportive individual糖心传媒攁 parent, a sibling, an older mentor糖心传媒攚ho is looking out for you.糖心传媒�

Early intervention can start before birth

Within Mt. Hope糖心传媒檚 , a nationally recognized preventive initiative that has served families for more than a decade, the intervention starts as early as the second trimester.

Building Healthy Communities provides home糖心传媒慴ased services for pregnant women in their second or third trimester. A family support provider with lived experience helps with the most concrete threats to stability糖心传媒攆ood, safe housing, transportation, school and work goals糖心传媒攚hile a clinician delivers evidence糖心传媒慴ased trauma-informed services such as the聽聽home糖心传媒憊isiting curriculum for parenting skills, child糖心传媒憄arent psychotherapy to repair attachment after trauma, and interpersonal psychotherapy to treat maternal depression. For up to three years, that team stays at the kitchen table and in the pediatric clinic, woven into well糖心传媒慴aby visits and immunization schedules, quietly working to keep those families connected to care and out of child protective services.

Meanwhile, Mt. Hope糖心传媒檚 afterschool and summer camp youth empowerment offer therapeutic, peer糖心传媒憀ed skills training for children already showing signs of emotional dysregulation: teaching them, concretely and practically, how to manage what they feel before what they feel manages them. Its parenting programs teach caregivers, including parents reentering from incarceration, to replace punitive responses with social糖心传媒慹motional learning strategies.

糖心传媒淲e are teaching parents how to have productive parenting strategies that change a child糖心传媒檚 behavior,糖心传媒� Noll says, 糖心传媒渁s opposed to escalating the fight.糖心传媒�

In these programs, opportunities abound for music, art, and play.

糖心传媒淥ne of the biggest diversion tactics is getting involved in something prosocial: sports, clubs, music, belonging,糖心传媒� Noll says. 糖心传媒淚f children discover an outlet early on, they can pour themselves into activities that form the foundations of self-esteem, self-confidence, and self-identity.糖心传媒�

Through the , a URochester affiliate, schools and community partners experiment with responses to harm that focus on accountability, relationship, and repair rather than punishment alone. Each year, the Gandhi Institute trains thousands of people in nonviolence and restorative practices and facilitates restorative conversations with students in school 糖心传媒淗elp Zones,糖心传媒� giving educators concrete, restorative alternatives to suspension, expulsion, or arrest.

Blackshear is himself living proof of what one caring network can do. He grew up in Savannah, Georgia, born to a teenage mother, his parents糖心传媒� marriage short糖心传媒憀ived, his house full of people and short on space. By most demographic measures, his story could have gone another way.

His mother insisted that he and his stepfather go to therapy in the mid糖心传媒�1980s. There was also his great糖心传媒憉ncle Willie. When Willie died, family legend holds that his last words were, 糖心传媒淭ake care of John. He糖心传媒檚 going to be somebody special.糖心传媒�

糖心传媒淣o matter what dark moment I was going through, I could tap into that story,糖心传媒� he says. 糖心传媒淯ncle Willie saw something in me that I cannot disappoint.糖心传媒�

Prison, jail, and reentry care in Rochester

On the other side of the pipeline, where people are emerging from jails and prisons back into the world, has built something rare: a clinic that was waiting for them.

Jails and prisons serve distinct functions; jails typically hold people awaiting trial or serving short sentences, while prisons, including federal facilities, house those convicted of more serious offenses, sometimes for decades. People cycle through both, and health consequences compound with every transition. A landmark medical study found that people coming out of incarceration have nearly of the general population in the first two weeks after release; the leading causes were drug overdose, cardiovascular disease, suicide, and homicide.

Morse, an internal medicine physician at URochester糖心传媒檚 School of Medicine & Dentistry, helped build a response. She was among the first physicians in the country to establish a transitions clinic: a primary care practice specifically designed for people in that precarious window after release. The WISH (Wellness Initiative Supporting Health) Clinic, now at the Rochester-based Jordan Health, serves people reentering from state and federal incarceration. When Morse audited her first hundred patients, she found that only 20 percent had had a primary care physician.

Her research with women in Monroe County糖心传媒檚 Opioid Intervention Court糖心传媒攎odeled on Buffalo糖心传媒檚 Opioid Intervention Court, the first such court in the nation糖心传媒攆ound that 24 of 31 participants (77 percent) described child, adolescent, or adult victimization and traced, in their own words, a path from early abuse to addiction to incarceration. 糖心传媒淎 lot of times people have a conviction, and they may not even be guilty,糖心传媒� Morse says. 糖心传媒淲e focus on moving forward.糖心传媒�

Studying more than patient charts

On Saturday mornings at Monroe County Jail, URochester medical students do something unusual: They sit down, ask questions, and listen.

The聽Health and Incarceration Connection, which includes an elective pathway in the University of Rochester School of Medicine and Dentistry, enrolls roughly 50 students who rotate through the jail across four years of medical training. Two of those students went on to found the聽, a free, student糖心传媒憆un primary care clinic that URWell operates in partnership with the Reentry Association of Western New York (RAWNY), with Morse as faculty supervisor. The model is built on trust developed before release: students meet patients inside, tell them where the clinic is, and promise to be there when they get out.

糖心传媒淲e thought we were the teachers. It was our patients who were teaching us how to listen糖心传媒攍istening to understand a human being,糖心传媒� says Anthony Pamatmat 糖心传媒�26M in a TEDxRochester talk. 糖心传媒淲e learned to second糖心传媒慻uess every preconceived judgment that we form.糖心传媒� For example, in reviewing patient charts, terms like substance abuse,听incarcerated, or聽诲谤耻驳糖心传媒憇别别办颈苍驳聽can create unconscious bias that may affect care. 糖心传媒淏ut when you care for people with these lived experiences,糖心传媒� Pamatmat continues, 糖心传媒渋t becomes very clear that the chart can never fully capture the person behind it.糖心传媒�

The death row case that shaped a career

Blackshear still thinks about Paul Brown.

He thinks about Brown when he meets a baby in a grocery store糖心传媒攚hich happens often, because he糖心传媒檚 convinced that babies are drawn to his face. He looks at them and thinks:聽Not one of you was born for this. Not one.

He thinks about Brown when he walks into jails and federal prisons to work with men whose stories he will spend years excavating. He thinks about him when he testifies before juries, laying out a life in full糖心传媒攏ot to excuse what happened, but to explain it, and to ask everyone in the courtroom to reckon with their own share of responsibility. 糖心传媒淚 want to implicate myself for negligence,糖心传媒� he says. 糖心传媒淚 want to implicate the jury, the judges, the attorneys, the gallery糖心传媒攂ecause I do believe it doesn糖心传媒檛 have to be that way.糖心传媒�