Growing Through Grief is a school-based grief support and crisis management program supported by the Park Nicollet Foundation that provides children with peer support groups, individual counseling, and death-related crisis response after they’ve experienced the loss of a loved one. Nicole Barnes, Growing Through Grief program manager, and Judy Brown, Minneapolis Public Schools mental health manager, outline the prevalence of childhood bereavement and share the C.A.R.E.S. (community, awareness, resiliency, empathy and strength) support group model. The episode will highlight how the partnership between health care and education systems brings additional resources to schools that share education and renewal practices with students that bring hope and healing.
Growing Through Grief is a school-based grief support and crisis management program supported by the Park Nicollet Foundation that provides children with peer support groups, individual counseling, and death-related crisis response after they’ve experienced the loss of a loved one.
Nicole Barnes, Growing Through Grief program manager, and Judy Brown, Minneapolis Public Schools mental health manager, outline the prevalence of childhood bereavement and share the C.A.R.E.S. (community, awareness, resiliency, empathy and strength) support group model. The episode will highlight how the partnership between health care and education systems brings additional resources to schools that share education and renewal practices with students that bring hope and healing.
Hosts: Kari Haley, MD, and Steven Jackson, MD
Guests: Nicole Barnes and Judy Brown
HealthPartners website: Off the Charts podcast
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Kari Haley:
He's a rehab doctor from Chicago.
Steven Jackson:
She's an emergency medicine doctor from the Twin Cities.
Kari Haley:
Together, we're examining the health equity emergency.
Steven Jackson:
Inviting voices for change without the cue cards.
Kari Haley:
I'm Dr. Kari Haley.
Steven Jackson:
I'm Dr. Steven Jackson.
Both, together:
And this is "Off the Charts."
Steven Jackson:
Hello and welcome to another episode of "HealthPartners Off the Charts." We have two amazing guests with us to talk about healing and transformation in Minneapolis schools amongst grief and trauma. And as we all know, in 2020, we were all faced with grief and trauma as a community and really as a state, as a world. And so I'm sure what you guys do and what you're faced with is exceedingly important, especially in the season and the climate that we're in.
So I just want to introduce first Nicole Barnes. She's the program manager for Growing Through Grief, a school-based grief support and crisis management program supported by the Park Nicollet Foundation. So welcome, Nicole.
Nicole Barnes:
Thank you.
Steven Jackson:
And also with us today, we have Judy Brown, and she's a social worker and the mental health supports manager for Minneapolis Public Schools. So thank you, and thank you for being here.
Judy Brown:
Thanks for having us.
Steven Jackson:
I guess tell us a little bit about yourselves and maybe your journey as it relates to what you're doing today.
Nicole Barnes:
Well, my background, I have a social work background and I've worked primarily in the medical field. And then I got connected with the foundation work and connecting community to the medical field and found just great magic in that and great reward in that as we bring community together and empower them with the major systems in our community to create change and to create well-being. And so that's a little bit how I got in my current position. It is a Park Nicollet Foundation program, and I've always loved working with kids in my career. And I have a 15-year history as camp counselor and all different roles with kids.
Steven Jackson:
Camp counselor. I wouldn't have guessed that.
Nicole Barnes:
Yes. Yes, I could put my camp counselor voice on if you'd like, but I'll try to keep it professional. And then as I got into social work, it was more about social justice and understanding the world and how complicated it is. And then I started working in the medical system. Just the layers of complexity came to light and then you bring it to the community and the family and the individual and it just became a great challenge and a great career adventure for me to partner with community members that want to make a difference our kids. And Judy is one of them.
Judy Brown:
Thank you. I guess that's my intro. Well, my name is Judy Brown. I am a clinical social worker. I got into this field, I think primarily due to the fact that I started off working in corrections and I was being teased because I was called the social worker and not the correctional officer, so more like the mama of the mod.
And I do activities. I like creating activities. My family is educators, and so I would create opportunities for students, or I shouldn't say students because right at that time they were youth in a correctional institution. I would create opportunities for them to be able to experience things that they never experienced before. Like applying for college, completing job applications. I don't know, I would do everything, teach them how to cook and barbecue. Because as the officer, we could create these opportunities to get food and programming different activities for them. So I was doing that and the other officers didn't do anything, so they want me to do it all for every mod. And so I did that and then they started teasing me again, saying, "You just need to be a social worker, because messing up my stuff. We don't want to engage with the kids." But no, they wanted to, they just didn't know how. Right you could engage over a meal, and it's cereal and everybody wants to eat the most popular cereal. And it would start a disagreement and they'd go in the rooms because there wasn't no cereal and they'd be arguing over the cereal.
And so just having conversations with students, I keep saying students because that's been my life for the last 17 years, but just creating opportunities for youth to do things that they never did before. And then went ahead and went to school. It took a while for me to even get into, not to corrections, but into the schools. And when I got in, I was a school social worker for some years, and then I did placements for setting threes and fours. But before that, while I was in the school, I was creating groups for students. So created a group that actually got me the Minneapolis Educator Leadership Award. And it was a group to teach students, females, about cultural similarities versus differences. And so that group was very successful because we taught them how to sew. And then they were sewing clothes that was ethnic specific. So everybody in every community, whether you're Native American, African American, you some type of clothing that represents your culture.
And so we were doing those things. And then families were coming in, younger kids were wanting to participate, and next thing you know, I end up saying, we need to do more of these groups. And we started seeing the need then for students to have a way to express grief and loss or just their feelings. It took a while to get to the fact that someone passed. So they'd be in the group and we'd be talking about cultural similarities in breaking down the stereotypical beliefs about what it was that girls should or shouldn't do. And then they started talking about traditions related to grief and how women play that role.
So in the African American community, you don't buy the food, they prefer you cook the food. So we would cook the food and then just hearing stories about roles in other cultures. So I would shared mine, and then everyone would share, but then they talk about how they lost someone really close to them. And then it was like, OK, we need a grief group. Transitioned in my role, became the manager of mental health, and we looked at the grief curriculum that was there and it was like, oh my goodness, we have some curriculum, but it was associated primarily to students that experienced loss through the death of a parent due to a medical issue.
Steven Jackson:
Interesting.
Judy Brown:
And we had a small group of students in those groups, but we had a large number of students experiencing grief and we didn't know why. So that's how we met.
Nicole Barnes:
That's kind of how it started.
Judy Brown:
So I know it was supposed to be about all me, but no, it's the coming together and creating something wonderful.
Kari Haley:
Well, maybe take a moment to tell us a little bit more about Growing Through Grief. And what the program is, how it works, and then a little bit more about the partnerships that you make within the schools and how that's been impacted within the schools and the students that you see
Nicole Barnes:
Growing Through Grief is a program through the Park Nicollet Foundation where we do school-based grief support for students. And we do that through peer support groups, individual counseling and death related crisis response. 27 years we've been in the business of doing childhood grief support. And it all started off of a legacy of Katy. Katy and her family. And Katy's dad died in our hospice program in the Park Nicollet Hospice program. And as a result of that, the family became close with Park Nicollet and our team and had a good experience. Katy was in high school at that time and she didn't have supports, and as a result, she chose some coping mechanisms in her life, which ended it in her 20s. So as a family reflected on those two deaths, they realized we really need to pay attention to the kids' grief as well. And that is how that rose in our status of importance is listening to the schools tell us grief is something that happens in our school, not every day, but it happens enough that we need partners to help us respond in a way that's professional and specialized and sensitive to these kids.
Well, since COVID happened and the George Floyd murder and the social rest, childhood bereavement has risen nearly 50%.
Steven Jackson:
Not surprised by that.
Nicole Barnes:
Yeah. And people don't always think, they think maybe Katy's the exception, she's a child that experienced a death. But people don't always think about the kids when they think about grief and when they think about community violence and when they think about the tragedy that can happen in our world. So we traditionally started with medical deaths, as Judy was talking about,.but we are now about 45% medical deaths and over 50% deaths that are related to suicide, homicide, accidents, overdose. And the research tells us that the four leading causes of childhood bereavement due to a parent's death, and this isn't including their classmates or their neighbors or extended family, but just due to a parent death, is related to COVID compared to pre-COVID, post-COVID. We've got COVID deaths, we've got suicide deaths of parents. The suicide rate for parents was dropping before COVID. And since COVID, it is now increased accidental overdose, which is the leading cause of parental death across all races. And then homicide by gunshot violence. And we know our kids have to answer a lot of questions about grief and trauma and figure this out at a young age. Where it's not, we don't want our kids to have to figure that out so young, but it is their reality.
Steven Jackson:
We're living in 2024, the age of technology, the age of social media, the age where things are just so readily available, more so than they ever have, especially when it comes to technology and every other thing that we have access to. Just wondering, with that availability of media and just that technology that we're talking about, does it make the situation worse or have you seen a correlation with a negative effect on trauma and grief?
Judy Brown:
There's definitely a correlation. There's been also an increase in, well, I'll start off this way. Typically, with youth suicide rates, African American youth have had a lower rate, but most recently I think it's increased by 50% in the last three years since COVID. And so when kids see things nine out of 10 times, they see it on social media before they see or hear it anywhere. So it's not just the good and bad, like you said, there's those in-betweens like AI has contributed to it as well. Right? Everything.
Steven Jackson:
That's another topic.
Judy Brown:
And kids see this. So some kids believe that life is rosy, while other kids know it's not. And so when they're looking at social media and they see things happening in the community, sometimes it's hard for them to make the correlation between what's real and what's not. And then there's the increase of anxiety and depression as well. So if you catch a kid at the most imperfect moment in their life when they're experiencing anxiety and depression, they may think about committing suicide, especially if they've lost someone. So we have them dealing with what they see on social media. Everybody's life is rosy and perfect, and then in the real world, why am I so miserable?
Steven Jackson:
Why is my life not rosy and perfect?
Judy Brown:
Exactly.
And so it goes much further than just their inability to express their feelings and talk about their grief and loss in a way that they think adults can understand. Because what we're learning is everything's about a show because of the social media. I'm fine, I'm perfect. But then there's so many kids we have that are cutting. And then you say OK. So grief and loss, they're grieving the loss of a student that may no longer be with them in the school, not because they passed away, but they might've gotten kicked out, or they're in the hospital and they've been to three or four hospitals and they don't have a way to connect to the kids. And nine out of 10 times, those two kids have shared the same experiences, and so they are doubly bonded with one another.
So when we talk about grief and loss, it's not just the absence of the person from this world, this place, it's from their environment, from their community. And that grief and loss is almost worse now than the grief and loss associated to the absolute death and loss of a person.
Steven Jackson:
Wow.
Judy Brown:
And it's hard to, when we make that correlation about media, social media, it really depends on the kid and where they are and what they're dealing with, that determines the type of grief and loss. And so that's how that C.A.R.E.S. curriculum came about because kids are experiencing so many types of grief and loss. And like I mentioned before, it's not just because this person is absolutely gone from their life, I mean from this world, but from their life Because, yeah.
Kari Haley:
No, that ties into one of my questions that I was thinking about since the program has been around, and you both have been in the field for pre-COVID, pre a lot of the social media stuff, but also pre that increase in the change in the why parents are dying. So as you mentioned, the beginning of this program was helping children move through medical, death, grief. So be it, I'm guessing, but cancer heart attacks, those things that killed parents previously versus now where there has been, I just read an article, the huge increase in overdose deaths from parents, suicide, violent death, sudden death versus prolonged medical condition, and then death. How are you seeing grief manifest differently? How are you dealing with that and how are you helping children? And what are you seeing in that space?
Judy Brown:
It's like, I can't remember what it was, but they used to call it the silent killer. You could be with the kid all day every day and not know that their parent is addicted to drugs until they disappear. And that they've had an overdose. You know what I mean? So disappearing parents may just not be around for a while, and then the kid will be at home taking care of their siblings. And so you just don't know what's going on. They just say, "Oh, I wasn't feeling good today." And then next thing you know, it shows up like a 911 mental health crisis. The kid is in school, social media has told them something, and it takes a long time to get them to calm down and be able to verbalize what actually happened. And when that happens, they're usually tearing up stuff because a lot of parents, and I say this because my mom used to always say, you need to control. Be careful what you say. It's not about what you say, it's about how you say it. And so these kids, they may not have gotten that message, so they're beating on walls because they don't have the words to say it.
And people are saying, this kid was going crazy, but they're not really going crazy. They just don't have the words. And they're overwhelmed with grief and loss, so.
Nicole Barnes:
Yeah, they need language.
Judy Brown:
Yeah. And they need to know that it's OK. It is OK to feel sad. It's OK to miss a family member. It's OK to just not want to talk and be by yourself for a little while. And when I say that, I'm not talking about the one who wants to be by themselves, I'm talking about the one who's poking at them because they are by themselves. So there's these antecedents to all of this that just explodes. Because as you know, in Minneapolis, we have a lot of kids impacted by grief. And so it's the buildup and they can contain themselves for only so long. And so that's how that crisis part really makes a big difference, because you have to be able to be tough to withstand what is the rebellious nature of a kid. Don't talk to me, leave me alone, that type of thing, so.
Nicole Barnes:
Yeah, you do have to be tough. And also have to be connected. So the C.A.R.E.S. curriculum is doing exactly what Judy's talking about. So it is creating community for these kids. It's creating a safe place, which they don't always have. So when the neighbor gets shot or when they're locking themselves in the house because there's sirens all around or whatever the situation is, maybe it's an internal situation, it's hard to find a place to talk about that. There's things going on at home, there's things going on in the community, even in their school building, there's things going on. They need a safe place. If that's one of the strongest lessons we've learned, it is to create a safe place. Because then once they can start, most of the kids when they come into group, "I don't want to talk about my feelings." "You do not have to talk about your feelings. All right?"
So we start with something very simple and a lot of education, and we build that confidence in the confidentiality amongst the peers, and then that creates the safety. Without safety, you can't get to the language. You can't get to the feelings, you can't get to we can heal, we can make ourselves new. You can't get there. It's a journey. You have to have the safety and the environment and the confidence that I know who I am. I've been able to share my story. I've heard other stories, and I know I can contribute to this world. This is just one small piece of their world. But it's a piece that's so important because it tells them in the right place, you can make the decisions that make sense for you. You can make the decisions that give you the power and help you make the difference you want to make in this world, whether it be for yourself or for others, or both. If you have the right place, you can do that.
Judy Brown:
Things will get better.
Steven Jackson:
I like the title or the name of the particular program, Growing Through Grief. And just talk briefly about what does that mean? Not necessarily the details of the program itself, but what does it mean to grow through grief? Because to some that might be counterintuitive, I'm grieving, how can I grow? I'm hurting, I'm upset, I'm confused. How does one grow through grief and what kind of tools do you guys provide?
Nicole Barnes:
So our experiences, our lived experiences, they stay with us. The same way our relationships stay with us. They don't go away, they stay with us. So one of our alumni said the other day at a presentation to some retired physicians talking about Growing Through Grief and how important it is to support grief in your clinics, especially with kids. And she said, "Grief doesn't go away and it doesn't shrink. You grow with it. And you learn to manage it."
Judy Brown:
That's perfect.
Nicole Barnes:
But if you have an expectation that it's going to shrink or get smaller or be fixed or go away, your reality is not quite there yet, because it is something we grow with and it becomes part of who we are. And then we find ways to take those memories and move them forward and live in the future with those pieces that make us whole and make us who we are.
Steven Jackson:
That's powerful. I think there are people who need to hear that, even myself. I've always said we had the tragic loss of my brother about three years ago, and that was probably the worst thing ever. Seriously.
Nicole Barnes:
Absolutely.
Steven Jackson:
And it's funny because part of me wanted to sort of get over it because of the sting, but at the same time I didn't because I felt like that meant that he was still present and the memories were still fresh.
And so I think I can understand personally what it means to grow through the grieving process because I don't want to forget, you don't like the pain, you don't like the sting of it. But I think we've learned through some informal and professional help to be able to grow through grief.
And how important is it to build trust? Because again, you're dealing with people that are grieving that don't want to talk about their feelings, but it sounds like they do, but they don't and they don't know how, they don't have the words. And it seems like you guys are key folks to unlocking.
Nicole Barnes:
Well, most of the time they don't feel safe talking about their feelings.
So that's what puts up that guard. So if we can take down that guard by building trust and building safety, then there's more freedom to share. We ask our kids about building trust. And trust building is a process, and trust building is on levels. We also have to find ways to build trust amongst our adults in our life or our mentors. We also have to find ways to build trust in our systems. Judy and I were just talking before we came in here about how grief and trauma really sits on all levels. It sits in our system level. It sits in a family level and a community level and an individual level. And we go into our professions, medical professionals and education professionals to help individuals. And then when we get into it, we realize, wait a minute, I can't really help individuals unless I really understand how to support families and communities and systems.
Because that's what Judy and I and our teams have done, is we've brought two systems together, our two main stable systems that are in every community, medical system and education system. They're never going to go away. They're always going to be there. So we've brought two systems together to explore how to support the grief and trauma in our schools. And we realized we found a way to start with kids, but we realized we need to evolve that and get the staff supported. And we need to get the system supported along with the kids. The kids are brave and they're resilient and they're brave. They're just willing to, 50% of our kids say they come to group because they've been encouraged by an adult. Well, that's because they trust whichever adult they talk to that said, "I'm going to go to a group." So we have help our professionals trust each other and our systems be trustworthy as well.
I can't remember. I think your question came back to trust. I would say when we ask the kids about trust, our surveys tell us that they've received trust by the second or the third group. It doesn't happen immediately and it won't with anybody. That's not the way trust works. It's a process and you have to feel safe, and you have to be brave. It's a two-way street. And so once you get a combination of bravery and safety and vulnerability and test it and is successful, you'll try again. And that's what we're trying to do, is just create an environment where kids can learn how to do that. Because we're not immune to that either. As adults, we have to do that in our own worlds. We have to figure out where we can trust and where we can't. And I'm telling you, if we sit alone and we sit at our desks and we don't interact, we're not going to figure it out. And loneliness and isolation is the worst enemy when it comes to mental health, mental well-being grief and trauma. We want protective factors all around us, and that's connections.
Kari Haley:
I don't know if we could say that any better ourselves.
Steven Jackson:
I know I can't.
Kari Haley:
I just think it's great that this program exists, one. And two, that it sounds like it's just laying some really amazing, maybe more than a foundation, but for sure a foundation for young people who are really the next generation. So me being hopeful is that having a program like this, using it and building on it and becoming more of a systemic thing, changes how we deal with grief as a society. Because as adults, I think we can all admit that we don't do it very well.
Nicole Barnes:
It's a topic we're not supposed to talk about, but that is, we are changing the world there.
Kari Haley:
This is amazing. I wish we had five more hours to talk about it.
Steven Jackson:
Oh, yeah. Heartfelt. Thank you to both of you guys for what you do for the kids and the adults that are benefiting just from your tireless efforts. I think you're teaching us all how to look at grief in a different way and look at trauma in a different way. I think it's a need. Our world is our world, and we have some challenges and the best way we can get through these challenges is to be well-equipped. So thank you guys for equipping us today and educating us and our listeners.
Nicole Barnes:
Well, thank you for having us. It's wonderful to be here.
Steven Jackson:
"Off the Charts" is a production of HealthPartners and Park Nicollet.
Kari Haley:
It is recorded by Jimmy Bellamy, with creative by Peggy Arnson, Tina Long, Tim Myers and Jeff Jondahl.
Steven Jackson:
Production services provided by Matriarch Digital Media.
Kari Haley:
Our theme music is by Ryan Ike.