Repeated childhood trauma does cruel things to children. Those things don’t simply “go away” with time; they settle into the nervous system as rage, numbness, self‑harm, suicide attempts, and aggressive behavior that can sometimes be managed—but only if a child gets sustained, informed help. Without that help, depression, pain, and sadness often become overwhelming, and too many children decide they cannot endure them any longer.
It is repeated childhood trauma, usually over years, that brings children into Child Protection. Most abuse is never seen or reported, and research shows the oldest child in a family often suffers years of harm before anyone intervenes. Even when someone does call for help, Child Protective Services in most states is overwhelmed and too often unable to provide the resources a child needs to heal and build the skills they need to live a full life. Many children go to their graves without ever having told anyone about their abuse.
Children involved in the CPS system need and deserve serious mental‑health evaluation and services. They have endured extended exposure to violence, deprivation, and chronic fear—or they would not be in Child Protective Services at all. Helping children heal from repeated trauma while they are still young is far kinder and far more effective than waiting until their pain erupts in ways that hurt themselves and the people around them.
Yet many states and communities still do not use simple tools like ACEs screening when children are removed from their homes and placed into CPS. There is no federal mandate to do so. The ACEs testing is brief, painless, and inexpensive. Compiling this information would have lasting value for the child, the CPS system, and the community. Suicide has been a leading cause of death for children 10–14 for many years, and a major driver of emergency‑room visits for self‑harm and suicidal thoughts.
ACEs testing is an easy way to begin evaluating the mental‑health needs of abused and neglected children entering the frightening Child Protection and juvenile‑court systems. If this data were actually gathered and used for each child, it would help both the child and the institution by making clear the depth and scope of the trauma being asked to “just handle” with far too few resources. It would also help us see patterns: which communities, schools, and systems are sending the most children into crisis, and where prevention and support are most urgently needed.
Right now, there is far too little public awareness about the mental‑health burden carried by children referred to CPS. Without better data about the numbers of children living with very high ACEs scores, we will never fully grasp the scale of need among our most at‑risk kids. CPS sees these children every day, but too often collects only the minimum data required by law—and rarely shares the kind of information that would let the public, policymakers, or even local communities understand what is happening to their children. It can’t be reported to the news, because the information isn’t there. We all suffer because of this silence and invisibility.
The medical and public‑health worlds are sounding the alarm. A recent report in JAMA notes that “despite being preventable, suicide remains the second‑leading cause of death for children and adolescents in the U.S.” Up to 80% of those young people had at least one contact with the health‑care system in the year before they died—moments when someone might have recognized the risk and intervened. In 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association declared a national emergency in child and adolescent mental health because existing severe challenges were made worse by the COVID‑19 pandemic. Pediatric mental‑health clinicians and facilities are critically overburdened, delaying access and flooding emergency departments with mental‑health crises.
As that same JAMA article explains, pediatric emergency clinicians have watched this epidemic unfold in real time. Over the past decade, pediatric ER visits for mental‑health concerns have grown faster than visits for physical emergencies. ED clinicians now routinely manage previously unrecognized mental‑health disorders, self‑harm, poisonings, and suicide attempts among children and teens. Suturing self‑inflicted lacerations, using chemical restraints for acute agitation, and safety‑planning with suicidal youth have become common parts of the job.
At the same time, despite an increasing stream of referrals from clinics, crisis centers, schools, and community programs, many ER teams still lack formal training in child and adolescent mental‑health crises and are not sufficiently skilled in suicide‑risk recognition and safety planning. As a result, more and more children and adolescents are “boarding” for long stretches in emergency departments, essentially living in exam rooms while they wait—sometimes for days—for a qualified mental‑health clinician and an open treatment bed. The system is completely encumbered by limits on time, training, and appropriate placement options. Children in deep distress are held in the one part of the health‑care system that was never meant to be a long‑term mental‑health unit.
All of this is connected: unmeasured childhood trauma, under‑resourced CPS and schools, a lack of basic screening like ACEs assessments, missing data, and an ER system absorbing the consequences after everything upstream has failed.
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All Adults Are the Protectors of All Children
“What we do to our children, they will do to our society.”
(Pliny the Elder, 2,000 years ago)Less is not more for keeping children safe.
Powerful call to action
If you have read this far, you are already one of the few adults willing to look directly at what repeated childhood trauma does to children. The next step is to use your voice where it matters most.
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Contact your lawmakers and demand that every child entering CPS receive ACEs screening, timely mental‑health evaluation, and trauma‑informed care—and that CPS be required to publicly report anonymized data on ACEs, suicide attempts, and mental‑health needs.
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Share this article with your State Representative and your local school board, and ask them what they are doing to reduce child trauma, suicide risk, and ER “boarding” for kids in crisis.
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Talk about this with people in your circles—parents, teachers, faith communities, colleagues—until child mental health and trauma‑informed care are seen as basic necessities, not optional extras.
Please start today by forwarding this post and a short personal note to your elected officials. Tell them you support at‑risk children in your community, and that you expect them to do the same.
Find your State Rep here. Then send this link, make the call, and keep going until children’s invisible pain becomes impossible for our systems—and our leaders—to ignore.
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KIDS AT RISK ACTION / KARA / INVISIBLE CHILDREN
