When I first came to Baltimore, I had a series of "listening tours." One of the most poignant experiences was with a group of youth — some no more than 8 years old. I asked them to share the single biggest issue on their minds. Their answers shocked and saddened me; the biggest problem these children saw was mental health.

They didn't say those words, but what they spoke about was trauma — trauma of watching people they loved being shot and killed; trauma of not knowing whether they would have a bed to sleep in or dinner that night; trauma of being the only person in the household who gets up in the morning because everyone else is addicted to drugs.


There are those events we can directly point to as a source of trauma — such as gun violence and death in the family. However, there are so many other inputs of trauma that impact our communities every day, including domestic violence, economic hardship and the experience of living with someone struggling with drug or alcohol addiction.

Tragically, our children are often the most at-risk to suffer the effects of this trauma. We know from scientific studies that childhood trauma is a risk factor for many adverse outcomes later in life. We also know that there is pervasive trauma in our communities, every single day. This is what our residents tell us; what our teachers tell us; what our families tell us; and what our children tell us themselves.

The Baltimore City Health Department, together with our partners across the city, knew that we needed to act. To address trauma, we started with four principles.

First, our children are not problems to deal with; they are our greatest assets. As our youth tell us, they are not "at risk," but rather "at hope."

Second, our city should not be branded as one of violence and unrest; we must set the expectation to become the national model of recovery and resilience.

Third, we must acknowledge that the pervasive trauma did not occur overnight. We must accept that decades of poverty, neglect, racism and widespread disparities have gotten us to where we are. This responsibility requires both shouldering the weight of our history and accepting the duty to reshape our future, and it is the underpinning of our new blueprint for health, Healthy Baltimore 2020.

Fourth, we must fight stigma with science. There is pervasive stigma and misconception around mental health and trauma. Science shows us that the earlier we get involved, the more we can improve outcomes for our young people. Science shows that we can break systemic cycles of trauma. Science shows us that mental health is just as important to well-being as physical health.

Last month, we were excited to announce a big step forward in our ongoing efforts to bridge the gap of unmet mental health and trauma needs here in Baltimore City. The Baltimore City Health Department, Baltimore City Public Schools and our partners were proud to announce multiple awards that will allow us to flip the narrative around violence, trauma and mental health.

Through a $5 million grant by the Substance Abuse and Mental Health Services Administration (SAMHSA), we will be able to directly fund our community partners to reduce the impact of trauma and build resilience in Sandtown-Winchester, Penn North and Upton/Druid Heights.

Through a $2.3 million grant from the U.S. Department of Education, we will be able to treat mental health with the same attention and focus as we do physical health, by expanding mental health services with a full-time clinician at each of our 13 focus schools. We will be able to provide training to all staff in every school so that teachers, support staff, and anyone who comes in contact with our students are trained to recognize, treat and prevent effects of trauma.

And through a $500,000 grant from the Department of Justice, we will be able to interrupt the cycle of violence and trauma in our hospitals so that those who are the victims of violence will receive outreach services at the time that they present with an injury.

These grants are just the beginning of many years of work that must be done. It will take all of our federal, state and local leaders to focus on prevention, increase treatment, reduce stigma and improve health, well-being and resiliency of our young people.

Congressman Elijah Cummings speaks about how our children are messengers to a future that we will not see. It is our duty to ensure that where our children live does not determine whether they live. It is our duty to create a community such that pervasive trauma is no longer the accepted norm. It is our duty to work in partnership toward a Baltimore where all young people are valued, protected and empowered.

Dr. Leana Wen is the commissioner of health in Baltimore City. Twitter: @DrLeanaWen and @BMore_Healthy.