Application of the Toxic Stress Schema: An Exemplar for School Nurses

Author:

Childs Gwendolyn D.1ORCID,DeSocio Janiece2,Sloand Elizabeth3,Gary Faye4,Burke Pamela J.5,Outlaw Freida H.6,Snethen Julie A.7,Lewandowski Linda A.8,Bowen Felesia R.9

Affiliation:

1. Associate Professor and Associate Dean for Undergraduate and Prelicensure Education, University of Alabama at Birmingham, School of Nursing, Birmingham, AL, USA

2. Professor of Nursing, Seattle University College of Nursing, Seattle, WA, USA

3. Johns Hopkins University School of Nursing, Baltimore, MD, USA

4. Medical Mutual of Ohio & Kent W. Clapp Chair and Professor of Nursing, Cleveland, OH, USA

5. LEAH Program Faculty/Senior Advisor for Nursing, Division of Adolescent & Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA

6. Executive Academic Consultant, Substance Abuse and Mental Health Services Administration, Minority Fellowship Program, American Nurses Association, Silver Spring, MD, USA

7. Professor and PhD Program Director, University of Wisconsin-Milwaukee, Milwaukee, WI, USA

8. Dean, College of Nursing, and Vice-Provost for Health Affairs, University of Toledo College of Nursing, Toledo, OH, USA

9. Professor and Associate Dean for Diversity, Equity, and Inclusion, The University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA

Abstract

For many children of color, the cumulative impact of pre-existing stressors, disparities, and pandemic-related losses has contributed to a toxic level of stress. Toxic stress can disrupt healthy brain development making children vulnerable to physical and mental health problems. School nurses are the primary health professionals who interact with children daily during the academic year, which positions them to identify risk factors within the social determinants of health that contribute to the development of toxic stress. The Toxic Stress Schema (TSS) provides a framework for assessment and care planning related to social determinants of health and potential sources of stress and/or buffering support for the physical and mental well-being of children. A case study approach is used to demonstrate the application of the TSS to school nursing and provide the basis for conceptualizing a plan of care and identifying resources to support the child's physical and mental health.

Publisher

SAGE Publications

Subject

Nursing (miscellaneous)

Reference35 articles.

1. American Academy of Pediatrics (2021 October, 10). AAP-AACP-CHA declaration of a national emergency in child and adolescent mental health. https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-national-emergency-in-child-and-adolescent-mental-health/

2. A Schema of Toxic Stress Informed by Racism, Transgenerational Stress, and Disadvantage

3. British Columbia Teachers’ Federation [BCTF]. (2019). Using the BCTF social justice lens to focus our work. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.bctf.ca/docs/default-source/advocacy-and-issues/sj-lens-booklet-revised-july-2019.pdf

4. Moving Upstream From the Individual to the Community: Addressing Social Determinants of Health

5. Center for Disease Control. (2021). Anxiety and depression in children. https://www.cdc.gov/childrensmentalhealth/depression.html

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