CEO Corner with Dr. Celine Coggins 


When Policy Is Aligned with Prevention: Supporting Youth through Trauma  


This past week I had the opportunity to attend Mindful Philanthropy's Accelerate convening and hear from one of the people who influenced my own professional trajectory, moving from the academic side of youth issues to a focus on mental health, Dr. Nadine Burke Harris. Her message reinforced something I keep coming back to: if we want better outcomes for young people, we need to focus on prevention, early intervention, and policy.


Today, there is often an 11-year gap between the first symptoms of a mental health condition and receiving care. By the time a child gets support, patterns are entrenched, treatment is more complex, and outcomes are harder to change. Dr. Burke Harris described the work she led in California on identifying young people with ACEs (Adverse Childhood Experiences) and ensuring those in high-risk categories gained access to reimbursable mental health supports, even before a formal diagnosis occurred.


ACEs include 10 categories of early adversity, including abuse, neglect, exposure to violence, parental mental illness or substance use, and family disruption. The impact is profound: these experiences don’t just shape childhood — they shape brain development and long-term health.


  • Youth with 4+ ACEs are 12-14x more likely to attempt suicide
  • They are significantly more likely to be treatment-resistant to antidepressants
  • And they face elevated risk across nearly every mental and physical health outcome


There is, however, real reason for optimism.


Through the ACEs Aware initiative, California is shifting from reaction to prevention. Instead of waiting for diagnosis, more than half of Medicaid eligible young people have been screened. Youth with four or more ACEs are eligible for reimbursable services before a formal diagnosis. This approach allows providers to:


  • Identify risk early
  • Intervene before conditions fully develop
  • Connect families to supports that reduce long-term harm


And the results are striking: preventative interventions for children with high ACEs have saved California tens of billions in healthcare costs, particularly within Medicaid.


This is what it looks like when policy aligns with prevention.