Baltimore City is undergoing a cultural shift in the way it approaches trauma and violence in the community.

As part of that shift, senior city officials and employees who deal with the public have begun undergoing required training sessions in what’s called trauma-informed care.

That’s an approach to healing someone who’s had a traumatic experience without re-traumatizing the person and acknowledging that trauma can be widespread in a community.

The sessions are led by the city health department and various community organizations. Members of the media were invited to a recent sample training, which began with a five-minute breathing exercise led by Atman Smith.

Smith is one of the co-founders of the Holistic Life Foundation, a Baltimore nonprofit that teaches yoga and mindfulness.

“We're going to inhale long, slow and deep through our nose with that audible breath, filling our stomach up with air,” he said.

Before he exhales he counts down - not up - from five.

“Counting up can cause anxiety in people that you’re serving, just because they don't know when the end is coming,” he explained.

Baltimore became the first major city in the U.S. to legislate trauma-informed care with the Elijah Cummings Healing City Act. Former Mayor Jack Young signed it into law in February 2020.

Councilman Zeke Cohen, a Democrat from South Baltimore, sponsored the legislation after a staffer at Frederick Douglas High School was shot in 2019. At the session, Cohen described the incident as a traumatic experience for the students and staff present, as well as the larger community.

“Trauma begets violence, and violence begets trauma,” he said.

But Cohen said in the aftermath of the shooting, students felt their voices were not being taken into account, especially as the school board proposed measures like arming school police - measures that did not help students feel safe.

“The whole approach of focusing on policing, or how to make schools harder targets, was dead wrong,” he said

Instead, students wanted resources to help them through the trauma they’d experienced and address the root causes of violence.

Cohen said trauma informed care training will help city officials lead that effort.

Youth advocate Jemira Queen said too many teachers in Baltimore City Public Schools fail to empathize with their students who are struggling with their mental health.

“Many of them label Baltimore City Public School students as angry, as violent,” Queen said.

Students in the community are often exposed to traumatic experiences like violence and poverty daily.

“When you're surrounded by negative things 24/7, it messes with your mind. It messes with your mental health,” Queen said. “And that can develop anger that can impact your everyday life.”

Growing up in Baltimore, Queen said, she and other students have not had access to meaningful mental health resources, like therapy.

“And then they ask why violence happens so much in our community,” she said. “It’s because we haven't healed from anything.”

Raguel Broy, of the city health department, says that nearly one third of Baltimore City youth have reported having two or more Adverse Childhood Experiences (ACEs). Those experiences have long term health implications, she said. The more a child has, the higher their risk for early death.

But Broy said there are ways to intervene.

“We know that if you intervene with someone who has high blood pressure, and they do the things that start to reverse high blood pressure, losing weight, taking medicine, they start to reverse the...negative impacts of having high blood pressure,” Broy said. “Same thing can be done with ACEs.”

Dr. Malik Muhammad is the leader of Akoben, an organization that provides trauma informed care training.

Muhammad said leaders who want to help heal others need to “connect and challenge” - in other words, build trust and push people to envision healing as a possibility.

Otherwise, Muhammad warned, leaders could potentially exacerbate existing trauma.

“It looks like an absentee landlord, someone who has responsibility for being involved in connecting and challenging, and they're not showing up in that way,” he said. “We see that sometimes in leaders, right, we see that sometimes in teachers, right, where we're there, we're occupying space, but we're not really there.”

Muhammad said leaders need to ensure that “connecting” is their first step.

“We find the humanity in each other first before we do anything else,” he said.