This is Valorie Carson’s first blog post in a series about trauma-informed care. A future post will examine the Task Force’s work and lessons learned since initially convening in April 2012.
By Valorie Carson, Community Planning Director for United Community Services of Johnson County
Childhood, for many, can be a time of extreme stress, with incidents of physical, sexual and/or emotional abuse, neglect, household members who are mentally ill or abusing substances, and violence in the home. For some, the experience of these events is overwhelming – leaving them unable to cope and feeling helpless. So it seems somewhat intuitive that a child who has these experiences might be more likely to experience mental health issues as an adult. But increased risk for liver disease, COPD, obesity and ischemic heart disease?
This is exactly what a study of 17,000 HMO clients found – that the number of different stressors or ACEs (adverse childhood events) that a child experiences is directly tied to increased risk for poor health and health-related outcomes as an adult. Outcomes such as alcoholism, smoking, depression, attempted suicide, and fetal death during pregnancy. And many of these health issues lead adults into our mental and behavioral healthcare systems, correctional system, and even homelessness.
Trauma-informed care (TIC) reflects a change in the way staffs interact with clients entering their systems, one that recognizes that many of the symptoms or “bad choices” individuals have made are actually adaptations or responses to previous trauma. Trauma-informed organizations create environments that reduce the likelihood that an individual will be re-traumatized — will again experience overwhelming feelings of hopelessness – and react in ways that create barriers to their recovery. Instead of focusing on the symptoms, TIC asks “What has happened to you?” as a foundation from which to build relationships, establish a safe place, and partner with the individual in his/her recovery.
Becoming trauma-informed as an organization has multiple benefits such as fewer assaults and physical restraints and increased staff safety, but ultimately it has the greatest benefit for those who have experienced trauma as children and who, as adults, continue to struggle with those feelings and their responses. When childhood trauma is not addressed, many within systems of care will continue cycling through those systems, experiencing poor health and earlier deaths.
Locally and nationally, the recognition of the role of childhood trauma in health and health-related outcomes is spreading. Work groups and task forces are springing up across the Kansas City metropolitan area, involving behavioral and mental health institutions, substance abuse treatment centers, juvenile and adult correction facilities, domestic violence organizations, child abuse and child welfare agencies, and law enforcement. Workshops and presentations are being held across the Metro, with demand for information and training often exceeding events’ capacity.
One example of how a community and group of organizations might move toward becoming trauma-informed is the Johnson County Trauma Informed Care Task Force — a collaboration of 11 organizations from multiple sectors committed to implementing TIC to benefit their clients and their staff, and working together to create a community of providers with shared practices and language. As a growing number of organizations and systems commit to becoming trauma-informed and awareness in the community about the relationship between early childhood trauma and adult health develops, local systems of support will be better and more effective partners with those who have experienced trauma as they work towards recovery.
Mental Health Care