Can Do Healthcare - Thinking Differently Together About Trauma Informed Care

From Hidden Harm to ACEs to Trauma Informed Approaches Sharon reflected back, how in 2008 she joined Suffolk County Council as a Young People’s Substance Misuse Commissioner, having come from a nursing and health improvement background. In starting to explore what this new role meant she rapidly became aware of two reports: In 2003, the UK Advisory Council on the Misuse of Drugs published ‘Hidden Harm’, the product of an inquiry that exposed the “problems” of parental drug misuse on their children and their families, and how professionals struggle to respond effectively. In 2007 there was a follow up and the UK Advisory Council on the Misuse of Drugs published ‘Hidden Harm Three Years On: realities, challenges and opportunities.’ This report suggested that, despite the report three years earlier, there was still an awful lot to do to improve outcomes for these families. In response to this, in 2008 the National Treatment Agency began a push for Drug and Alcohol Action Teams to benchmark themselves against the recommendations in the Hidden Harm Reports and develop partnership action plans to address shortfalls. Sharon explained how, in doing this work she developed a huge passion for what the evidence was showing on how a difference could be made – and understanding the linkage between poor parental mental health, domestic abuse and drug and alcohol misuse within a family. This was becoming often referred to as the ‘Toxic Trio’. Knowing that this toxic trio equally has its roots in hardship, poverty, lack of income, lack of employment, unstable housing, and then goes on to perpetuate those hardships, and that for children growing up under these circumstances, there is a risk of growing up to perpetuate the same difficulties for themselves and for any children they may have – giving rise to an intergenerational cycle of negative consequences. The Toxic Trio is now more commonly called the ‘trio of vulnerabilities.’ A multi-agency, Hidden Harms Steering Group was established that was both an operational and strategic partnership of like-minded enthusiasts who wanted to improve outcomes for children and families. Their work was prioritised by the Local Safeguarding Children’s Board and the Children’s Trust in their Children and Young Peoples’ Plan, with a strategy and actions that were reported on and evaluated. As a result, there was a lot of work on raising awareness, with both policy and service development being impacted, along with improved partnerships and collaborations and a lot of interest being generated in the work. Fundamentally important is the notion that just because a person has experienced such adverse childhood experiences , doesn’t mean that they are going to have a detrimental impact going forward – there are protective factors, and it is those that we really need to enhance, promote and put into place. "Just because kids are growing up in what we consider adverse circumstances – it doesn’t mean that they can't succeed. Parents and other caregivers who are supportive have a lot of power to be buffers, so building the skills and capabilities of all caregivers is a big deal – ensuring that they have the skills they need to provide a stable, responsive environment for children." Tassy Warren, Centre on the Developing Child, Harvard University 2. Understanding the story Sharon Jarrett - Head of Health Improvement (Children, young people and families) and risk behaviours, Suffolk Public Health Domestic Abuse Substance Misuse Mental Health Toxic Trio 5 | Suffolk and North East Essex Integrated Care System