Can Do Healthcare - Thinking Differently Together About Trauma Informed Care

The group ran until 2017, and as its momentum began to wane, the science of Adverse Childhood Experiences (ACEs) came into greater focus. Studies had been taking place in the late 1990s that looked at the correlation between adverse childhood experiences, and the long-term impact into adulthood on the physical and mental health of the children and families who experienced the repeated trauma associated with such factors. Most importantly, the children and young people that experienced them, have a greater risk of impaired development, impacting on their ability to learn, their cognitive development, emotional regulation, ability to socialise, have good relationships and be able to behave in a way that conformed. The results of this could be seen across our system. The CDC-Kaiser ACE Study, conducted between 1995-1997, was the first to examine the relationship between early childhood adversity and negative lifelong health effects. This and other studies found that the long-term impact of ACEs determined future health risks, chronic disease, and premature death. Individuals who had experienced multiple ACEs also faced higher risks of depression, addiction, obesity, attempted suicide, mental health disorders, and other health concerns. ACEs Childhood abuse: • Verbal abuse • Physical abuse • Sexual abuse • Neglect And households which included: • Parental separation • Drug misuse • Alcohol abuse • Domestic abuse • Parental incarceration • Poor parental mental health Yet ACEs are not inevitable, nor do they have to determine the destiny of a child who experiences them. ACEs can be prevented, and when they do occur, concrete steps can be taken to help children heal. Healthy parent-child relationships, or other supportive relationships, can serve as a protective buffer, and help children foster resilience and thrive. The neuro-science underpinning ACEs takes away any possible predisposition to blame of parents and carers, and it can help us as service-providers be kinder to ourselves, each other and those we are trying to help. Experiencing the stress of this constantly repeated trauma or major trauma during our development, or at any stage in our lives, can have long lasting effect and impair our emotional regulation, distort our perception of how we are received and our ability to socially and familially engage and nurture; how we learn and find meaning, and at worst, pre-dispose us to perpetuating some of those negative factors. So – where are now: We have a core multi-agency strategic group for ACEs, including those with lived experience, with a strategy, an action plan and an associated web based large Community of Interest, providing a quarterly newsletter and information and resources. We are developing a series of webinars on ACEs and trauma informed approaches that will form a programme of awareness raising and learning, available at any time for professionals to access virtually. Training and awareness-raising initiatives are being developed in collaboration with CCGs and Suffolk County Council drawing on evidence-based models such as Signs of Safety. This includes a pilot programme of workforce training on ACEs and Trauma Informed Care, which will be delivered by Survivors in Transition. Trauma informed approaches are now being embedded across Suffolk County Council’s children’s and education services, and mental health services are developing further, giving us a good foundation to learn from and build on. Looking forward. Recent evidence reviews and reports from the Early Intervention Foundation advocate further research into ACES and trauma informed approaches to build the evidence base of what works and recommend adopting a Public Health Approach of whole system action from prevention, early intervention to mitigate risk and specialist intervention to aid recovery when consequences are already being experienced. You can read the full report here: Adverse childhood experiences: Building consensus on what should happen next | Early Intervention Foundation (eif.org.uk) Thinking Differently Together | 6

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