Traumatic experiences in early childhood can put individuals at risk for future substance abuse, mental health disorders, chronic health conditions and early death.
But efforts to combat those adverse experiences can help set children up for a brighter future, says Becky Haas, author, advocate and community educator.
“No on picks where they start in life. But the good news is we can come alongside our children and help them have a better finish,” Haas told a group of community representatives April 28 at a symposium held at Tennessee College of Applied Technology at Crossville.
The session was the kick-off to a two-day community training event made possible with a District 6780 Rotary Grant sponsored by the Fairfield Glade Rotary Club, Crossville Breakfast Rotary Club and Crossville Noon Rotary Club.
The goal is to help develop a collaborative effort to make Cumberland County a trauma-informed community.
“All of you are here today because we need you to actively participate in this movement,” said Donna King. “It’s going to take all of us working together to make this happen.”
King spent 35 years in education. When she first learned about trauma-informed care and its impact on children and families, “it was like a lightbulb went off in my head. This is the missing piece of the puzzle … This is what is going to help us do better in our jobs, how we deal with children, how we deal with families.”
But trauma-informed care goes beyond just the schools, King said. All elements of the community can implement trauma informed concepts, she said, and impact all areas of the community, including health and safety, workforce development and economic development.
“Today is a day about the wellbeing of our children and our families so that they can face the future with all the skills they need to be a productive citizen,” King said. “Today is the day that we can begin to make certain that every person has the mental and emotional resources that they need to survive and succeed.”
Haas developed what has become the model for a trauma informed system of care in Johnson City, TN, beginning in 2015.
She was working for the Johnson City Police Department, charged with reducing drug-related and violent crime in the city and reducing recidivism among offenders.
“I had no idea how addiction trickles down in a community,” Haas said of her experience.
She started a day reporting center in Johnson City, a model that is now being expanded across the state through Gov. Bill Lee’s criminal justice reform efforts, and that garnered national awards. Programs she worked with reduced crime by 40% in one neighborhood.
“We used a community collaborative approach,” she said.
This was her first introduction to adverse children experiences — ACES. According to the Centers for Disease Control about 61% of adults in 25 states reported they had experienced at least one type of ACE while 1 in 6 reported they had experienced four or more types.
In Tennessee about 17% of adults had experienced four or more ACES with an estimated $5.2 billion in direct medical lost productivity.
ACES can include natural traumas, like natural disasters or pandemics, and created trauma, like abuse, neglect, or growing up in poverty or in a household with substance abuse.
“I wondered why no one was talking about this,” Haas said. “I literally felt like I had heard the cure for cancer and if I did not go back and tell my town, I would be held responsible.”
Research on ACES stretches back to the 1990s. Since then, researchers have found some populations are more likely to have experienced multiple ACES, including homeless individuals. A study of juvenile justice settings found 94% of children had experienced trauma.
Brain imaging shows differences in the brain development of children without adverse childhood experiences and children who have experienced trauma or neglect, Haas said. That leads to difficulty forming attachments and cognitive impairments.
“And that’s going to lead to the health risk behaviors to cope,” Haas said.
SAMHSA had recommended communities implement a public health approach to combat childhood trauma.
Haas joined with Andrea Clements, Ph.D., a professor in the psychology department at East Tennessee State University. Over the next three years, they trained more than 4,000 professionals in a trauma informed approach across 45 organizations.
Haas said the key principles offered an “upstream” approach to the issues that trauma can cause, like substance abuse, physical abuse and poor health outcomes.
“It doesn’t cost a lot — not compared to building more jails, not compared to building more hospital beds,” Haas said.
Haas then went to work for Ballad Health Systems, which operates 22 hospital in northeast Tennessee and southwest Virginia as a trauma informed administrator.
“We made headlines in the fact that the largest health system in that area recognizes this as a social determinant to health,” Haas said.
She began working with school systems in the region to help teachers understand student behavior.
“You’re not going to punish trauma out of children,” Haas said, likening it to other health conditions.
Much like working with students with autism or hearing loss, Haas said teachers needed to be equipped to better work with those students who have experienced trauma.
Much of that training is now being incorporated into teacher training programs.
Haas is also working with police departments across the country on trauma behavior and implementing the state’s new Handle With Care law in which police officers contact schools to inform schools of students who may have experienced something traumatic recently.
“It’s not about knowing the story,” Haas said. “It’s about training you with new tools to deal with the effects of trauma.”
She noted trauma informed systems of care were not about excusing behavior or avoiding consequences.
But there are many things communities can do to help provide interventions, like trauma groups in jails or calming rooms in schools or mentoring programs for youth. Haas said positive childhood experiences can help children develop better coping skills and become more resilient.
“Trauma informed care is … we can just bring more kindness and empathy into our community,” Haas said.
Positive experiences include children being able to talk with family about their feelings, to feel supported in difficult times, enjoying participating in community traditions, a feeling of belonging, feeling supported by friends, having at least two non-parent adults who genuinely care, and feeling safe and protected by adults at home.
The toolkit Haas and Clements developed begins with advocacy, followed by educating diverse groups and then collaborating in multi-disciplinary teams. The teams can include individuals from justice, health care, human services, faith-based communities, education systems, media, mental health and substance abuse services, philanthropy, child welfare and businesses and corporations.
Colleen Mall, with the Fairfield Glade Rotary Club, said the session was the first step in bringing a trauma informed system of care to Cumberland County.
A District 6780 Rotary Grant will provide support for following up on the symposium.