1 Reversing the Tide Proven strategies to reduce the individual, community & business risks fostered by adverse childhood experiences DRAFT.

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Reversing the TideProven strategies to reduce the individual, community & business risks fostered by adverse childhood experiences

DRAFT

2Today we’ll gain knowledge, skills

&ideas:To ensure that people in our community—including those facing major life challenges—have joyful, productive and fulfilling lives;

And improve the profitability of businesses in our community.

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The Way You Spend Your Days Matters

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“Our prime purpose in this life is to help others. And if you can't help them, at least don't hurt them.” -Dalai Lama

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Pathway to Improved Quality of Life

ChildhoodExperience/Stressors

Home, Work& CommunityLife

Emotional& IntellectualAchievement

Development& Health ofBrain & Body

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The Brain’s Developmental Sequence

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Examples of Developmental Outcomes

Early Childhood •Self-regulation•Production of happy hormones•Verbal memory•Regulation/ dys-regulation of mental health

Adolescence•Executive function•Sound judgment•Understanding of consequences

Middle Childhood•Connection between hemispheres•Multi-modal problem solving•Understanding social cues

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Brains to Fit the Life We LiveDEVELOPMENT

for a tough life:•Emotion processing regions smaller, less efficient•Efficient production of stress-related chemicals•Dysregulated happy hormones•Fewer receptors for calming•Less white matter

WHY IT WORKS

Under the worst conditions, such as war & famine, both the individual & the species survive.

INDIVIDUALcharacteristics

& traits•Competitive•Hot tempered•Impulsive•Hyper vigilant

•“Brawn over brains”

Toxic Stress

DEVELOPMENT for a good life:

•Emotion processing regions robust and efficient•Abundant happy hormones•High density white matter, especially in mid-brain

INDIVIDUALcharacteristics

& traits•Laid back•Relationship-oriented

•Reflective•“Process over power”

Neutral Start:

All brains are made to adapt WHY IT

WORKSBy striving for cooperative relationships, individual & species live peacefully.

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Socially & Economically Valued Skills

INDIVIDUALcharacteristics &

traits

•Competitive

•Hot tempered

•Impulsive

•Hyper vigilant

•“Brawn over brains”

• Brainstorm: What kinds of jobs are a good fit? Why?

• What knowledge and skills would a young person need to develop to be successful at those jobs?

• What kind of learning environment would best support a young person in acquiring the needed knowledge and skills?

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Adverse Childhood Experiences Study:Physical, Mental & Behavioral Health Built by Experience

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1. Child physical abuse

2. Child sexual abuse

3. Child emotional abuse

4. Neglect

5. Mentally ill, depressed or suicidal person in the home

6. Drug addicted or alcoholic family member

7. Witnessing domestic violence against the mother

8. Divorce or parental separation

9. Incarceration of any member of the household

The Adverse Childhood Experiences (ACEs)

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Dose gets bigger

Resp

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Dose-Response Relationship: More ACEs = More Disease

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Higher ACE Score Increases Smoking

6 of 100 people with 0 ACEs smoke

11 of 100 people with 3 ACEs smoke

17 of 100 people with 7 ACEs smoke

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High ACEs Creates Pathways to Lower Quality of Life: High Risk of Poverty

High Risk for:•Mental Illness•Substance Abuse•Incarceration

Trouble:•School Failure•High Risk Sex•Relationship Issues

Toxic Stress

Poor Health:•Chronic Illness•Attention, Emotional & Behavior Issues

PovertyJoblessHomelessAloneHopeless

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• Alcohol, tobacco & other drug addiction• Auto-immune disease• Chronic obstructive pulmonary disease & ischemic heart disease• Depression, anxiety & other mental illnesses• Diabetes• Multiple divorces• Fetal death• High risk sexual activity, STDs & unintended pregnancy• Work problems—including absenteeism, productivity & on-the-job

injury• Intimate partner violence—perpetration & victimization• Suicide attempts• Liver disease• Lung cancer• Obesity • Self-regulation & anger management problems• Skeletal fractures

Life-long Physical, Mental & Behavioral Health Outcomes Linked to ACEs

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ACE Score Increases Suicide Attempt

1 of 100 people with 0 ACEs attempt suicide

10 of 100 people with 3 ACEs attempt suicide

20 of 100 people with 7 ACEs attempt suicide

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If our community really understood how ACEs get wired into biology, what might change? What are a few things our community might do differently to help everyone have more joyful, fulfilling & productive lives?

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ACEs and Disability in Washington

84.2% of Washington adults experienced no disruption to daily activity in the last month due to disability

9.1% disabling condition + 1-15 days disrupted activity (LOW)

3.2% disabling condition + 16-29 days disrupted activity (MODERATE)

3.5% disabling condition + 30 days disrupted activity (HIGH)

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ACE Study Washington BRFSS

Prevalence of ACEs: ACE Study & Washington State BRFSS

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“Muscles aching to work, minds aching to create - this is man.” –John Steinbeck, The Grapes of Wrath

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ACEs & Disability

ChildAbuse

PermanentInjury

PermanentDisability

High ACEScore

SubstanceAbuse

TemporaryDisability from Work

Anxiety, Depression, Other Mental Health Disorder

IntermittentDisability

On-the-JobInjury

High ACEScore

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Lost Time Doubles Risk of Unemployment over Disability Alone

No DisabilityNo Lost Time

DisabilityNo Lost Time

DisabilityAny Lost Time

Un

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t (%

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For the most part, resilience is about the positive day-to-day ways we interact with, support and help each other.

How might we go about making fostering resilience a key component of leadership in our community?

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Resilience is the ability to “meet challenges, survive and do well despite adversity” –Kirmayer, 2009

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Unemployment: Lost Days & Resilience

% U

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High Resilience Low Resilience

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Unemployment: ACEs by Resilience

High Resilience Low Resilience

% U

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Unemployment by ACE & Days Able to Do Usual Activities

0-2 ACEs 3+ ACEs

Un

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(%

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Community Capacity - The ability of community members to use the assets of their community, e.g. residents, associations and institutions, to improve the quality of life for those living in the community. Each community's collection of assets is unique and reflects the specific characteristics of its population, its political structures and geography.

Community capacity is defined as “the combined influence of a community’s commitment, resources, and skills that can be deployed to build on community strengths and address community problems.” A variety of individuals, families, community groups and institutions contribute to community capacity. Each is a potential partner in the work of strengthening the viability and vitality of communities. In partnership, each can gain in capacity.

Community capacity is the interaction of human, organizational, and social capital existing within a given community that can be leveraged to solve collective problems and improve or maintain the well-being of a given community. It may operate through informal social processes and/or organized efforts by individuals, organizations, and the networks of association among them and between them and the broader systems of which the community is a part.

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Low Capacity High Capacity

High Community Capacity, High Social/Emotional SupportAges 18-34, 3-8 ACEs

% R

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Frequency of Social/Emotional Support

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Serious Mental Illness & Community CapacityAges 18-34, 3-8 ACEs

Low Capacity High Capacity

% R

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Men

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Serious Mental Illness

Severe Depression Depression

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Factors that contribute to resilience include:•Close relationships with family and friends•A positive view of yourself and confidence in your strengths and abilities•The ability to manage strong feelings and impulses•Good problem-solving and communication skills•Feeling in control•Seeking help and resources•Seeing yourself as resilient (rather than as a victim)•Coping with stress in healthy ways and avoiding harmful coping strategies, such as substance abuse•Helping others•Finding positive meaning in your life despite difficult or traumatic events

This Emotional Life is a co-production of the NOVA/WGBH Science Unit and Vulcan Productions, Inc. A Film by Kunhardt McGee Productions. ©/™ 2009 WGBH Educational Foundation and Vulcan Productions, Inc. All Rights Reserved.

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Psychologists Richard G. Tedeschi and Lawrence Calhoun have found in many cases that reports of growth after traumatic events far outnumber the reports of disorders.

They describe five areas of growth reported by people who have experienced traumatic events:

Discovery of new opportunities and possibilities that were not present before-Closer relationships with others, especially others who suffer-Greater appreciation for life-Greater sense of personal strength: “If I lived through that, I can face anything”-Spiritual growth-

We need to understand and remember that growth comes from the struggle to cope with the trauma—not from the event itself.

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“Rugged individualism” is a stereotype in American culture, and a myth. Resilient people are resourceful, and friends and family are among their most important resources. Resilient people have strong social networks, close connections to family and friends, are able to self-disclose about their troubles to people close to them, and ask for help when they need it.

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Community Capacity Building Recognition and Inventory of Existing

Assets

Cultural and Historic HeritageHealth and Well BeingEconomic Opportunity

Sustainable EnvironmentCommunity Services and InfrastructureSocial Networks and Civic Engagement

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Community Capacity Development

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Next StepsMake a time and a space for our community to:

▫ Learn about ACEs and▫ Generate ACE-informed solutions to ACE-related problems

Use the strengths of many to improve resilience among adults with high ACE scores, such as:

▫ Generating accommodations for normal response to toxic stress,▫ Reducing trauma triggers in schools and the workplace,▫ Promoting healthy social networks at work ▫ Supporting employees in developing skills and habits that are

transferable to great parenting – especially the kind that will prevent ACEs in the next generation

Lead efforts to develop community capacity, for example, by:▫ Participating in, co-leading or convening community dialogues

addressing issues that matter the most to us▫ Learning together ▫ Initiatives to expand leadership in generating community solutions ▫ Lending expertise and time to help community leaders become results-

oriented and to measure results

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Thank you!

•Skamania Klickitat Community Network Building strong, healthy communities

•1-866-631-1997

• http://community.gorge.net/skcnparentsupport

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http://vetoviolence.cdc.gov/childmaltreatment/phl/resource_center_infographic.html